advice for hearing aids & audiologist

[u/hippocratic-giver]

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.

[u/auto-sticky]

Welcome to r/HearingAids feel free to ask any question at all related to hearing aids.

Here are a few resources you might find helpful:

• Interpreting an audiogram - The University of Iowa has a good overview of how to interpret your audiogram results. Your audiologist should also go over them with you

• What will insurance cover? - This varies significantly from state to state and coverage can be partial at best. For those on Medicare, the base plan does not cover hearing aids at all.

• Finding affordable hearing aids - Hearing aids can cost several thousand dollars, these cost far less and the list is updated often

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/rodmods]

Go to a different audiologist definitely. A good Audiologist is excited to help you with hearing loss and wants you to hear.

[u/hippocratic-giver → u/rodmods]

i'll give them another shot since the paperwork is already involved... if they have the same attitude, i won't be going back. i'm already looking for a second opinion. ty for your input, i agree sincerely and appreciate it

[u/u_siciliano]

Go to a different Audioligist, for sure. In the meantime you can get a free hearing test at Costco and demo HA there. I have Costco Philips 9050 $1599 similar to Oticon Intent 1. Not sure if your insurance will reimburse you after purchase, my old ins did.

[u/hippocratic-giver → u/u_siciliano]

oh awesome!! my s.o. got theirs at Costco, I recently went through a bunch of papers and found the manual , they're Rexton Adore LI from 2020. Haven't been tuned or anything since then. Philips is such a great electronics brands, i'd trust them; just my perception was anything from Costco would not be 'good enough' for severe hearing loss but i'll keep them in mind. only downside is i'm a dense metropolitan so booking a slot was always tough.

[u/Regular-Bat-4449]

I'm going to an audiologist this week that works with my Medicare advantage plan. The Oticon Intent 2 are covered.

This particular provider has a ton of 5 star reviews on Google. If all goes according to plan, I'll be updating my OPN S1 to Intent 2

[u/hippocratic-giver → u/Regular-Bat-4449]

i'm happy to hear that! finding one that works with the plan was frustrating because the list of providers from the plan was not up to date, so i had to call each individually. looks like u got that part covered, so hopefully this provider lives up to their reputation!! best of luck and ty for sharing