EPIC Hearing Health Care

Hearing Aids
#1

I am a new member who has really benefited from the wealth of information here. One thing I could not find was much information on EPIC Hearing Health Care, which my insurance company uses to administer their hearing benefits.

So here is what I have learned in the past week:

EPIC has negotiated prices with manufacturers (their brochure lists Phonak, Resound,Siemens, Oticon, Sonic, Unitron, and Widek). They will provide quotes on other manufacturers, but at least with Starkey, the pricing was not very good.

Based on the experience of someone else in the forum, the EPIC benefit can be offered by an insurer in two ways: either as a referral for discounted pricing (perhaps no benefit at all, depending on the HA and the discount); or with an actual coverage amount. For example, my insurer covers a specific dollar benefit and sent me to EPIC to handle the following process:

  1. EPIC refers patient to a local audiologist who recommends a specific HA.

  2. EPIC provides a price that includes fittings and follow-up.

  3. The patient pays EPIC the difference between the coverage amount provided by the insurer and EPICs discount price, and the audiologist orders the unit and dispenses.

  4. The patient has a 45 day trial period. Returns may incur a $175 clinic fee, depending on local regulations and the situation.

  5. Normal manufacturer warrantees and loss coverage apply, but are administered through EPIC.

So far EPIC has been very responsive, but I will update this once the trial period is over to let everyone know how the full process went. I have no affiliation with the company, but this might help others whose insurance companies also use EPIC to administer hearing benefits.

Michael

#2

I tryed to use them with no company benifits,I did better on my own.I beat there prices by $300 per pair.

#3

That seems consistent with what I have been seeing. For most aids I have checked they are 200-400 higher than the low internet prices, but for a couple they are 200-400 lower. What makes the difference for me is the insurance company contribution that seems to be coming only if I use EPIC.

#4

I am currently going through Epic for my instruments. My Audi suggested the Agil Pros and in checking with 2 different Audis the price was $3,000 and $3,200 each respectively. Through Epic the price is $2,499. Epic’s coverage through my insurance (PacificCare) is 50% with a $5000 maximum, in other words they buy one aid and you buy the other. My out of pocket cost including the bluetooth and TV streamer was about $2,700. Of course every insurance carrier can write their own ryder, so check yours carefully.

#5

Michael, your understanding of Epic is exactly right. In the best of all worlds it works exactly as you outline. As an audiologist who works with Epic, I have a love-hate relationship with them. it can be a good solution for people, specifically if your insurance company pays a portion of the cost by using Epic. The monetary savings is the only advantage; you get no benefits or assurances above what you’d usually get from a private aud.

On the negative side, you want to make sure that you get the most appropriate hearing aids at the outset. Changing hearing aids through Epic is time consuming for you and frustrating for the audiologist. Epic is not set up for exchanges so spend an extra 10 minutes on the front end to make sure you are making the most appropriate hearing aid selection.
Epic saves you money up front but after 12 months your follow-up visits to the audiologist will cost you $40-$60/visit. When you purchase from an audiologist these visits are often included through the life of the warranty.

If your insurance doesn’t provide any benefits for payment ask your Aud if they will match the Epic price. You may match the Epic price and give a better warranty with service. By contract the Aud can’t offer this option to you but if you request this information they can provide it.

If you are comparing Epic prices to internet prices then Epic, and any Aud for that matter, will be higher. The difference is that Epic is guaranteeing a good, local provider as part of their price. $400 in savings is quickly forgotten if your hearing aids aren’t providing the expected benefit.

#6

I just found this thread after speaking to Epic today. I don’t have any insurance. So I’m wondering if anyone here has used Epic or an on-line sales and then their provider, or if they’ve successfully bargained with their audiologist to lower prices to Epic’s.

You can pm me if you prefer.

Eager to hear from any/all of you as I’m not sure how to proceed. (I have an audiologist I’ve used through a state program. But I don’t qualify for that program any more.)

#7

Mech29,

I can’t PM you. So could you PM me or write here and tell me where you got a better deal than Epic?

Thanks so much.

Nancy

#8

I had a patient come in the other day who had EPIC. We are not an EPIC provider. Our fees were better than her EPIC “discounted” fees by $400 an ear. But I’m not sure if this is typical…

dr.amy

#9

Did you go with Epic? I went thru them and went to their assigned Audi (Newport Audiologist) today and they have fallen off the contract wagon with most manufacturer. They only had 3 (Phonak, Unitron and GResound (sp)??) manufacturers. The audi tried to talk up Phonak having the best technology out there and since I have profound loss (80db-1000Hz, 90db-4000, 110db-6000 thru 8000), she wanted to recommend Unitron BTE - it was huge! Also, since I’m active, she said I can’t get sweat on it or it will stop the HA from working so she suggested I wear a headband…Lord, I can’t see myself wearing a headband on the treadmill or in Pilates class at the gym. I am looking at Starkey and Siemens since they carry CIC for profound loss and Starkey has water resistance for their aids. Should be getting a call from Epic in a few days with the price.

#10

I just want to add that I went through Epic. I did not have supplemental insurance, so I paid their prices. The selection they offered me included, Starkey,Oticon, Phonak, Resound, Seimens and a number of others.

I bought the Oticon Agil Pro Rite Minis. They were $2599/aid and I paid $200 for the remote. They gave me a choice of audis in the area. I chose one who said he was comfortable with Oticon. I’m just finishing my trial. I found Epic to be helpful and their prices definitely below the market prices here in Connecticut.

Dr. Amy, so sorry you’re not here. :frowning:

#11

I know the Phonak Nadias are coated and sweating does not affect them. I think most of their other models are also but only trialed the Nadia SP and they also have a UP model. Might be worth checking there specs.

#12

I agree, but would add DocAudio, ZCT, Um Bongo and a couple of other professionals here to the list.

I think we take sometimes these kind, sharing patient people for granted.

#13

I definitely did NOT mean to leave any of the other audis out! I was just replying directly to your comment. I thank all of you professionals here who take time to offer their wisdom to all of us who have benefitted from it. You all have been so so helpful.

#14

Newport Audiology is owned by Phonak. So it is not surprising that they only recommended Phonak and Unitron. Epic’s prices are fair. If you have an insurance benefit use it. If you don’t. Epic’s prices will be comparable with going to the specialist of your choice. Epic lost their largest insurance provider at the beginning of the year, so those patients will get ‘discounted’ pricing with no insurance benefit.