— David Decker had all the signs.
missed things that actors said on TV. Hearing in crowds was a
challenge. And when he came home each day from work in a noisy
data center, where cooling fans whirred nonstop, his wife
would tell him he talked too loudly.
get hearing aids? A big reason: the cost.
70, of Philadelphia, learned what millions of aging baby
boomers are starting to discover. High-end devices can cost
$6,000 a pair, and most insurance plans cover a fraction of
the cost at best. Medicare, to the astonishment of many,
covers none of it.
costly," Decker said. "Insurance companies basically
options have started to emerge in recent years, but some
entail less in-person service. And for the uninitiated, the
menu of choices may seem daunting.
retailers such as Costco sell lower-cost hearing aids. One
insurer, UnitedHealthcare, sells the devices through a sister
company, both to insured members and others, who pay slightly
more. And like most other things, hearing aids can now be
consumer frustration remains rampant, said Carolyn Meyer,
outreach coordinator for the Pennsylvania Office of the
Hearing Loss Association of America, a consumer group.
71, who has worn a hearing aid for decades, estimates that she
gets three calls a week from people dismayed by the price tag.
She provides information about financial assistance for
low-income people with hearing loss, but options are limited.
breaks my heart," the Jenkintown, Pa., resident said.
technology has undergone great changes in the past two
decades. Virtually all hearing aids now are digital, meaning
they can be programmed to amplify sounds of various
frequencies by differing amounts, depending on the person’s
hear the rumble of a garbage truck but have trouble
understanding the high-pitched voices of children? A digital
aid can help.
newer developments include custom settings for listening to
music and talking on cellphones via wireless Bluetooth
costs money, but customers wonder why a hearing aid should
cost more than other sophisticated devices, such as a laptop
officials cite multiple reasons, among them that the products
are medical devices sold in lower numbers than computers. But
the biggest is that the price includes much more than just the
who have traditionally sold most hearing aids, usually include
an array of follow-up care in a unit’s price. The tab
includes fitting, programming, adjustments, and training,
among other services.
also teach strategies so that new hearing-aid wearers can make
sense of the sudden influx of sound. After years of living
without amplification, their brains are likely to need help,
said Lynda Wayne, treasurer of the Pennsylvania Academy of
Audiology, a professional group. And everyone’s brain is
different, so the sound-processing algorithms that work for
one person may not work as well for another.
not like you slap them on your ears and you’re good to
go," said Wayne, of Cadence Hearing Services in
Langhorne, Pa. "You’re not buying a washer and
of the device alone is hard to find out. When The Inquirer
asked six major manufacturers for the wholesale prices they
charge to audiologists, all declined to answer.
Porter, the chief executive officer of Embrace Hearing,
estimates that it costs a manufacturer $400 or $500 to make a
good-quality pair of hearing aids, which are then sold to an
audiologist for $1,000 and to the end-user for $5,000 or more.
Rogin, president of the Hearing Industries Association, a
manufacturers’ group, said that at a typical audiology
practice, one-third of the consumer’s total price is for the
device, and two-thirds for the professional services.
audiologists say they need to do better in explaining the
cost, and have begun to "unbundle" their services,
letting patients pay for a hearing aid and follow-up care
what eventually happened with Decker, the Northeast
Philadelphia man. He recently bought a pair of hearing aids
from audiologist Elizabeth Gray-Karagrigoriou, who engages in
what she calls "partial unbundling" at Ascent
Audiology & Hearing in Holland, Pa.
charges one fee for a hearing aid, fitting, programming, and
the initial 30 days of training. That’s $2,000 for a
high-end model, or $4,000 a pair, which she said would cost
$6,000 at a traditional audiology practice. She then charges a
separate fee for optional service plans of one, two or three
years — a fee that most audiologists fold into their higher
bought a pair of high-end hearing aids made by the Starkey
company. Although he opted to add on a three-year service
plan, his total was less than $5,500 for what would have
typically cost $6,000.
audiologist said her goal in charging less upfront was to get
patients to start wearing devices sooner, while their brains
are more "plastic" — adaptable.
hoping that people will say ‘Yes, I’m going to go in and
do this a decade earlier than I would have before,’"
2012 survey by the American Academy of Audiology, one-third of
audiologists reported that they charged separate fees for
follow-up care, said Debbie Abel, senior specialist in
practice management at the professional group.
audiologists say they are loath to unbundle their prices,
fearing that if customers have to pay a fee every time they
need a follow-up, they will choose not to come at all, and
stop wearing their aids.
want people to come in to see us at no extra charge so we can
fix any problems they have," said Kathy Landau Goodman,
president of Narberth, Pa.-based Main Line Audiology. It
allows customers to make unlimited visits for three years, she
there is Costco. The membership-based warehouse chain has been
selling hearing aids at lower cost than independent audiology
practices for years.
chain offers its high-end aids for about half the going rate
at typical audiology practices — about $1,400 for a
behind-the-ear model. Sold under Costco’s Kirkland brand,
the store’s devices always have been made by major
manufacturers, now Denmark’s GN ReSound, said Costco senior
vice president Richard Chavez.
chain can sell the devices for less because it does so much
volume, and spends nothing on marketing.
the company’s sites are staffed by hearing aid dispensers,
who must pass state licensing exams. But unlike audiologists,
they do not need an advanced degree. Audiologists caution that
their additional years of training allow them to spot problems
that need medical attention.
Costco worked for Tasha Turner, 46, of Highland Park, N.J.,
who in December bought a pair of aids for the first time and
has been back to the chain’s Edison, N.J., store for five or
six tune-up visits. "They are just absolutely fantastic
on follow-up," Turner said.
point on which all providers agree is that most
hearing-impaired people wait too long to buy the devices, if
they ever do at all. Studies have found that just 20 to 25
percent of hearing-impaired people wear them.
also suggest that people with hearing loss are more prone to
cognitive decline, though it is not clear if one problem
causes the other.
nothing else, a hearing aid helps you communicate rather than
drift off into your own world.
the proper price for that? The marketplace is still deciding.
BEGIN OPTIONAL TRIM)
hearing aids online has advantages — but it’s not for
worn a hearing aid for nearly four decades, and I cannot
imagine life without one.
pricey devices keep getting more expensive. My current model,
bought from a trained professional called an audiologist, cost
make sense to save money by ordering my next one online?
cardboard box arrived in late November from Wilmington,
Del.-based Embrace Hearing, holding what I hoped would be the
was the X-Mini, an aptly named model about the size of a
kidney bean. It was packed with electronics and features
similar to what I have in my old hearing aid, yet it sells for
away I hit a small roadblock. I was not entirely sure how to
put it on.
minutes after I sent a question via e-mail, the company
responded with helpful guidance, and I was on my way.
X-Mini worked well.
sound was a bit metallic the first few times I wore it, but a
new hearing aid often sounds a bit unnatural, regardless of
where it is bought. The brain may need a few days to adjust to
a given device.
more, it was the first time I had tried a hearing aid that
fits into the ear canal by means of a "dome" — a
small, plastic cone that fits any adult-sized ear, rather than
the traditional, custom-fit earmold.
an hour of turning on the X-Mini for the first time, I put it
to the ultimate test: lunch in Philadelphia’s Chinatown.
with a hearing loss will tell you that restaurants can be a
challenge, and this one, a crowded hole-in-the-wall with no
carpet or wall hangings to absorb noise, was a killer. Between
the clatter of kitchenware and the chatter of fellow diners, I
was prepared to miss some of my lunch partner’s
worry. I simply pressed a button on a remote control, thereby
putting the X-Mini into "speech beam" mode.
two things. The rear-facing microphone was turned off, so I
could focus on the sound coming through the forward-facing
microphone. And for that front-facing mike, the frequencies
associated with speech were pumped up while other kinds of
sounds were tamped down a bit.
digital hearing aids, including my old one, have similar
features. My version of the X-Mini had five other settings,
including one for music.
should everyone buy online?
opinion, no. If the person is fairly tech-savvy and likes to
figure things out, then sure.
the wearer is older and requires lots of hand-holding, buying
a hearing aid online could lead to frustration and ultimately
a refusal to wear it. Hearing aids are tricky if you have
never worn one, and an audiologist can teach strategies for
getting the most out of them.
patients, because of the nature of their hearing loss, will
need multiple follow-up adjustments to their devices. Embrace
Hearing offers to adjust a hearing aid if you mail it back,
but that could be a hassle.
my X-Mini did not need any modification. I had sent the
company the results of my most recent hearing test in advance,
and they programmed the hearing aid to amplify sound at
various frequencies by whatever amount I needed.
company allowed me to wear the X-Mini on a trial basis for a
few weeks, and now I’m back to my old one, made by a firm
called Oticon, which I got from Main Line Audiology and like
not sure what I’ll do when it’s time to buy a new hearing
aid in a few years. Rest assured you will never find me
STORY CAN END HERE)
have traditionally sold most hearing aids. Some lower-cost
options have emerged, though not always with the same level of
service. Here are prices for a pair of high-end devices by
includes extensive service, such as programming, training, and
upkeep for up to 3 years
"unbundled" audiology practice: $4,000
charges separate fees for service plan, so patients are not
daunted by a large up-front price.
store’s aids are made by major manufacturers, and price
includes unlimited follow-up care. But most of its dispensers
are not audiologists, and are not required to have nearly as
online retailer mails hearing aids to the patient. Adjustments
are free, though the patient has to send the device back. If
in-person help is needed, the company will contact
audiologists who charge an extra fee.
can be ordered by phone or online. Patients insured by
UnitedHealthcare, a sister company, pay even less. In-person
service available from contracted providers; the nearest is in
devices are worn in the ear and make sounds louder, but are
less sophisticated than hearing aids, and the FDA does not
allow them to be marketed as such.