Anyone buy HA's through Kaiser Permanente?

Hearing Aids
#17

Sierra, That’s a lot to digest. A couple of questions:

  1. 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?
  2. It looks like the gain curves for the frequencies below 750Hz for Smartfit and NAL2 are similar.
  3. It looks like the gain curves for frequencies above 6kHz for NAL2 and DSL v5 are similar.
  4. If you max out the gain at 6kHz through 8kHz, are you more likely to still have gain through 12kHz? (You mentioned that above.)
  5. Is the compression at the frequencies with the highest gain an expected outcome of hearing Aids in general?
  6. 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.

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#18

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.

  1. 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.
  2. 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.
  3. Yes, with DSL v5 slightly higher
  4. 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.
  5. 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.
  6. 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.

Hope that helps some,

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#19

Sierra: That helps a lot! I’m going to have to plug those numbers into a spreadsheet to see if I can make some more sense of it all!

Thanks!

#20

You can find links to the programming software here. I downloaded the Connexx 8.5 software and use the Rexton Emerald data.

#21

I went to my fitting today at HearUSA.

I met with a young looking (she later said she was 40) Doctor of Audiology, and she said all the right things except the price of $8500 for the pair. That is very expensive, and I said so. I told her the difference between the Signia 7Nx and the Costco KS8 (besides the $7000 difference in price) is the service and her expertise. She agreed and talked about what she can do for me such as real ear measure and multiple readjustments during my new use of HAs especially at the beginning. She even mentioned her school (in Ontario Canada) pioneering some of the algorithms such as DSL v5.

They wanted $8500 for the Signia 7Nx with 312 battery. I expressed my reservations about 1.5 year old tech and she disagreed. I asked if she only fits Signia, and she explained that she also fits Oticon. I decided to go with the Oticon OPN 1s with 312 battery. It is the same price and with my $4000 insurance coverage it will cost me about $4500. They have to order it and I’ll have it fitted next week. I am starting to get a little excited, but those numbers would have scared me off for another 5 or 10 years if I were not so motivated by my 4 year plan to retire.

I was disappointed to not be able to get the Phonaks which are easier with Android Phones, but I will make it all work even if I need an add on device. I’m trying to focus on the hearing functionality, and not get bogged down by the specific features.

I’ll post another update after next weeks fitting.

#22

I wonder if Kaiser pays HearUSA for the “benefit,” or if HearUSA pays Kaiser for the marketing advantage? I’m kind of guessing the later. They get a bunch of appropriate referrals that already have an audiogram. Personally I think Kaiser should strike up a deal with Costco.

#23

Yeah. Something smells in the business agreement. I’m guessing they overcharge the captive audience, and split the benefit. I don’t see a $4000 value for the $4000 benefit.

I can’t get the HA for $4500 with good service and support, so I still come out ahead versus paying it all out of pocket (unless the service turns out to not be all that good). I would much rather NOT have the exclusive agreement, and just take the $4000 benefit to the provider of my choosing.

#24

Keep in mind that you could get a pair of aids from Costco that is very similar to the Signias for $1599 with generally good service.

#25

You’re being charged way, way beyond the max for “state of the art” hearing aids. What good is a Kaiser Permanente discount, or $1000 off each HA, when someone jacks up the “standard price” 50% to 80%?

I’m curious where you are getting the $4000 in insurance coverage for the Oticon since Kaiser Permanente seems to only offer $1000 off for each hearing aid ordered over a three year period. So my understanding is if you buy HA’s through KP you get a total of $2000 off if two HA’s are bought.

In any case I’d call around and get other quotes or visit some private Audi’s and then when you go in and test your new Oticon - you could mention what the going rate for the HA’s are on open market versus the “jacked” up quote you received.

#26

The Kaiser Benefit level varies by the group/company that purchases the coverage. My company is rather generous with the $2000/ear coverage. The on-site consultant was surprised at that.

I can definitely see myself going the self program path in three/four years when I replace them. Since I am a new wearer, I can actually benefit from the expertise of the Audiologist even at that obscene cost.

This industry is badly in need of overhauling!

#27

I have Kaiser in oakland/Walnut Creek. My Kaiser plan gives $0.00 towards hearing aids. Nada. I got my first hearing aid at Kaiser and it was fine. Oh, Kaiser itself has an audiologist give my hearing test; very good. But the hearing aid people are completely separate from Kaiser.

I bought the aids I use now from a very local independent dealer and they’re top notch. They offer terrific cleaning and other services for free–and I can just walk in for a cleaning. Much better fine tuning of my aids, including installing a music program, than the Kaiser affiliate offered.

I’m glad I passed on Costco just for the ease of service.Also, the aids I tried at Costco didn’t work as well for me as the ones I now have.

#28

Interesting! I thought Kaiser NCAL would at least be consistent throughout the region, but I guess not. Fresno Kaiser has a hearing aid center staffed by Kaiser audiologists. The testing aspect is considered a different department than the hearing aid department, but the staff is all Kaiser.

#29

I got my HAs. I got the Oticon Opn S1 with the connect clip. Open fitting. They are the first Opn S1 she had fit. She mostly does Signia Pure 7NX and Opn 1 HAs.

Dr. D’Cunha ran the REM test just like on Dr Cliff’s Youtube videos. She used the NAL-NL2 fitting formula. It was a little different in that they also did a word test as part of it. The words were a mixture of 6 languages and were unintelligible.

The HAs are really subtle in that it was hard to tell they were there unless certain sounds were made. I can actually differentiate between Ch and J sounds. I went on a two hour hike when I got back home, and didn’t realize how many background sounds/noises I was missing. I have only said “What?” once so far!

Their appearance is also really subtle. I had told several co-workers I was getting them and none noticed them even after I pointed them out. They are really small and the wire is fine. I am getting a haircut tonight, so tomorrow should be interesting.

The only disappointment so far (besides the price) is the streaming. I got a ConnectClip ($100) and use it to connect to my Note8 phone. I don’t think it is worth it even at that price.
The streaming is really tinny, but I think it is because the ConnectClip/HA are only producing the frequencies that the HAs are programmed to boost. I’ll have to work with the doctor to boost all the frequencies to some extent, or I may just have to use over the ear headphones.

I go back in two weeks to re-adjust the programming, since I’m a brand new HA user.

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#30

I mentioned your experience with Kaiser Oakland to a Kaiser audiologist and he was surprised. He said Kaiser Oakland definitely has a hearing aid center. He did say that pediatrics is their specialty. Oakland is one of two facilities (as well as Sacramento) in NCAL that does cochlear implants. In general I do know that Kaiser will refer to outside facilities when the demand is high or at patient request.

#31

I bought my first hearing aid from Kaiser in Walnut Creek. They are affiliated with Kaiser but my understanding is that they are a separate entity. They can do hearing tests, but currently I see a Kaiser audiologist for my hearing tests. That audiologist has no relationship with the hearing aid center, which is an independent contractor. I may be wrong! In any case Kaiser insurance gives nothing towards hearing aids.

#32

In Fresno, hearing aids and audiology are separate departments, but they’re both run by Kaiser. Perhaps similar to how there’s an Opthalmology/Optometry department and optical sales. I’d guess Oakland would be similar but clearly don’t know.

#33

You may well be right. I think I get a 20% discount on glasses at Kaiser optometry because I’m a member. No such luck with the HA dept.

#34

Hi all,
I thought I would pop in and update.

When I was first fitted, Dr D’Cunha actually used the Oticon proprietary fitting formula. In one of my follow up appts, she added the NAL-NL2 as an optional setup.
Over these past 6 months I have concluded that the NAL-NL2 is my preferred setting of the HAs. I also use the OpenSound Booster as a preferred default setting.

When I started, I would do an A B comparison of the two fitting formulas and had challenges hearing a difference. After a few months and in a variety of settings at work, the difference between the settings has become dramatic.

I go back for a thorough cleaning/new wax guards on a three month interval for now. At one point I had one of the aids get clogged with wax and essentially stop working.

In summary, I love Dr D’Cunha and the Oticon 1S HAs, but think I overpaid! I don’t know how I got by with no HAs, and wish I had done it sooner! Thanks again for all your help in this process.

#35

Sierra, I’ve been following your comments. You know so much! What would need to be compressed if a person (me) had pretty much a flat across audiogram in the 65-70dbs? It seems to me I could get away with these new amplified OTC’s coming out in 6mos, right? T/u.

#36

That is an interesting thought. Yes, having a straight across loss would seem to simplify things somewhat. But there are complications. First is that a 70 dB loss is a pretty significant loss especially if it is a low frequencies. In a standard hearing aid you would need a Power receiver, which is getting up there. I wonder what power levels will be offered OTC? A second issue is the sophistication of the aids. Even with a flat across loss a normal hearing aid will not provide a flat across correction. The correction is based on a formula like NAL-NL2, and once it is programmed best practice is to measure what you get with a Real Ear Measurement process. Not something that you can do at home. However there are aids with what is called in situ measurement which kind of do the same thing, so that may not be a major obstacle. Last with that kind of loss you are likely to have feedback issues if you provide the needed gain in the 3-4 kHz range.

Current hearing aid technology does not just use a single gain for all sounds. Soft sounds are amplified more, and loud sounds are amplified less. Here is what the gain curves look like for a 70 dB loss flat across the frequency range, while using a NAL-NL2 formula. Note the shaded blue and red areas. When the gain goes into those areas, there is typically feedback issues. Will OTC aids be able to deal with all of this? Don’t know. Technology development often surprises us. Back in the 35mm SLR camera days, I used to believe there would never be an autofocus camera. Wow, was I wrong on that one!

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