It is always the same story in every industry. The middle reaps the rewards and the providers and consumers are left being financially drained and under served. My personal belief is that medical regulations should be scrapped and rebuilt with a MUCH smaller footprint. Smaller entities could then get into the market, compete and put downward pressure on prices.

As always, I enjoyed your video. Interesting learning of the upcoming insurance issues with hearing aid coverage. I feel fortunate that even though I have Medicare I kept my previous insurance (now my secondary) as parts C & D. So I have a substantial amount being paid towards my next pair of hearing aids. The one thing that I understand is that a prior authorization is required now which should not be difficult to defend since I have been needing them for over 10 -12 years now. Thanks for sharing your time and knowledge.

I just yesterday went to a private practice, who DOES work with Nations Hearing the 3rd party managed care. I learned that in the long run better services without going thru them. Lots of hassle to work with them according to them. No experience with this as this is the first experience with Medicare Advantage benefits. Decided not to go with 3rd party because of discussion in the office. Was wanting to more info….so thank you Dr. Cliff. Going to keep researching….

If there is a need there is going to be greed

Thanks for explaining the problem so well, Cliff. People need to understand how everything truly works so that they can make wise decisions. ❤

From you blog, I should only get hearing aids via a private pay customer. With the cost of high level hearing aids ( extremely high), many cannot afford hearing aids, except through Advantage programs , since traditional Medicare does not cover the aids. Therefore, many will not be able to afford any hearing aids . NOT a good thing. Better to get a lower level hearing aid than none at all. If you have a “ reputable “ professional , he should be able to get you a good hearing solution to your problem with almost any level of hearing aids. AJC

Thank you for saying all of this, Dr. Cliff! I have seen recently doors to providers close because they got inundated with MC patients, and couldn't afford to stay open. I am glad this shift is coming, and hopefully it will be a win-win for patients and providers alike.

I really liked your discussion with Dr Keith, Cliff.

I am shopping for Signia 7AI hearing aids outside of TruHearing managed care offered by my Medicare Advantage plan because the plan only carries the previous AX model, which I know has great reviews but the AI revision is much better for conversations in crowds - and I dance to live bands and rollerblade at skating rinks where communicating with folks in noisy places requires the latest technology. I think I will only pay twice the amount that I would pay as insurance deductible, but I want the latest and greatest. I subscribed to this youtube stream because I hope to learn whether there are better hearing aids than the Signia 7AI or if that is a good choice for me. So far I am really enjoying these informative videos. Thanks much.

Same thing that happened with Spec Savers / Costco with Phonak and Signia - Why would you put your flagship brand in a discounted store. Thus also killing small independent clinics who just cannot compete with big larger corporations getting a 80 - 95 % on wholesale pricing. You also now have Private Health in Australia advising their customers that they cannot choose which hearing aids and to get completely reimbursement they must go to clinic X with their preferred brand.

I live in Vancouver BC and have been going to an Amplifon clinic and I have received excellent care. At this time I need to replace my hearing aids and can not purchase the Oticon Intent through Amplifon at this time. I do not have insurance so I would pay 100% of the cost. I can not understand why Oticon would not use Amplifon if a person, such as myself, does not use an insurance company. I did see one of your videos last month mentioning that Oticon would not be distributing to a number of clinic such as Amplifon and thought is was only in the States.

Dr. Cliff describes the situation well. The part he can't say is what some of us understand. United Healthcare is a behemoth insurance company, bigger than many other insurers combined. It is the actual power behind the AARP special interests group, and was the strongest advocate of Obamacare. ALL of our health care has deteriorated since the passage of Obamacare, and most of that deterioration has been caused by the exact issue Dr. Cliff discusses, lower payments to care providers. Obamacare would never have passed without your votes and United Healthcare's influence. They're the gorilla in the room that's making the rules. They don't actually PRODUCE anything, but deem to tell the real producers, such as Oticon, what financial limits they have. Yes, the issue might be coming to a head in hearing care. It needs to come to a head in all health care industries ... in the places where the providers actually make and produce, rather than cower to regulators.

Your opinion here is one sided. You are not giving the other perspectives. Getting Hearing Aids to those needing them at a good cost is what the insurance companies do. All Hearing providers in or out of program can provide one, two or three year service plans for all patients whether or not hearing aids were purchased from them. Say three year plan is $600, two year $450, one year $175. I don’t appreciate my provider of my Oticon hearing aid. I would gladly pay $600 for a three year service plan. You may not like hearing this, but many hearing aid providers of Oticon, Widex, etc, are greedy. Most of us that have hearing aids that went comparative shopping has found this to be the truth. From my perspective as one with Oticon Hearing Aids, Oticon has really forgot about us common folks out there needing hearing aids. This is truly about the greed of Hearing Aid Providers. No one will ever convince me different.

So basically Oticon will suck more money out of the patient vs the insurance company. This situation has played out in so many areas of healthcare. The manufacturers get greedy and charge significant prices for their “top tier” technology. The insurance companies look at those prices, do some basic math, and come to the conclusion that they can’t make their margins with those prices. It becomes a game of whose greed wins. Meanwhile the patient who probably has coverage but because it is bare bones doesn’t use it and pays thousands of dollars out of pocket for the devices and clinical visits. This benefits no one because the people who need and want hearings aids are now priced out of the market. I don’t know this for sure, but in my former industry we were selling very complex implantable devices for thousands of dollars mostly to Medicare patients. The advances in technology were “stepping stone” very similar to hearing aid new features. Rarely do you see a feature added that makes a huge clinical impact for the patient. If you look at a hearing aid from 1970 to now it looks like comparing a horse to a Ferrari. However, the Ferrari was a Porsche last year but the manufacturer wants a huge price bump. Like the business I was in I’m guessing the actual manufacturing cost of a hearing aid is sub-$500 each. Their margins are huge. The benefits managers came along because they, and the insurance companies, know this. They are happy to take a piece of that very rich pie. OTC was supposed to disrupt this model and help patients afford devices and care. It has not and it may never. My hearing aids are 6 years old, were bottom of the tier back then, and I haven’t seen a clinician for 3 years because they are all on the TrueHearing network and only do the basics. If Oticon, ReSound, etc all get together and decide to pull their mid to top tier technology out of the managed care marketplace that hurts no one but the patient. I would also add that they are basically colluding and doing back door price fixing. I know as a clinician you want to side with the manufacturers and blame the big bad insurance company. The fact of the matter is that just like Big Pharma, Oticon and others have created their own demon by pricing consumers and insurers out of the market.

My big issue with the cost of hearing aids and associated services is that for the amount of premiums that I pay for insurance coverage, the insurance company pays a pitifully small amount towards the cost of the hearing aids. My insurance company only pays $1250 per ear every 3 years and that hasn’t changed in more than 10 years. My newest pair 2 years ago ran $4300 total and insurance paid $2500. So that’s $1800 out of pocket for me which is ridiculous since I’m paying more than $500 a month in insurance premiums.

I have a profound hearing loss and I can’t even afford to eat anymore. Every thing is so expensive.

At what point should we start considering a Cochlear over Hearing Aids?

This has been the case for a while also with Kaiser Permanente through Medical (Covered CA). They only authorize the lowest basic models for hearing aids through their coverage. Nothing new. And yes, I felt that the service I received while getting fitted with HAs at HearUSA was extremely subpar and deficient. Next time I will buy online. Keep in mind we the patients don’t have a choice but to go to the only retailer that we are authorized.

I've been watching 👀 Cliff.

My situation isn't like that of many, many others, but it's worth pointing out something. I chose my Medicare supplement plans based on my ability to pay, which is relatively substantial. I paid for my premium hearing aids and excellent care completely out of pocket. That makes me completely unqualified to express an opinion on this subject. I'm saying the above because it's possible that someone in my fortunate situation might be tempted to tell others what's best for them..... but they shouldn't IMHO.

You are right, except... I can still get top of the line but the service is limited to 3 short visits. UHC. This is where the scheme fails. If will force people to over the counter aids like Jabra.

I just paid over $6,000 for a ReSound hearing aid aid a receiver for my other ear. Medicare and my BCBS supplement paid $0!

Several lawsuits out against these managed care plans as well for up charging of services to get more money, etc. Hospitals and doctors are also starting to drop these plans.

MCOs are incentivized to make profit by reducing or eliminating care provided to patients. It's their business model, they have little oversight, and it sucks. What's also frustrating is that traditional hearing aid insurance still exists. Three major employers over the past 20 years and all let me go to any in-network PPO audiologist for hearing aids. Why that's frustrating is that while providers ditching MCOs is great and I am all for it, they also remain out of network for traditional insurance so I can't use them.

This video parallels what happened at my Lifetime Gym. People got used to the "free" gym membership at a premium gym. Lifetime realized they were losing full pay customers because so many seniors crowded the gym at peak hours. I also heard United Healthcare cut what they paid. Lifetime had to drastically cut Advantage plan hours OR those people could now pay $100 a month to make up for UHC subsidized gym payment to regain full access. Nothing in this world is truly "free". Someone has to pay for it.

Are hearing aids becoming like cars? That is,. technology for technology's sake rather than just doing their intended purpose? My first hearing aids were from Sam's Club. I was fitted with a pair while my wife was shopping. I searched her out and that I could now hear her clearer than I ever remember was quite the moment. After a few years, I wanted something less clunky, Bluetooth wise. I bought a name brand, no point in naming it, and now had my invisible headphones and a cellphone app to fine tune this and that. Two years later, the warranty expired and just as if it was programed to do so, I started have some nagging issues with them that would come and go. I dug out my old Sam's Club hearing aid, got some #13 batteries and hear just as good as the name brand ones. Look, I like technology, but I'm willing to pay more for it. I'd like the insurance benefit to give an allowance towards it and I'll pick up the rest.

Last Fall I went to a local audiologist for a hearing test. UHC Hearing assured me that the test was covered by my insurance. To me that meant that UHC was paying for the test. I was rather shocked when the audiologist told me that, no, they were not being paid anything for the test. So I guess that they end up with the same level of service as places like Sam’s Club and CostCo, which provide “free” hearing tests.

The healthcare industry in my opinion has gotten so bloated with overpricing and justifying it as there being paid for research and development. Well let’s take apple or google as examples. Both seem to be doing well. Both spend a lot on research and development yet are still able to compete price wise. My really advanced iPhone doesn’t cost me $7000 and have limited features depending on who I buy it from. Doctors just play into this so they can overcharge for their services. I think if prices for hearing aids was set so comparison can be made. Then hearing centers could then add their own fees based on how much time the patient wants them to spend. There is just way too much of costs that are kept hidden.

Oticon/DeMont also owns Hearinglife, which has thousands of locations across the United States. So this benefits them as well because they are no longer working with any of the manage care companies.. I agree with a majority of what you say Dr. Cliff, but I disagree here, this is a move to pad their pockets. I don’t believe they have the best interest of the patient at heart with this subject.

Yes, yes, yes! But my insured hearing aid ( phonak cros) was obtained through medicare ; not through managed care which you say is even worse…but i also had no care. It fitted poorly and didnt work properly. No one cared.The entire situation has been mishandled and the poor patient is the loser. However…The cost i think has been too inflated from the private provider as well …who hopefully would feel compensated enough to be more patient responsive.. So…work it out! Care is so important to me and thankfully it is possible for me…so i will even pay the full retail price to get the best possible solution to live a “hearing” life. The new 2 channel oticon cros sounds very interesting.

add Wellcare to that list too hey will only grant me 1,000.00 towards a pair of Audebel hearing aids at thier contracted hearing aid dispensers for now I may end up getting those and saving my money to get a pair Phonak hate doing it this way the only bright side to this is having a back up pair

I am getting used hearing aids from ebay. I will have my audiologist reprogram them. Yes. Be careful. Do your research. But this is what I have done.

And furthermore…Hillcrest Hearing in Dayton ohio, the biggest provider in the city, says they have never hear of “real ear measurement”. Whats going on??

Fact Dr.Cliff it is bad for people really needs the hearing aids and professional help with the New hearing aids. I don't like 3rd party insurance companies

Oticon is going to find out no one wants their product, if they have to pay a fortune for it. I have Oticon and I won’t be getting another from them if that is their attitude.

Healthcare (cost) “management” carriers as a business model is not sustainable when scaled up to entire populations, yet they depend on just that very ubiquitous growth to attract investors. They offerED some COST savings (NOT cost containment) benefit when there were few patients enrolled, effectively those patient members were THE EXCEPTION rather than THE RULE. I applaud Oticon taking that stance that they did, and given the HIGH likelihood that these healthcare COST “management” carriers will TRY to erode care to THEIR OWN most profitable scenarios (i.e., OTC hearing aids with NO fittings or adjustments), I would urge ALL audiologists on behalf of their patients to contact hearing aid manufacturers to take a similar position as Oticon’s so that technical advancements DO NOT get “starved” for capitalization underfunding by the leaches that healthcare COST “management” carriers are to public health.

Sir, don't hearing aids , required medicines or injection for Sensorial hearing loss cure . please sir.Why the scientists are not interested and focus on Sensorial hearing loss.the scientists not taken seriously.

I think it is time for more legislation regulating hearing aid providers. Maybe there should be legislation to allow Costco to sell all hearing aids including Oticon and Widex. I believe they will do a better job than many of the so called hearing professionals. They don’t competition, all they want is a monopoly so they can change whatever they want to anyone they want. Don’t these providers realize Medicare Advantage patients are on fixed income with little extra funds.

My hearing aid coverage is only$300.00 per pair. United Healthcare Sucks.

We voted for a healthcare system that advertised reduced costs. While that didn't actually happen, nothing government promises ever does, The government responded by putting financial pressure on ALL healthcare providers, reducing what they are paid by the government for their services.. The providers are paid less and less under the healthcare policies WE VOTED FOR. Why complain when it gets too expensive for a provider to offer their top tier under that system? Quit complaining: we voted for it! It's long past time that we take "3rd party payers" (the US Government and government managed insurers) out of the middle and go back to a healthcare system where we can see actual prices and pay cash for what we want or can get. Prices will come down when we do that.

lol what a joke, so that you guys can charge an arm and a leg by setting whatever prices for these products, and not support affordable access to care! This should be illegal

I have never had my HAs covered by insurance, so I have always had to pay for them out of pocket. Sounds like managed care is a greedy middle man that can go bye bye.