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How does pricing work?

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In reply to @Neville

Are they that much more expensive in Canada?

There is no way invoice cost on a pair of intent is US$2500 each as places sell them with some services for less than that. Real 1 were definitely under US$2500 per pair. Even with some small increase, Intent 1 would be about the same. The has public data but I can’t find it right now.

In reply to @WhiteHat

How is their pricing? Some larger centers are very expensive while others are comparable to the costs in that market.

More importantly are they good? Academic centers are sometimes a revolving set of staff and it is not easy to have good continuity of care over time.

In reply to @user490

@user490 said:

The VA has public data

I post the link a couple times a year. The thing to understand is that public contracts like the have different rules than a retailer might see and the VA is probably the largest purchaser of globally. Do they have power to drive down prices. A small private shop probably pays a lot more wholesale than the VA, but I doubt the mfrs are losing money on the VA contract. The closest view you’ll see to what they cost to make you’ll find, I think.

WH

In reply to @user490

Mass Eye and Ear is pretty good. They are huge. I suspect there is a fair amount of turnover. However I know some of the audiologists there 5 years ago are still there. They are a teaching hospital and their practitioners often also teach. My at Mass General taught at Harvard medical school one day a week. I didn’t see their (MEE’s) pricing. My audiologist came to directly from MEE. She is great, and I’d highly recommend her. All the folks at the clinic I go to for hearing have been amazing both in skill and attitude.

WH

Edited

In reply to @Neville

@philbob57 said:

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

@Neville said:

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 HIS 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.

I am still somewhat confused?

Are Costco Hearing Aids “prescription” hearing aids in US, Canada, UK, Australia etc? It certainly seems they are?

Here in the US they are not hearing aids and I don’t think that category even exists in the UK, Canada and Australia.

If they are “prescription” hearing aids presumably they meet the requirements to be prescribed and fitted in each country?

In that case my insurance company (Aetna) seems to be requiring more than the local country/state authorities?

@flyjazz said:

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

@Neville said:

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.

Wow if that is really the price per device the clinic or audiologists are paying I can’t see how any could survive! My local audiologist quoted me what I thought was a high $8000 for Oticon Intent 1’s with 3 years support. If she was paying $6800 for the devices (Edit if $3400 is Canadian $ even at US $5000 a pair) there is no margin to pay for the office in an expensive SF Bay Area Zip code, utilities, office staff, equipment and herself…

I have got to believe no clinic or audiologist is paying anything close to that unnegotiated price.

Now I am not saying the Audiologists don’t deserve to get fair payment for their training and experience and it must be really hard to compete with Costco offering similar hearing aids at ~25% of the price.

Edited

I’m mostly interested in what they cost to manufacture. As most are made in China, we can use that as a starting point. My guess is they cost a few hundred to make. I’m also curious about the production of the different technology levels within a model as I have a suspicion they are identical as it would cost more to make them different, just easier to hard code them as they come off the assembly line. Improvements seem to be primarily software driven with some generational hardware updates like chips.

I’ll avoid discussing the retail business model as it’s too opaque. Being that it’s a regulated industry in many countries adds to end users cost. It’s unfortunate so many go without due to the lack of affordability.

In reply to @coastal_california

@coastal_california said:

I am still somewhat confused?

Are Costco Hearing Aids “prescription” hearing aids in US, Canada, UK, Australia etc? It certainly seems they are?

In that case my insurance company (Aetna) seems to be requiring more than the local country/state authorities?

Yes, they are prescription hearing aids. At Cosctos here, they are either overseen by an audiologist or they are getting the family doctor to sign off on the precription. But realistically, doctors know very little about hearing aids and the “prescription” that they give isn’t a full prescription. Maybe the insurance just recognizes that. Ontario recently tried to remove doctors signing for hearing aid prescriptions, but there were, as you might imagine, strong HIS complaints and now that process is bogged down in bureaucracy. However, I don’t know how the American system deals with this.

@coastal_california said:

Wow if that is really the price per device the clinic or audiologists are paying I can’t see how any could survive! My local audiologist quoted me what I thought was a high $8000 for Oticon Intent 1’s with 3 years support. If she was paying $6800 for the devices (Edit if $3400 is Canadian $ even at US $5000 a pair) there is no margin to pay for the office in an expensive SF Bay Area Zip code, utilities, office staff, equipment and herself…

Yes. She probably has a bit of a better deal. But not even approaching the deal that costco has or, yes, the . But sometimes I see these ideas floating around the forums that audiologists mark up hearing aids some ungodly amount, “those damn greedy audiologists”. There are certainly predatory clinics out there, but a lot of price differences come from the manufacturers selling the hearing aids at very different costs to different places. Audiologists are not raking in money hand over fist. They generally make less money than comparable professionals. I think there was some attempt here to try to limit the manufacturer’s ability to sell a device for $3400 to one person and $680 to another and make things more fair for the little guy, but either it fizzled out or is also bogged down. America is less likely than we are to make rules like that.

@flyjazz said:

I’m mostly interested in what they cost to manufacture.

If you’re stripping out R&D, marketting, etc. then yes they probably cost a few hundred dollars to manufacture. I agree with you that they are not making different tech levels differently–they are probably just limited after production.

@flyjazz said:

It’s unfortunate so many go without due to the lack of affordability.

Eh. In the UK you can get free hearing aids provided by their healthcare system and the number of people who need hearing aids and go without isn’t any lower. Lots of clinics have more affordable options, refurbished options, or will work with a person to access charitable programs. Hearing aids are certainly too expensive for some people, but I’m not sure that’s the top factor that keeps people out of them.

Costco has the best prices/services by far IMO! Been using hearing aids for 25 years. I have the Phillips 9050s which are basically the coveted Oticons (sp?). A pair for less than $1500.

I was going to ask if there was a way to finesse the system, like buying from Europe or China, but it seems the real way to Finesse the system is to buy from Costco.

There are hearing aid shops that sell on eBay or sell under a different name online than the name of their brick-and-mortar shop. You can find Oticon Intent 1 for around $2,000 for both ears.

Edited
@StataHA said:

There are hearing aid shops that sell on eBay or sell under a different name online than the name of their brick-and-mortar shop. You can find Oticon Intent 1 for around $2,000 for both ears.

I just looked up a set on ebay. very interesting. he’s getting his from Denmark and will program and tweak them.

Edited

Hi 2ball,

I don’t think the pricing to the audiologist or clinic for the aids is the 5,000 mentioned in post #1.

The insurance company sent me an EOB showing what they paid the medical practice (otologists, neurotologists, and audiologists) for the hearing aid devices & services which I was provided.

The amount paid by insurance was only 1,448.00 USD for the pair. My co-insurance was zero.

The devices are Signia Pure Charge and Go BCT . The amount paid included 1 year of unlimited follow-up visits with an , unlimited cleanings, ear tips, concha locks, a 3-year warranty (including damage and loss- loss with a deductible) And, a spiffy charger & cleaning kit, plus a bunch of .

I don’t think the devices are by any means the highest end on the market and maybe not as feature rich as Oticon Intent 1, but they aren’t dollar store cheapies. (These were the ones that best suited my loss needs.)

Paul

@PJB12 said:

I don’t think the devices are by any means the highest end on the market and maybe not as feature rich as Oticon Intent 1

How so? They are the latest tech from Signia IX platform and preform as good as any others on the market, they don’t have if that’s what you mean, or do you mean you have the 3IX version and not the premium 7IX I wonder.

Edited
@tenkan said:

How so? They are the latest tech from Signia IX platform and preform as good as any others on the market, they don’t have AI if that’s what you mean, or do you mean you have the 3IX version and not the premium 7IX I wonder.

I was simply trying to be polite and not chance casting any disparagement upon anyone who paid more than this amount for devices. Writing “I’ve the latest and greatest for lower money than you paid” seemed very insensitive. .

Mine are “middle of the group” Signia. They have devices with more channels and frequencies, much thinner models, models with more programming features and models with . Mine lack Telecoils.

Paul

As I said, there’s huge variability. Your insurance company may have negotiated their own cost. I’m just reporting basic list price.

@2ball said:

was going to ask if there was a way to finesse the system, like buying from Europe or China, but it seems the real way to Finesse the system is to buy from Costco

Yes, if you can find a good provider at Costco. Otherwise, you can buy online but you’d want to know the clinic’s cost to refit and manage the hearing aids from the place you’d like to go for and services once you have them. That can range from a little too a lot to “I don’t do that”. You typically lose a lot of warranty coverage on the international hearing aids.

First a person must ask themselves this question. What I am willing to spend to be able to see again? Then ask yourself what am I willing to spend to be able to hear again? Can you put a price on either one of these things? I just spent 6000.00 on a pair of Resound Vivia 9 hearing aids (I needed new aids and it hurt my wallet). My 7 year old Phonaks cost me 5500.00 and I got service whenever I needed it from my audiologist no questions asked. My new H.A.s come with 4 years service any time I need to go for adjustments etc. In the fitting and trial along with the Spheres (did not like as well they did not sounded as natural) my audiologist has spent about 6 hours of her time. Get what works for you and get the most expensive you can afford and yes have them setup like Dr.Cliff says on his videos. You must be the judge on how they sound and try out different brands as they sound different. I would never get across the counter and setup as you don’t possess the knowledge or equipment. If you do not get them to sound right you will not wear them. Once again the eyeglass thing about seeing as a comparison. If you cannot see correctly with your glasses they are worthless. Hearing aids are far more complicated so my experience has been then switching lenses on glasses. Good luck on your adventure to better hearing.

@chipman said:

. Get what works for you and get the most expensive you can afford and yes have them setup like Dr.Cliff says on his videos.

Yes, but if you can pay less for the same device and service, why wouldn’t you do that?

@chipman said:

I would never get across the counter and DIY setup as you don’t possess the knowledge or equipment. If you do not get them to sound right you will not wear them

Certainly it’s your choice if you are not comfortable with . Many (most?) of us who do DIY do so because we were not happy with the results after using one or more professionals. Just as a matter of note the only equipment you need for DIY is a Noahlink wireless (about$150) and a windows laptop. You don’t need the same amount of knowledge as an audiologist since you only have one client and that’s you. I fully agree DIY is not for everyone just like learning to fly an airplane is not for everyone.

In reply to @chipman

@chipman said:

What I am willing to spend to be able to see again? Then ask yourself what am I willing to spend to be able to hear again? Can you put a price on either one of these things?

This always gets a chuckle out of me.

Sounds like a hearing aid sales person.

Edited

In reply to @chipman

@chipman said:

First a person must ask themselves this question. What I am willing to spend to be able to see again? Then ask yourself what am I willing to spend to be able to hear again?

That statement reminded me of something Ray Charles once said (paraphrased below):

Of all the senses, to lose hearing would be the most devastating.

How valuable are my gift of sight and my ability to hear? As long as I can feed the family, it was money well spent. (Says the guy who spent ca. 5,500.00 USD on eye surgery this month…)

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