EPIC Hearing Health Care

I am a new member who has really benefited from the wealth of information here. One thing I could not find was much information on EPIC Hearing Health Care, which my insurance company uses to administer their hearing benefits.

So here is what I have learned in the past week:

EPIC has negotiated prices with manufacturers (their brochure lists Phonak, Resound,Siemens, Oticon, Sonic, Unitron, and Widek). They will provide quotes on other manufacturers, but at least with Starkey, the pricing was not very good.

Based on the experience of someone else in the forum, the EPIC benefit can be offered by an insurer in two ways: either as a referral for discounted pricing (perhaps no benefit at all, depending on the HA and the discount); or with an actual coverage amount. For example, my insurer covers a specific dollar benefit and sent me to EPIC to handle the following process:

1. EPIC refers patient to a local audiologist who recommends a specific HA.

2. EPIC provides a price that includes fittings and follow-up.

3. The patient pays EPIC the difference between the coverage amount provided by the insurer and EPICs discount price, and the audiologist orders the unit and dispenses.

4. The patient has a 45 day trial period. Returns may incur a $175 clinic fee, depending on local regulations and the situation.

5. Normal manufacturer warrantees and loss coverage apply, but are administered through EPIC.

So far EPIC has been very responsive, but I will update this once the trial period is over to let everyone know how the full process went. I have no affiliation with the company, but this might help others whose insurance companies also use EPIC to administer hearing benefits.

Michael

Michael, your understanding of Epic is exactly right. In the best of all worlds it works exactly as you outline. As an audiologist who works with Epic, I have a love-hate relationship with them. it can be a good solution for people, specifically if your insurance company pays a portion of the cost by using Epic. The monetary savings is the only advantage; you get no benefits or assurances above what you’d usually get from a private aud.

On the negative side, you want to make sure that you get the most appropriate hearing aids at the outset. Changing hearing aids through Epic is time consuming for you and frustrating for the audiologist. Epic is not set up for exchanges so spend an extra 10 minutes on the front end to make sure you are making the most appropriate hearing aid selection.
Epic saves you money up front but after 12 months your follow-up visits to the audiologist will cost you $40-$60/visit. When you purchase from an audiologist these visits are often included through the life of the warranty.

If your insurance doesn’t provide any benefits for payment ask your Aud if they will match the Epic price. You may match the Epic price and give a better warranty with service. By contract the Aud can’t offer this option to you but if you request this information they can provide it.

If you are comparing Epic prices to internet prices then Epic, and any Aud for that matter, will be higher. The difference is that Epic is guaranteeing a good, local provider as part of their price. $400 in savings is quickly forgotten if your hearing aids aren’t providing the expected benefit.

I just want to add that I went through Epic. I did not have supplemental insurance, so I paid their prices. The selection they offered me included, Starkey,Oticon, Phonak, Resound, Seimens and a number of others.

I bought the Oticon Agil Pro Rite Minis. They were $2599/aid and I paid $200 for the remote. They gave me a choice of audis in the area. I chose one who said he was comfortable with Oticon. I’m just finishing my trial. I found Epic to be helpful and their prices definitely below the market prices here in Connecticut.

Dr. Amy, so sorry you’re not here.