Any insight on the Oticon / UHC wars?

Hearing Aids
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I’ve been fairly absent from this forum since I lost one of my Oticon hearing aids a few years ago.

I can’t put off getting new ones any longer. I’m probably going to try Costco’s Philips HearLink 9050, but my insurance does offer a benefit for hearing aids. In-network costs me 10% after a $4,000 deductible (I typically have very low health costs, so this means they’ll effectively cost me $4,000+10% of the balance). Out-of-network is 30% after the $4,000, but they’re unable to tell me whether Costco qualifies as out-of-network (purely to have the cost count towards my deductible…certainly better than nothing). I still wanted to try the Oticons, or just see about pricing at the very least, so I tried to get that set up. It requires me to choose (without any info other than a wesite) a hearing clinic in the UHC Hearing Network, go into their office, get a test, and after that they will release the pricing info to me. (So, already that’s scammy because the UHC person on the phone with me knows what the pricing is and just refuses to tell me).

I then found out that Oticon won’t release the latest tech to UHC, and I read a post by Volusiano that indicates it’s bigger than just UHC. And this is where I get confused.

So, is Oticon trying to force all consumers who want their tech to just pay out of pocket? Because in other places on HearingTracker it seems like you can get Oticon Intent through whatever those “middleman distributor programs” are for about $3,000. I did that last time, with my Oticon OPN3s, and I didn’t prefer it because they didn’t have any clinics in-network who could service the Oticons. The clinic brought in a girl from somewhere else to program them the first time, and then basically that was it. And it was fine…but rather than have that experience again, I’d prefer to go to Costco. Paying $6,000-7,000 out-of-pocket is out of the question (especially given that, for once in my lifetime, I actually have an insurance benefit). But I’m not sure I like the idea of paying maybe $4700 and not even getting the latest technology.

So here’s my question: what’s this war really about? The audiology clinic told me it’s about protecting audiologists. Well, it’s not doing that because I’m going to go to Costco. They certainly aren’t putting consumers first if they’re denying us the latest technology. Typically everything comes down to money. So is Derwent/Oticon mad about negotiated pricing?
Like the insurance companies aren’t willing to pay them what they want for the tech?

I just would like to understand this better. I’ve been saving since I lost my old aids because I really did want to stay with Oticon. My first audiologist was really great, and I would like to support independent audiology clinics where possible. That said, I’m not in a position to pay $6-7k for hearing aids - it’s even a stretch to pay the $4700 I’d likely pay with my insurance. (And that’s just for the aids - I use the associated devices too.) This whole situation - all the way from the price opacity to being gatekept from the latest tech (but still expected to pay crazy prices nobody else in the world pays), is making me feel like I should just go to Costco. It may not be as good, but it will be better than nothing. And since I’m already struggling (as a first time home buyer who bought an over-valued house last year at 6.5%!), this decision is kind of making itself.

I still just would like any insight on what the fighting is about and what either side is hoping to gain in the long run. It feels like a protectionist measure, and we have ample historic evidence that those do not work over the long term.

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Last year I met max out of pocket so I was able to get new hearing aids covered 100%. However, I had to go through Hearing Care Solutions and indeed the latest available Oticon aids they could only get for me was the Real 1, not the Intent 1, for $3700. So the war on not making the latest Oticon models available through these nation wide HA brokerages for insurance companies is real. The $3700 was only with the standard desktop charger. If I wanted the Smart Portable charger, it’d be an additional $375 out of pocket not covered by the insurance. I declined and just bought one from ebay for $130.

It’s very simple, the fight is just about the HA mfgs not wanting to give deep discounts to those outfits for volume sales to insurance companies anymore. But I don’t think they’re under any illusion that it’ll pressure these nation wide brokerages to give in and pay more for the latest models because the patients don’t really have any power to demand the latest models “or else”. All they can do is accept what’s available to then from the insurance company, and the insurance companies are under no pressure to try and get the latest models for their customers. So it’s the customers qualified for hearing aids through the insurance who will get the short end of the stick, so it’s a lose-lose proposition all around for just the end consumers and nobody else in that chain of supply.

To make the matter worse, I predict that when the next generation after the Intent comes out, I really doubt that Oticon will start releasing the Intent out to these brokerages for the deep discounted price. Oticon will probably hold the line and the end consumers of these insurance companies will be stuck with 2-generation-old, then 3-generation-old HAs as the years progresses, until something gives

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Check the details of your hearing aid coverage.

My insurance will cover (in and out of network) hearing tests and hearing aids ($1000 per ear every 3 years) with no deductible - but only a hearing visit and evaluation for a hearing aid prescription performed by:

  • A physician certified as an otolaryngologist or otologist
  • An audiologist who:
    • Is legally qualified in audiology
    • Holds a certificate of Clinical Competence in Audiology from the American Speech and Hearing Association in the absence of any licensing requirements
    • Performs the exam at the written direction of a legally qualified otolaryngologist or otologist

and likely more importantly Electronic hearing aids, installed in accordance with a prescription written during a covered hearing exam

Costco does not meet this requirement - confirmed by Costco when I showed them the requirement.

I am also looking at Hearlink 9050 and Oticon Intent. I am going to a very well reviewed local audiologist on Wednesday for a complementary Hearing Device Evaluation (as I have a recent Costco Hearing Test they are Ok to start with that). They also said they will be happy to explain the “differences” (quotes are mine) between Costco’s Philips Hearlink 9050 and Oticon Intent 1’s (which they carry). I guess I will also find out pricing then as well…

If I do proceed with the Oticon Intent 1’s I assume I will need a hearing test from them to meet my insurance requirements - but if I do that should be covered as well.

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Thanks! Yes I am going to assume Costco isn’t even covered as out-of-network. UHC is extremely cagey and basically refuses to give me any information about specifics as far as what’s covered. Nothing is written down anywhere in as much detail as what you’ve shared here.

If you wouldn’t mind following up with what you learn, I’d be grateful. I think I will still go for the covered hearing test, since that’s the only way for me to get pricing information, and will almost certainly still end up at Costco. I was upfront with the person I spoke with from the clinic, and basically said, “Look, I know what you provide is better - service and tech - but it’s really a lot of money and if I’m not even getting the latest tech that’s not great, from the consumer’s perspective.” I shared that I was considering Costco even though I know it doesn’t compare, and he said, “Well if you’ve had hearing loss since birth I don’t think Costco is going to offer what you need…,” (I have bilateral sensorineural, moderate-to-severe, “cookie bite” loss). And he might be correct. But I have free trial to be able to make that determination for myself… I was actually more afraid of jinxing myself by buying them out of pocket and then having some sort of medical emergency this year that makes me spend up my full deductible (meaning the Oticons would only be a 10% cost to me, if I’ve already met the deductible). I can be weirdly superstitious like that, haha.

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Thanks! Yes, it just sort of makes no sense all around…the insurance companies aren’t going to give in (it’s not in their financial interest to do so), and if Derwent doesn’t expect them to then that must mean most of their market share is coming from other streams or from outside the U.S., or from extremely brand-loyal people (admittedly, like me…before this craziness).

It’s rather frustrating but I’m having to look at it from a strictly logical perspective. It is simply not logical to be to pay ~$4700 for last year’s tech when next year’s tech will be coming out soon. That’s another thing - when I first was fitted with hearing aids as an adult, a little over 10 yrs ago, Oticon released a new model maybe every 2-4 yrs. Now they release an entirely new model every single year. My audiologist told me people should plan to get new aids every 3 yrs to keep up with the tech - ok well there is no way I can justify even $4700 every 3 yrs, let alone paying the list price without any discount. Not even adding in office visits makes that worthwhile…I’ve historically been a very low maintenance hearing aid wearer. Once they get fitted I come back max. once per year, if that.

It just seems like breaking my brand loyalty is the only logical option here (and Philips is made by the same manufacturer so not even sure it counts…but I think it does).

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Well I think it is going to be Costco - the Audiologist quote was $7980 (!) for the Oticon Intent 1 including 3 year service (but hey they threw in a free smart charger!). For 1-year service it would about a $1000 less.

The audiologist was not very specific about the differences between the Oticon Intent 1 and Hearlink 9050 - the basic summary was she could access more programmable features, had better programming/analysis tools and she was a fully qualified and experience audiologist and Costco staff were licensed hearing aid fitters not necessarily audiologists.

At Costco I can get the Hearlink 9050 for around $1500 with if I understand correctly lifetime support. The Costco person who did my hearing test seemed proficient and willing to spend time with me…

Even if I get $2000 back from my insurance with the Audiologist/Oticons it seems to be no contest…

After all if try the Hearlink 9050’s at Costco and they don’t work well I can return them after the 6-month trial period.

Edit: A couple of more comments. The Audiologist 3 year quote was for 3-year loss and damage insurance but ($425 deductible per device). Costco 2-year loss-and-damage warranty, with no deductible cost, to replace up to one hearing aid per ear during the warranty period. Both have the manufacturer 3-year warranty. The audiologist quote included 3-years supplies (domes and wax guards) - I am guessing some value but maybe not many many thousands of dollars…

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Well not quite, it’s actually a bit more then that, but I see a time when every 12 months like cars,phones etc is not far away at all.

Always a good idea to go with what works best for you after a trial, makes no sense to go for something that doesn’t meet your needs, Phillips of course are made from the same parts bin all the others from Demant, your not exactly breaking “brand loyalty” at all.

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oticon-managed-care-strategy-update-april-2024.pdf (126.3 KB)

The original letter about the situation (above).

And now it looks like a reversal is on the way (from medwatch) today:

IMG-20250206-WA0001
IMG-20250206-WA0001943×769 63.4 KB

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Thanks for sharing this news! Just my luck that I couldn’t get the Intent last year and had to get the Real. But I’m still thankful nevertheless that I was able to get anything at all covered 100% by my insurance (due to meeting my max out of pocket).

It does make me curious on how they could incur significant losses when de-prioritizing the channel, because it’s not like they couldn’t make any sales at all through the channel. They were still selling the Reals model through this channel just the same. Did any vendor in this channel decide to stop carrying the Demant aids at all because of this? The vendor my insurance (Banner Aetna) deals with, Hearing Care Solutions, still carried the Real last year just the same. As did Amplifon, although they don’t deal with my insurance in my state.

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United Health I think entirely discontinued covering all of oticon

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Ah, OK, that’s why Oticon is hurting. Serves them right to be so greedy. The HCP I inquired the Oticon Intent 1 quoted me $8200 for a pair through her normal channel. Compared to the $3700 Hearing Care Solutions charged for my Real 1 to my insurance company, I can see how they get greedy thinking they can sell more than twice the money via the HCP channel. I guess they didn’t expect UHC would retaliate and also carries that much weight in volume, huh?

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