United health insurance pays 100%

I have united health insurance that covers hearing aids 100% up to $5000 every 3 years. Sounds great but I can’t find anyone who will give me aids without me paying upfront. I don’t have that much money. Has any body received aids and the provider of the aids collected from united health or any other insurance company?

Eight years ago I got aids and the office billed United Health. It was a real hassle. Three years ago when I went to get new ones, I had to pay up front. I put it on a credit card, and luckily got reimbursed before the payment was due.

I don’t understand why providers won’t except the payment from insurance company. I even had the insurance company call and talk to the provider. Provider stated it is common practice for them to collect 1/2 of the payment upfront. The provider told me that they didn’t trust the insurance company to pay. So I have a great benefit that no one will honor.

Both times with mine I had to get someone in my company HR department to talk to United Health to get them to pay up. They were a major PITA to deal with.

Im in the process right now of buying new aids with United Health Care Insurance. I had the Audi send in a letter asking what they would pay even though it says in the benefits that it will pay up to $5000 minus your deductible. She got a letter back with no clear answer. I can see its going to be a pain in the ass but you better believe I will keep on them to do what they say in the benefits. If anyone has any tips on how to make things easier please post them or PM me .

I paid up front supplied the paperwork to United, they followed up with the office to verify and I had payment in 2 weeks.

It was a great experience… I do think Providers should accept payment form Insurance companies, but fully understand why they need to collect up front some funds to cover their costs.

I have a dental policy, my Dentist accepts payment from the Insurance group and I pay my deductible, some charges have gone as long as a year before the Dentist is paid, in my mind for silly reasons.

Why not make an agreement for the hearing aid place to just hold them until the insurance company pays for them? Or is that not possible?

I just got my EOB from United and it says the amount covered is $4200 !! minus my deductible of course. Im very happy with that. So really if you do the math because my audi wont take just what the insurance will pay only one HA is covered about $3000 :slight_smile:

Unfortunate, but all too common. You can pretty much lay this in the lap of the insurance company. Phone calls from a member or provider to an insurance company don’t guarantee at all that they are telling you the right benefit or that they will pay any or all of the claim. That is why many providers ask for payment up front. They can and should prepare all of the claim paperwork for you and submit it, with the HCFA marked that any insurance payment should go directly to the patient.

Brad is right - it all boils down to the fact that just because insurance companies say you have a benefit and what it will pay, it doesn’t mean the provider will get paid.

Often times, we file a claim and the patient gets fit, and then the claim is denied or they only pay a small portion. Then we have to come back and collect the balance from the patient. If the patient can’t pay it - then what happens? It’s not like want to repo hearing aids!

It’s simply too risky because the insurance companies are so dodgy about what they cover…

dr. amy

Nobody really likes filling out paperwork, answering tedious and embarrassing health questions, or going from one company to the next to the next, comparing quotes and wondering whether the offers we’ve been getting are actually reasonable. For some of us, there simply doesn’t seem to be enough time in the day to get all these things done. The good news is that this isn’t actually true.

I know it’s longer after the original post, but I have encountered this same problem. I have United and 100% to 5000. Can’t find a provider that will direct bill the insurance company. I called United complaining that I could not find a provider on their in network list that would sell be the hearing aids and direct bill them. They are now calling the provider for me. It’s not allowed by the provider to refuse to bill the insurance company when the have a contract with them. I am still waiting to hearing back, ( only called yesterday) but I was given the impression the provider must do this. I was told the most they could do is hold a deposit for any deductible or coinsurance payments a patient might have. The providers are all saying they can’t get paid from the insurance company, I’m guessing that can be a problem. I would call the insurance company and ask them to call your provider to remind them of the contract they are under.
Good Luck

Thats only IF they are under contract with them for hearing aids tho. Because the evaluation is consider a diagnostic task and the aids are consider medical devices, practices can be contracted for one and NOT the other. For example, our practice in considered “in-network” for all hearing evaluations with BCBS so the insurance company will cover 100% of the cost of them. But we are NOT contracted by BCBS for hearing aids, which they consider a completely different process. So be sure that the list of contracted providers they are giving you is the list of “hearing aid providers”. Sticky, I know, but just wanted to be clear about that.

dr. amy

I have UHC in Knoxville, TN- I have $2500 in coverage, but they have no network providers in my area.
So far, they have made me have my family doctor call their Gap Extension line (my policy does not require referals)
I don’t know the results of that but my calls to their service line were a waste of many hours. They couldn’t tell me anything.
I went to HR and the local reps have not called back.
I contacted the state insurance commission and they told me to file a complaint as it is illegal to offer a benefit without a provider.
I will pay for the exelia arts on Tuesday, knowing UHC it will be a fight to get anything back.
My provider told me that she used to take UHC, until they sent her $800 for $4000 aids, with a letter telling her she couldn’t bill the customer.
I understand the president of UHC got over $120 million bonus last year, go figure?
Any advice?

Speaking from experience, we are switching to no longer being a provider for ANY insurances for hearing aids after we received a whopping $256 for a hearing aid that sells for $2750. I was able to balance bill the patient $36. We took a huge hit on this, as the patient was a child and just couldn’t “repo” the hearing aid from them.

I’m a self-employed individual and I’m planning to get a health insurance for hearing aid because I have a problem on my left ear it seems that I can hear too low.

In my office we do exactly what Darrell outlines; we decide with the patient exactly what aids are necessary, we get verbal and/or written confirmation about benefits from the insurance company, then we file a claim for that amount. Sometimes we are required to order the aids first, sometimes not. In any event we receive payment from the insurance before doing the fitting. This way everyone is sharing in the waiting period and we verify the exact amount being paid before fitting the aids. If insurance reimburses less than expected (a common occurrence) then we discuss what is available at that lower price. In all this has allowed us to better service our patients and lessen our exposure to loss because of unfulfilled insurance promises.
Perhaps all of you with insurance benefits can pose this type of arrangement with your audiologist.

Well its been a long time since my original post. Now an update. As of January united Health Insurance has contracted with Epic hearing. Epic has contacted an audi for me. I have been examined by an audie and he prescribed phonak audeo smart iv. He had to have an authorization from Epic before ordering. Epic has called me an said that it is approved for the full amount. No out of pocket from me. I will be fitted with two aids on Feb 14th.

Well its been 4 days since I picked up my new aids. Epic has come through fine for me and united health. As a reminder united health has contracted with epic beginning 01.01.11. to find and pay for audi’s that will except insurance. So far I have not paid a dime out of my pocket. The aids are top of the line phonak smart ix. I have been fitted and have 45 days to trail them. I can try several if I like. I can try one and go back to the original one if I choose. I am getting all service as if I was a cash paying customer. I will up date as needed… Jack

I have United health care for health insurance as well. For the last 10 years or so they would pay 1000 per year for hearing aids. That is if the provider was an approved provider. I have used this 1K many times to get a Hearing aid. The provider is also under contract to the insurance to provide a 30 % discount on all hearing related devices and the remainder of the cost of the hearing aid.

Typically the Audi would manipulate the price and end up taking a trip to Hawaii.

This year 2011

Price quote from this audi was
Oticon Chili SP 9 was 3500
Streamer package /mic 1000

Out of pocket would have been 2150.00 for all

On line I found a guy who offered the following price

Oticon Chili SP9 1895.00
Streamer package/mic 648.00

Shipping 20

2663 total

At the second Audi I went to , They said that UHC this year went to the Epic plan.

Off of the top of my head
EPIC prices for the
Oticon Chili SP 9 was 2200
streamer package 325
mic 200

so with the 1000 from united health care, I ended up paying 1625 for all, up front.

When my Audi gets back from vacation I will be able to pick up the Oticon Chili SP 9 and Streamer package/mic.:slight_smile: