I was wondering the level of service Kaiser Permanente offers HA users and selection of HA brands offered. Particularly in the Maryland, DC, Virginia area. Does KP have trained professional audiologists and if so do they sell a wide range of HA’s to test? From what little research I’ve done it seems KP sells directly to KP members with a decent discount on each HA. Something like $1000 off per aid. So just wondering if Kaiser does everything in shop and if so - are KP members satisfied with HA service they receive and prices offered for new hearing aids.
Could be wrong but with KP discount, HA’s prices should match Costco and (I assume) KP offers current 2019 model hearing aids where Costco unfortunately offers older brands.
I can only speak for Northern California Kaiser audiology in Fresno. From what I’ve seen with my Mom, all fitting is done with audiologists. They’re ok and helpful, but they don’t do REM on everybody and exams seem rather cursory. Prices ranged from $2500 for a basic aid up to $5800 last time I checked. Costco’s prices are much better. They carried Oticon, Phonak, Signia and Starkey. They also had a fair amounf of pediatric patients. (By “they,” I was referring to Kaiser NCAL.)
I have Kaiser (Southern California) for medical through work. It has been obvious for some time that I have the hereditary hearing loss from my mom’s side of the family (mom has profound hearing loss). I have an appointment this week for an audiometric exam.
Since there is minimal information about the quality and breadth of KP auditory services, I will try to document what I learn. If I’m dissatisfied, I may go out of pocket.
Thanks to all on this board for my free pre-exam education!
There is a bit of misinformation around about Costco offering old lower level hearing aids. I can see no evidence that is correct. See this Letter from Costco disputing the claims.
I have not looked real hard at the Costco HA’s other than their Kirkland Signature 8.0 model. It probably is about a year since it was first introduced, but HA manufacturers don’t release a new model every year. The KS8 is essentially identical to the Signia 7Nx model and the Rexton Emerald 80 8C model, but without the tinnitus masking. They are the current top of the line models from Signia and Rexton. The KS8’s sell for $1600 a PAIR in the US.
My only comparison was that KP offers new hearing aids that hit the market day one (I believe) where Costco does not. Some folks might not mind buying a HA brand that came out in 2017. Personally I’d rather have the option to buy or test “new HA technology” when its offered. To each his own but I’d rather concentrate of HA’s with good reviews that are “current” versus slightly older technology.
Use KP in Oakland. Bought first HA seven years ago. Very professional audiologists. Excellent service. Bought second set a year ago. However, the service has degenerated quite a bit in the last two years. If needed (which wasn’t often) you could get an appointment in one to three days. Now they want you to wait three weeks! The prices are excellent. They sell a few different brands. And they sell the latest equipment.
I guess there will always be some manufacturer that has the “newest” HA on the market because they don’t all release new ones at the same time. All I can say is that the current Kirkland Signature 8.0 represents the newest technology that Signia/Rexton has. It is not an old model. Something newer may be coming, and Costco will sell it as the KS9, or it may be another brand this time.
I went for my hearing test at Kaiser today. The test was conducted by a Doctor of Audiology.
They performed an audiogram measurement, a bone conduction test on my head behind the right ear, a tympanic test(?) and several different word recognition tests with the audiologist speaking the words as well as recorded words at different volumes.
The audiologist explained my results and showed me the graphs of my “Cookie Bite” hearing loss. She said that hearing aids would benefit me. She was professional, knowledgeable and personable.
Now onto the interesting part: Kaiser Southern California contracts with “HearUSA” to handle the selling and dispensing of Hearing aids. HearUSA has a sales rep on site to discuss your Kaiser Benefits coverage that can vary based on your employer. HearUSA has many offices throughout Southern California. The representative said that most of the offices do REM if appropriate or requested.
I made an appointment for Monday at the Reseda Office which is run by a Doctor of Audiology. The bad news is that HearUSA deals mostly in Signia (Siemans) Hearing Aids. I believe they can get other brands, but that is the vast majority of what they fit.
I will post another update after my Monday Appointment.
Some comments. Yes, that is somewhat of a cookie bite loss. The good news is that you can still hear some of the high frequencies that a lot of us with the ski slope loss do not have. You should be fine with a RIC style HA with a standard lower power receiver.
I would insist on having the REM done. If they don’t do it then they do not know what volume is being produced in your actual ears. All ears are different, and the computer program cannot exactly predict what the volume level is going to be in your ears, just the average ear. A fitter is cutting corners if they do not do the REM test and subsequent adjustments to target.
I don’t think you have to be concerned about getting a Signia HA if it is the latest Pure 7Nx model. They are premium level hearing aids. The work best with an iPhone, but can be set up to use an Android. Keep in mind that this is essentially the same HA as the Kirkland Signature 8.0 that sells for $1600 a pair in the US. I think you can expect a much higher price if it has the Signia name on it.
With your minimal loss at the very high frequencies you should look for a HA that can go up in frequency. The Signia 7Nx claims their HA’s go up to 12,000 Hz. I can’t verify that from personal experience with the KS8.0 because my hearing is toast at those frequencies.
What you should ask the fitter about is using the DSL v5 fitting formula. It attempts to restore the higher frequencies, while other common formula like the NAL-NL2 kind of gives up on the high stuff, and tries to restore the speech range.
Well I hope you make out OK with “HearUSA”, but reviews for that HA service have not been good. Furthermore I’ve noticed high turn over in HearUSA staff or Audi’s with limited experience. One would think a large organization like Kaiser would not only screen for hearing loss through Kaiser professionals but also offer HA’s directly through Kaiser. Not sure why Kaiser contracts out for this service since it should all be done in house at a Kaiser facility. And I’d be careful picking HA’s from a limited list of options. Signia in my opinion is not a “top” hearing aid and as we all know Siemans bread and butter doesn’t come from selling HAs.
For what it is worth, Consumer Reports, did an update article on hearing aids in January 2019, but it was based on a survey in the Spring of 2018.
Their ratings for brands of hearing aids was based on user ratings of over 17,000 CR members. The top rated brand was Costco Kirkland Signature. #2 was Signia. In the detailed breakdown of the various areas issues rated, the results of the KS and Signia were identical except for value, and the KS rated Excellent, while the Signia rated Good. I find this interesting because the last two models of the KS are made by Signia. It seems the only real difference is the price, which makes a lot of sense.
Consumer reports also rated HA vendors but the sample size was lower at about 4000. Costco again rated at the top of the retailers with a score of 89. Connect Hearing was second at 85, and HearUSA third at 82.
Also for what it is worth, Siemens sold their hearing aid division over 4 years ago to Sivantos. Signia along with Rexton have been owned by Sivantos, and have more recently merged with Widex to form a new company called WS Audiology. There are not as many HA choices on the market as there appears to be!
Just to point out again, Kaiser is not a monolithic entity. Each region has a lot of independence. From experience with NCAL Kaiser, I know space is at a premium and I suspect the same is true of SCAL. For whatever reasons, Kaiser SCAL chose to outsource their hearing aid fitting. I wonder if that’s also true for pediatrics?
I did a search on HearUSA and was NOT happy with the results. Sounds like a disaster with bankruptcy and all kinds of financial shenanigans.
The HearUSA on site Rep said that they can get other brands, but said they do the vast majority of fittings are done with Signia HAs.
It just chaps my hide to pay more out of pocket with my significant Kaiser benefit than Costco charges. It feels like I’m getting old technology as the first of the Nx HAs were introduced in October of 2017. The service better be significantly better than Costco or why bother with the added expense?
I think I am going to try the 7Nx with the Sierra recommended DSL v5 fitting formula for the trial period. If something new comes out, or I don’t like the sound, I may demand a change in device or office.
Costco generally offers pretty good service, certainly as good or better than I’ve gotten from NCAL Kaiser. Do you really have a hearing aid “benefit,” or a negotiated deal with HearUSA. Although I have very good health insurance coverage through Kaiser NCAL, I have no hearing aid coverage. They sell hearing aids at prices very competitive with community prices, but not even close to Costco. Unless there’s something very specific you want that Costco can’t offer, I’d go straight to Costco and skip the anguish.
And regarding “cookie bite” loss. Whoever you see, would be a good idea to ask if they have any experience fitting such losses. It’s my understanding that they can be tricky to fit. If they don’t have experience, seems like a reasonable followup would be what resources they have to help them (often factory reps can get involved)
Here is what your sound levels delivered to your ear with inputs of 50, 65, and 80 dB would be estimated at with three different formulas using an M receiver:
They all are probably going to sound quite different. The SmartFit would be the least aggressive, and the DSL v5 the most aggressive.
One possibility if you have a cooperative and experienced fitter would be to put one fitting in the standard Automatic program #1, then put the other two in copies of the Automatic program but with the different fitting formulas. That would allow you to easily switch between fitting formulas by just making a program change. Not 100% sure it can be done, but I think it can.
Sierra, That’s a lot to digest. A couple of questions:
What do you mean by aggressive? Under-amplifying the LF signals to allow my natural hearing to come through and over-amplifying the higher frequencies to maintain as much high freq signal strength as possible?
It looks like the gain curves for the frequencies below 750Hz for Smartfit and NAL2 are similar.
It looks like the gain curves for frequencies above 6kHz for NAL2 and DSL v5 are similar.
If you max out the gain at 6kHz through 8kHz, are you more likely to still have gain through 12kHz? (You mentioned that above.)
Is the compression at the frequencies with the highest gain an expected outcome of hearing Aids in general?
Are there adjustments by the software for all 20 bands in the 7Nx HA? Any of the bands above 12kHz or below 250Hz?
Thanks for your help! The audiologist is going to just LOVE me.
First off, I am no expert in HA’s. I use the KS8’s but only have about 10 weeks experience with them. I just downloaded the software so I could understand what they can do better.
By aggressive, I mean by how much they are adding in gain to the natural sound. Your left ear with an 80 dB input in the 2-4 kHz range is peaking at about 100 dB in your ear. The NAL-NL2 hits just a touch over 100 dB. The DSL v5 is getting up to about 112 dB at 3 kHz. That should sound twice as loud as the SmartFit or NAL-NL2.
I would not worry too much about the lower frequencies. Your hearing is good there, and there should be no problem hearing the lows, even with a closed fitting.
Yes, with DSL v5 slightly higher
Not totally sure what happens at higher frequencies. The formulas seem to just stop at 8 kHz. However the last adjustment handle says it is at 10.6 kHz. I assume after that you get no gain from what is naturally there.
Compression is not a given in the HA, but it is most often needed by your ear. For example if you have a 70 dB loss and you try to restore that to zero you would need something like 140 dB in the ear. That is not going to be pleasant! So compression of louder sounds is desirable. The other deeper issue is that with hearing loss your hearing typically goes non linear. So while you may have 40 dB loss with quieter sounds, you may have much less with really loud sounds. For that reason compression is a good thing.
The 20 handles for adjustment go from 63 Hz at the lowest, to 10,625 Hz at the highest. There are actually 48 bands, but you only have handles for 20. The HA’s distinguish down to 48 bands, but you can only adjust 20 groups.
