The Changing Face of Hearing Aid Insurance Benefits
Hearing aids are notoriously costly.
The reasons behind this are a topic for another conversation, however insurance companies over the past few years have changed the way they approach hearing aid benefits.
As an audiologist who participates in these plans, I find myself spending a lot of time reflecting on what’s truly the best “deal” for my patients.
TruHearing is one of the largest of a new breed of “Third Party Administrators”, or TPA’s, in the hearing aid world. TPAs are companies that contract with (or are owned by) insurance companies, and they manage the hearing aid component of your insurance benefit.
Several of the other big hearing aid industry TPA’s include Hearing Care Solutions, HearUSA, American Hearing Benefits, and UnitedHealthcare Hearing.
These companies promise to lower costs to patients while offering premium levels of technology and care.
So the question is, can you truly get excellent results at discounted prices through your insurance TPA programs?
I’ll break down all of the pro’s and con’s to these programs for you below.
Traditional Hearing Aid Costs
In the USA without a hearing aid benefit you can expect to pay anywhere from $1,500-$8,000 for a set of hearing aids, depending on who you’re buying from and where you live. The average cost sits right around $4700.
Without a doubt, hearing aids are one of the larger out of pocket investments that most people make in their healthcare.
The tricky thing is that, as a consumer, it is hard to truly nail down what you’re actually paying for.
The cost of your devices should include the following:
- Devices, custom-selected with the assistance of an audiologist (following a hearing evaluation) for your unique needs and hearing profile
- A fitting and training session using real ear measurements with a qualified audiologist
- Several follow-up visits to gradually build your devices up to full prescription and ensure that you’re adapting to wearing your hearing aids
- Supplies for your hearing aids
- A structured follow-up care program for a pre-defined period of time (often either lifetime or for the duration of the device warranty)
- Regular device maintenance, testing of devices using HIT (Hearing Instrument Testbox) measure
- Regular (every 1-2 years, or more if hearing changes are perceived) hearing checkups, and device reprogramming if hearing changes
If all of the above is included in the cost of hearing aids, continuously providing expert follow-up care to keep you hearing well for 3-6 years, the cost of hearing treatment accurately reflects the level of care that you’re paying to receive.
The problem in our industry is that many clinics charge the full price, only to follow through with poorly programmed hearing aids (often fit without real ear measurement), and minimal follow-up care.
A 2011 AARP article following over 1,100 secret shoppers found that over 65% were fit incorrectly.
I talk to patients regularly who bought hearing aids for thousands of dollars, only to be told: “Give us a call if you have any problems”.
This is not the quality of care that you should expect to receive after making a sizable investment in your hearing care.
So, as an industry, we have done this to ourselves.
Consumer trust in the hearing care field has been eroded after decades of high costs that aren’t backed by the promised level of care.
Are “Discount Programs” the Best Solution?
As insurance companies, consumers, and entrepreneurs wrestle over finding cost-effective, quality solutions to hearing loss, TPA’s appear to be coming out on top as the solution of choice in the healthcare industry.
If your insurance has outsourced your hearing aid benefit to a TPA, you will likely have some degree of “discount” on hearing aids with hearing care providers who participate in your program.
When purchasing hearing aids through one of these programs, you can expect a different experience than buying direct from a hearing care provider.
I’ll outline a few of the key things to know when purchasing hearing aids through a company like TruHearing.
ADVANTAGES of TruHearing and Other TPA Programs
Standard Reduced Pricing
Based on your particular health insurance policy, you will have access to hearing aids from any provider who participates in your program.
The cost of the hearing aids will be pre-determined through negotiations between your insurance, the TPA company, and the hearing aid manufacturers.
These prices will be consistent regardless of the participating provider you’re visiting.
That means you shouldn’t have to worry about if you’re getting the best price - you almost certainly will be getting a lower cost than if you’d purchased the devices traditionally, with a bundled follow-up care program.
Because prices are set by your program, you have access to all of the information about pricing. There should be no guessing about purchase costs, what your insurance will cover, or costs of follow-up care
Disadvantages of TruHearing and Other TPA Programs
Limited Follow-up Care
TPA companies guarantee that you will receive some amount of care with your devices, although how much care varies based on the program.
In our clinic we participate with programs that provide as few as 3 follow-up visits, and as much as one year of unlimited follow-up care.
After you’ve used up your allotted visits, your TPA may also stipulate how much you can be charged for ongoing visits.
Reduced Quality of Care
I’ll provide you with the behind-the-scenes perspective on TPA programs.
As hearing clinic providers, we agree to set “fitting fee” rates with 3PA programs.
Some of those rates are sufficient to cover the time and expenses of a skilled and highly educated audiologist providing best practice care...and others aren’t.
Increasingly, as more hearing providers participate in these plans, the plans are pushing reimbursements down so they get to keep a bigger piece of the pie.
So...what does that mean for you as a consumer?
To be honest, it depends on the clinic you visit.
Many clinics are strategizing to find the way to fit hearing aids at the lowest cost with these TPA programs to stay profitable.
That might mean that you see a less skilled provider (like a hearing aid dispenser instead of a Doctor of Audiology). It might mean that your follow-up care is provided by a technician.
Or it might mean that they don’t really provide much follow-up care at all.
Private Label Devices
On some plans, you are only able to choose from one, two, or a small handful of private labeled devices.
This technology might not always be the best for you, or the best product on the market.
You also won’t know exactly what technology you’re purchasing, because these devices are often slightly different from their branded counterparts.
So, while you can likely get good technology at a reduced price, you may have to settle for more limited options.
Not Necessarily the BEST Price
Just because TPA programs offer discounts doesn’t always mean you’re getting the very best price when you look at the cost of care over the life of a set of devices.
In my clinics, you can typically get a pretty good price on TPA hearing aids if you’re purchasing premium level technology.
You may save anywhere from $1500-$3000, depending on the devices, the clinic pricing, and the TPA deal.
That being said, if you return for regular follow-up care you’re likely going to spend a few hundred dollars a year on follow up care.
It starts looking like less of a bargain if you’re searching for rock-bottom prices.
For example, in our clinic we offer fully bundled digital devices starting at around $2000 for a set of hearing aids.
The same products often cost about the same or even more if you buy them from a TPA, and then you’ll be paying for follow-up care on top of the device cost.
So...are third party hearing aid discount programs like TruHearing a good deal?...
I know, that isn’t the answer you’re looking for. But it’s the truth.
Some of these plans are a great price for you as the consumer, and private practices simply can’t compete directly.
And if you pick a reputable audiologist, you can likely expect good follow-up care (although you might have to pay for it).
However, it’s always worth asking your audiologist if they offer competitive pricing to TPA programs, or if they have unbundled or partially unbundled service plans that might offer better care at a comparable or even better price.
You may be surprised to find that if you work with an audiologist that is transparent with their pricing and services, you could get a better deal, or access to better technology by working with the audiologist directly.
As always, finding a great hearing care provider to work with is key to your success with better hearing.