Yep, the model I bought is an AQ-C05 (MSRP around $11,500 per pair), (there is also a C07 and C09) that I think roughly corresponds to an Oticon OPN-1. Not certain of that though.
The whole pricing & out of pocket cost for me is something else I am not comfortable with.
He said they have to bill the insurance the full MSRP. The insurance coverage is for 80% of “reasonable and customary” charges. So they bill the insurance full MSRP, but he said the insurance often comes back with a check that is approx 50% of MSRP rather than 80% because the insurance does not consider the inflated MSRP to be reasonable (I don’t either).
So if they did that, they would be paying for 50% of $11,500, or $5750. Normal price (whatever that means) is $7,000 for the pair of C05s. He said they discount them 20%, down to $5600 (plus earmolds, no sales tax). So what is confusing is that it sounds like the insurance company would pay $5750 on a pair I could buy for $5600. That doesn’t make sense.
Further, he said they will not know how much my out of pocket is until:
- they fit me and the 45 day trial starts
- the check arrives (what amount is not clear) from the insurance, and I would be on the hook for the balance
My mama din raise no dummy. I don’t want to get into this open-ended pricing thing when the dollar amounts are so high. If the HAs were $25 I would still want to know my OOP cost before committing.
Overall, I am just too uncomfortable with the unknowns here to proceed. At least with Costco you know what you are getting and it is a firm price.