Thirty-seven and a half million Americans have trouble hearing, and of those people who could benefit from hearing aids, it’s estimated that fewer than 30 percent have ever used them, according to the U.S. Department of Health and Human Services. The hefty price tag attached to hearing aids may be chief among the barriers, as a pair of custom-fitted hearing aids can cost between $1,000 and $6,000, finds Consumer Reports.
Doctors sometimes charge a full 100 percent or more markup on hearing aids, says Sarah O’Leary, founder and CEO of ExHale Healthcare Advocates, a national independent consumer health care company. And, unfortunately, the cost of hearing aids and other medical devices is not always covered by insurance. Some insurers cover hearing tests, but not the device itself. In a handful of states, insurers are required (with some exceptions) to cover hearing aids for children and, in three states, they must cover them for both adults and children. Veterans may be entitled to free hearing aids through the Department of Veterans Affairs.
However, just as online startups have disrupted the traditional eyeglass industry and others, new players are providing more affordable channels for buying hearing aids, walkers, prosthetics and other medical devices. Buying a device from your local doctor or clinic may be a convenient option, but it’s not your only option — nor is it typically the cheapest.
“The status quo of the hearing aid industry was that the only way you could hear again was going through the expensive brick-and-mortar channel,” says Patrick Freuler, founder and CEO of Audicus.com, which aims to do for hearing aids what Warby Parker did for eyeglasses and 1-800 CONTACTS did for contact lenses. “The technological complexity of a hearing aid is not beyond modern cellphones, so we dug a bit deeper and saw that a lot of the pricing is driven by service components. We wanted to provide an alternative dispensing mechanism.”
Audicus sells German-manufactured hearing aids for around $1,200 per pair, with a 45-day trial period. Like Warby Parker, where customers visit their doctor for an eye exam and send in their eyeglass prescription, Audicus has customers visit their local ear, nose and throat doctor or audiologist for a hearing test. Patients are entitled to a copy of their audiogram. “Send us the results of your hearing test [typically via fax or email], and then you receive a customized hearing aid in the mail a couple of days later,” Freuler says.
Another player in the move toward lower-priced hearing aids is hi HealthInnovations, which is part of UnitedHealth Group, but sells its hearing aids to those with or without a UnitedHealth policy. As Lisa Tseng, CEO of hi HealthInnovations, describes it, “we’re hearing-test agnostic. You can get your hearing test anywhere you want, and we custom program your hearing aids to your needs.”
Its prices start at $699 per ear for policyholders or $799 for other consumers, but discounts are available for certain groups. “We have discounts for churches and community groups that want to work with us to make this more accessible for their population, and discounts for law enforcement,” Tseng says.
Shifts are happening with other types of durable medical equipment, too. In the past, patients were “forced to get [devices] directly through the hospital as part of a prescription or forced to go to durable medical retailers,” says Robert Grajewski, president of medical device invention platform Edison Nation Medical. “It was all based on reimbursement codes, and they charged very high fees for those products. What we’ve seen in this industry in the past two to three, maybe four years, is that durable medical equipment companies as well as the hospital health care systems have less of a monopolistic share on that market.”
For instance, Edison is developing a walker that seniors will be able to use as leverage to assist them when standing from a seated position. Grajewski hopes it will help reduce seniors’ risk of falls and plans for the product to hit retailers later this year at a price point that’s lower than a traditional walker.
Some companies are now using 3D printing to produce prosthetics, hearing aids or dental devices that are much cheaper than their counterparts available through traditional channels, plus they provide a greater level of customization.
Of course, before assuming you must pay out-of-pocket for a medical device, check with your insurer and find out if specific types of devices are excluded. For instance, for a patient getting hip replacement surgery, O’Leary recommends making “certain their insurance covers the type of medical device recommended they are to receive, and that they have all necessary pre-procedure certifications in place prior to the surgery.” To keep medical costs down prior to surgery, patients should request both their insurer and health care provider to detail all associated costs for the device and procedure, she says.
For devices that don’t need to be custom-fitted or made to specific parameters, you may be able to find a suitable gently used item for a fraction of the price of a new one. For instance, GetATStuff.com is a collaboration between the New England states and New York state where users can buy, sell or give away assistive technology devices such as wheelchairs, scooters, walkers and canes. Some states also have loaner programs where you can borrow an item and assess whether it’s the right fit for your needs before you buy.
For pricey devices like an artificial hip, O’Leary also suggests comparing prices, since they can vary by thousands of dollars depending on the rate the hospital has negotiated. That may be easier said than done, as many hospitals aren’t transparent about pricing. “Treat it like you’re a detective,” O’Leary says. “Would you walk into a grocery store where they didn’t have any pricing on the packaging?”
If two hospitals charge different prices for, say, the same type of artificial hip, you may be able to keep the same specialist but have the procedure done at a more affordable facility. “Some specialists are affiliated with more than one hospital,” O’Leary says. If cost is a concern, don’t assume the device recommended by your doctor is your only option. Always ask about alternatives. “Physicians may have gotten very used to a certain type of knee device, but there might be a more cost-effective option for you,” she says.
Questioning the cost of medical devices may be uncomfortable for consumers, but in the long run it could save you money and help create awareness of more affordable options.
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How to Save on Medical Devices Not Covered By Insurance originally appeared on usnews.com
