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How does pricing work?

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How does pricing work from big companies? I am assuming that Oticon sells the intent 1 to Audiologists for $5,000 and each audiologist mark them up to what ever price they want? That’s why everyone has a different price? I guess the best move is if I have settled on a specific model I would call all of the audiologists in network and see how much they would sell me then for? Also, are we haggling the audiologist? I assume there are no sales or coupons?

I have insurance that covered $3100 every 3 years for hearing aids. I am checking to see if I can go out of network, pay out of pocket and file a claim myself.

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The large variation you can see in pricing is most likely due to:
(1) Bundle pricing: Unlike MDs, audiologists cannot bill insurance per visit, which is why bundle pricing is used at the time of purchase. This pricing can vary greatly depending on local costs, taxes, regulations, and desired profits. The bundle often includes services for three years, such as warranty coverage, unlimited adjustments, and supplies.
(2) Volume: Those that can sell very high volume have lower pricing from manufacturers. Local audiologists have low volumes. Costco has higher volumes. In another thread, someone posted that the average Costco sells 2 pair of aids per store per day. If that’s the volume for Costco, it’s unlikely that a local audiologist sells more than that.

Like with anything else, it’s wise to shop around and focus not just on the best price but the best value for your money. Your insurance coverage might vary depending on whether you get the aids in-network or out-of-network. There’s no universal rule—just aim to be a smart and informed shopper.

This is why so many people in this forum recommend Costco: Simple pricing, premium devices, good return warranty and their specialists don’t work on commission. But Costco doesn’t work for everyone.

Check out the web page of ZipHearing. They sell through local audiologists at a significant discount. Prices for premium models including fittings and adjustments for one year are around $4,898 plus a 45 day return period, 3 year warranty etc. On line purchases cost even less but you are limited to online fittings.

Costco is out of network for me. I buy, file a claim, and have no trouble receiving a check.

Insurance programs differ from one another. If you like Oticon, Costco carries a similar brand, but it looks like it’s similar, not the same. If you like Phonak, Costco carries a version that’s a line or 2 back. If you like ReSound or Signia, the Jabra and Rexton look like clones. If you want Widex, you’re out of luck. But you save a lot of money.

Some people have little to no respect for Costco’s staff members. Reading reports and my own experience tell me Costco’s staff members, like audiologists and other fitters, range from great to abysmal.

My insurance only covers hearing exams from qualified Audiologists and probably more important only hearing aids installed in accordance with a prescription written during a covered hearing exam

This unfortunately precludes Costco (confirmed by Costco).

That said the insurance only covers $2000 every 3 years. My local audiologist quoted $8000 for Oticon Intent 1s with 3 years support. So I would still be $6000 out of pocket.

I ended up going with Costco (and not using insurance) and got Jabra Enhance Pro 30’s at $1700 with lifetime support.

My experience with the Costco fitter was actually better than the audiologist. The Costco fitter was willing to spend time to understand my goals and work with me to achieve them. The audiologist just seemed to want to sell me expensive hearing aids. However as @philbob57 said there will be good and bad Costco fitters and good and bad audiologists so it is important you find someone you are comfortable to work with.

The fitting and support will likely at be least as important as what hearing aids you select in achieving good results.

@coastal_california said:

My insurance only covers hearing exams from qualified Audiologists and probably more important only hearing aids installed in accordance with a prescription written during a covered hearing exam

Yikes! That looks like a set of provisions written by an insurance company that doesn’t want to pay for .

You bring up a good point though, so I’ll add that Costco does hearing tests at no extra cost for its members. So if HAs are your only purchase there, you’ve got to pay for the membership. We buy other things there - like, when our kid visits, he stocks up on staples….

Choose your hearing care professional carefully. Their skill and your relationship with them is more important than the brand of you get. Well fitted mediocre aids tend to perform better than poorly fit top of the line aids. If something is wrong, and your won’t take the time to work it out with you, you’ll go nuts.

WH

@WhiteHat said:

Choose your hearing care professional carefully. Their skill and your relationship with them is more important than the brand of HAs you get. Well fitted mediocre aids tend to perform better than poorly fit top of the line aids. If something is wrong, and your HCP won’t take the time to work it out with you, you’ll go nuts.

I didn’t get a great feeling about the one audiologist I’ve been to. She set up a hearing aid for me to wear while I was there. There were issues i didn’t like, but we were not there to fine tune a set of hearing aids I probably was not going to buy. I demoed a top of the line $7200 hearing aid. Very hands off since I left.

Edited

In reply to @philbob57

@philbob57 said:

Yikes! That looks like a set of provisions written by an insurance company that doesn’t want to pay for HAs.

Maybe? Hearing aid prescription where I am is a controlled medical act that can only be done by an audiologist or a doctor, except that realistically a doctor can’t actually do it their college just has a lot of power and doesn’t like giving things up. If an isn’t overseen by an audiologist, where are they getting their prescriptions? I don’t know how things work in the states though, but it doesn’t seem outrageous to me for a medical insurance company to want to cover medical prescriptions.

@flyjazz said:

I’m think a lot less than that and I mean a lot !

List price I saw on a recent manufacturer bill was about $3400 per device. Now, that’s the unnegotiated price, so it’s what a clinic is paying to a manufacturer that they haven’t negotiated some other deal with. Costco probably pays 10-20% of that? Doesn’t seem fair. And then you can try to imagine what the hourly is for an audiologist and add up the hours you spend with them, which will also vary by your location. Probably somewhere between $200-400? Unless you’re in Toronto then a billionty dollars to cover the rent I assume. Assumedly more than a massage, but sadly less than a chiropractor which seems strange because audiologists have more equipment and more actual good science to back up their interventions.

In reply to @Neville

Interesting, Neville.

What does a prescription look like? Here the seems to be the prescription. My one experience with an independent audiologist was that he did the test, printed it out, and told me I needed a $6,000 pair of aids and there were no good alternatives to the aids he had.

I believe in my state the fact that licenses are required for hearing aid providers is the only control.

In my state, then, an audiogram by a license holder is the prescription, but all my insurance co wanted was the paid bill that showed aids with serial numbers of nnnnn and aaaaa were actually received by me according to the laws of my state.

BTW, thanks to you and other registered providers who participate here for sharing your expertise and experience. If I lived in one of your neighborhoods, I’d make an appointment the next time I buy aids.

@2ball said:

I am assuming that Oticon sells the intent 1 to Audiologists for $5,000

It looks like this is a discussion that only refers to the US market. You can easily get Oticon intent1s for well below $2,000 apiece in France, for instance (see below). I bought my p90 Audéo Phonaks there not long ago for about 1,500 USD each (including fitting).

IMG_5953

In reply to @Neville

CA$3,400 or a bit under US$2,500 for a pair on Intent 1 sounds about right. The bundled price equals price for whatever services are included plus profit less invoiced cost of hearing aids. The markup on the hearing aids alone is often 50-100%. Then there’s profit in the services cost.

Are there any cost plus audiology practices around the world? Finding unbundled options is not easy at least in the US. That limits access to care as a hearing aid user is not able to drop in to a new practice if something is needed as many practices will charge high fees for adopting the patient and the luxury of more high fees afterwards. Don’t underestimate how useful it can be to have the global Costco hearing aid network if you travel and need something far from home.

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