I’m writing for help in this new world of hearing aids for a loved one. We have Medicare A & B, NY Medicaid, Hamaspik MLTC. Recent hearing test shows moderate-severe hearing loss in both ears. 5 y/o Rextons from Costco don’t hold charge. Idk if Medicaid covers hearing aids so I asked audiologist offices if they accept my MLTC (secondary insurance?). Trying for Starkey, Oticon, or Phonak - not educated on all of their models.
Had an appointment, audiologist seemed disinterested/relieved we did a test. According to them, our insurance only covers Sombra brand, which doc admitted were basic. I asked if insurance could cover a “better” brand; he agreed to write a letter of medical necessity for Oticon. To my surprise, there was a blank box for $; I don’t know how insurance works, so I’d like to learn. He put ~$2000 from what I recall (for “basic model”) and said to revisit after approval.
I expected to walk with a pair of trial hearing aids, so I was somewhat dismayed. Felt like he could not give us anything unless the product was already paid for (by insurance?). Naively, I thought the doctor could write a letter of medical necessity for any aid/price and insurance would just cover it if default was inadequate. But there’s is a cap? Could he have put a higher figure? It seems like the audiologist takes a cut too? We signed a purchase agreement.
Also learned all brands (Phonak, Oticon, Starkey) follow the same price tiers: 2950, 3950, 4950, 5950, 6950 usd. What I don’t remember the audiologist answering is the price point at which the hearing aids are utterly useless for our level of hearing loss and diminishing returns? Is there a standard price across industry that includes the adjustment services along with the aids themselves? I asked if they do Real Ear Measurement, which I read somewhere is a “gold standard” – they said no.
If I book another appointment somewhere else, how should I start? Ask directly for Phonak/Oticon/Starkey If I’m already paying out of pocket, do I need to restrict myself to audiologists that accept my insurance? I’ve read that the key is not the brand but to find a “good” audiologist, or I guess really one that seems like they care about sick/old people and wants to helpful in improving our QoL. Please, any and all advice would be most appreciated because this loved one is very sick. Thank you.
Had an appointment, audiologist seemed disinterested/relieved we did a test. According to them, our insurance only covers Sombra brand, which doc admitted were basic. I asked if insurance could cover a “better” brand; he agreed to write a letter of medical necessity for Oticon. To my surprise, there was a blank box for $; I don’t know how insurance works, so I’d like to learn. He put ~$2000 from what I recall (for “basic model”) and said to revisit after approval.
I expected to walk with a pair of trial hearing aids, so I was somewhat dismayed. Felt like he could not give us anything unless the product was already paid for (by insurance?). Naively, I thought the doctor could write a letter of medical necessity for any aid/price and insurance would just cover it if default was inadequate. But there’s is a cap? Could he have put a higher figure? It seems like the audiologist takes a cut too? We signed a purchase agreement.
Also learned all brands (Phonak, Oticon, Starkey) follow the same price tiers: 2950, 3950, 4950, 5950, 6950 usd. What I don’t remember the audiologist answering is the price point at which the hearing aids are utterly useless for our level of hearing loss and diminishing returns? Is there a standard price across industry that includes the adjustment services along with the aids themselves? I asked if they do Real Ear Measurement, which I read somewhere is a “gold standard” – they said no.
If I book another appointment somewhere else, how should I start? Ask directly for Phonak/Oticon/Starkey If I’m already paying out of pocket, do I need to restrict myself to audiologists that accept my insurance? I’ve read that the key is not the brand but to find a “good” audiologist, or I guess really one that seems like they care about sick/old people and wants to helpful in improving our QoL. Please, any and all advice would be most appreciated because this loved one is very sick. Thank you.