united health insurance pays 100%

[jackpell]

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?

[jay_man2]

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.

[jackpell]

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.

[jay_man2]

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.

[Statos]

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 .
Thanks!

[roberthamden]

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.

[dfarrell8]

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?

[Statos]

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 :)

[Brad]

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.

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.

[dr.amy]

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

[tinkroper]

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.

[jrowles]

Hi
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

[dr.amy]

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

[tnleafer]

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?

[DocAudio]

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.

[boylbm]

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.

[CarScott]

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?
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.

[jackpell]

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.

[jackpell]

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

[John59]

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.:)

[Normandy]

The benefits from any insurance provider is based on the specific contract between the insurance company and the employer. There any number of benefits or benefit levels that the employer may purchase / provide within the insurance policy. The more and better benefits, the higher premium cost to the employer. It has been my experience that coverage for hearing aids (http://www.hearsource.com/index.html) is few and far between in insurance policies. Today, any hearing aid benefit is a blessing.

[663518]

Try government recognized insurance company would be the great option for insurance. They have great insurance plans which are really legit and profitable too.

[molly88]

seems to be to good to be real... we will see in the near future.

[skunker]

Can someone confirm that United Health Care is indeed paying 100% for hearing aids for the 2012 season? I have read elsewhere in this forum that there's a catch--you have to buy their specific aids. I need to know before I enroll with UHC. Thanks!

[me75006]

Can someone confirm that United Health Care is indeed paying 100% for hearing aids for the 2012 season? I have read elsewhere in this forum that there's a catch--you have to buy their specific aids. I need to know before I enroll with UHC. Thanks!

sent you a pm concerning my uhc / HA coverage. its a url to a post I made. This board won't let me post url's yet :rolleyes:

[skunker]

Just a note that I called them on this and they said they are going to fast track it to management and get me an answer tomorrow. The rep on the phone said they pay 100%...but she said she would call me back with more info. Will report back.

If not, Blue Cross is doing $1250 per ear, so I may go with them.

[prodigyplace]

Just a note that I called them on this and they said they are going to fast track it to management and get me an answer tomorrow. The rep on the phone said they pay 100%...but she said she would call me back with more info. Will report back.

If not, Blue Cross is doing $1250 per ear, so I may go with them.
Really? What plan? I have Anthem Blue Cross (Keycare 300) and they only pay for the hearing test, not for aids.

[skunker]

Really? What plan? I have Anthem Blue Cross (Keycare 300) and they only pay for the hearing test, not for aids.

I have Blue Cross (Basic version) from my employer, a federal agency. Perhaps that is why.

[skunker]

Hi all,
I have an update. I finally spoke to UHC about the 100% hearing aid coverage and they told me that it is correct, however, they only pay for ONE aid (not both ears) and you have to go through EPIC HEARING.

Currently, my employer plan pays $1250 per aid, but even if UHC paid 100% of one aid, it may still be cheaper to go with UHC. I don't know anything about Epic Hearing, but they claim that they sell brand names and not a private label version.

Does anyone know more?

[DocAudio]

I have Blue Cross (Basic version) from my employer, a federal agency. Perhaps that is why.

Federal employees BC/BS has a $1000/aid benefit.

[skunker]

Federal employees BC/BS has a $1000/aid benefit.

For 2011, yes. But for 2012 it has been bumped up to $1250 which is very helpful.

[DocAudio]

For 2011, yes. But for 2012 it has been bumped up to $1250 which is very helpful.

That's good to know! I run across patients with this every now and then...

[vespa]

I am actually quite stunned at some the hassle and the cost of hearing aids. I don't know why the US hadn't gone down the socialised healthcare route as has Canada, the UK National Health Service is socialised and any service you get is free, without question with pre condition or cost except your taxes of courses.

[prodigyplace]

I am actually quite stunned at some the hassle and the cost of hearing aids. I don't know why the US hadn't gone down the socialised healthcare route as has Canada, the UK National Health Service is socialised and any service you get is free, without question with pre condition or cost except your taxes of courses.
The private health insurance would not allow our government to even consider a government health insurance option during the recent Health Care law reform.

The insurance companies lobby the government and make larger campaign donations to insure the laws that get passed benefit their businesses.

[vespa]

I feel for you guys, I liked America having been there 7 times on several road trips, the countryside, national parks are a wonder and found the people to be welcoming and helpful, but I am not keen on the system that operate in your country that only benefits the top 5%, maybe you should reconsider that decision to break from the British Empire :)

[MWP]

I have United Health Care. After my ENT examined me, he sent me to his Audi to look at hearing aids. She warned me about the hassles of insurance. So, I called United Health twice and talked to different people and they both gave me the same answer.

With an out-of-network provider, I have a $6,000 deductible and then they pay 70% of the balance.

With a preferred provider my deductible was $3,000 (our company HSA deductible) and then they would pay 90% up to $2,500 United contribution - the rest was mine. In my city there is only one Preferred Provider - HearingLife - which has offices around the country. They supply Sonic HAs (Oticon). Under their arrangement, they work with Epic, an insurance claim company - to handle the paperwork. As a Preferred Provider, they must discount to the Insurance Company in the same way that Doctors' offices do. Epic handles the claim, and I pay them my out of pocket amount, and they pay the Audi. The Audi is able to deliver the HAs based on the eligibility statement provided by Epic. The Audi says they are slow sometimes, but they always pay, so it doesn't slow down my process.

I have a pair of Sonics on order with a fitting on January 6. I talked to the folks at Epic and they are a go. However, we're delaying the transaction until January 3, when I'll give them a credit card for my out of pocket (from my HSA account). That way my entire 2012 medical deduction will be met and my insurance coverage is in place for the rest of the year. So, with the $3,000 out of pocket paid on the 3rd, I get full coverage for the year - so I'll actually be out much less than the $3k I'm paying up front.

My Audi, United and Epic have been very easy to deal with. It is imperative that you communicate with your insurance company in advance and find out who their preferred providers are. Then contact the Audi and communicate your insurance information immediately. I'm going to end up paying over $3,000 LESS because I had all of the communication in order before the order was placed for my HA. I still get the 45 day money back guarantee. BTW, coverage does not extend to remotes or bluetooth devices, just the hearing aids.

My choice in hearing aids is limited, but the insurance part of it is doable. Just check it out first - and make sure everyone is on the same page.

Mark

[Mick Shu]

Can someone confirm that United Health Care is indeed paying 100% for hearing aids for the 2012 season?

what any insurance provider will pay depends on what your company negotiated when they got their plan rates. You just have to play the game and know the rules. Read your companies benefits paperwork. then go to your HR/Benefits dept and talk to someone. this should get the the person/persons name at the insurance company assigned to your company. Then get a hold of them and explain the whole deal again and see if their response aligns with your HR peoples. Document every conversation. Understand what they will pay and your deductible. If you plan to have other expenses this year you need to add things up. What ever you need to pay use your FSA account and at least pay with pre-tax money. Our company would let you use the total amount you declared on Jan 1 (little secret if you do and get canned before the end of the year it's their lost not yours).

[prodigyplace]

I hope you do not expect a reply. You are answering a spam-bot.

[corey]

http://en.wikipedia.org/wiki/Ponzi_scheme

Haven't you noticed how long it takes for the insurance to actually pay out? bigger the payout the longer it usually takes.

it isn't the paper work for the reason of the payment delay. The paperwork is the tactic used to delay payment till they actually get the money together from the current people paying premiums.

I know from personal experience Had a insurance claim for 45,000 for heart surgery. The law says pay in 30 days but there is a loophole as long as you request new piece of info the insurance company gets another 30 days till they have to pay. They keep asking for new info piece meal and my insurance company put it off for a year before paying and stuck me with 5000+ debt with 7 years of bad credit for not paying on time the first 30 days. Was waiting for insurance to pay so I could file for charity assistance. Can't file for charity till after insurance pays. Thus the 7 years of bad credit. At the time was extreme poverty so couldn't even pay 5$ just to keep medical institution of my back till insurance actually paid.


See insurance company had pocketed all the profit not paid out up to that point. The money used to pay my claim was collected over the year from current paying premiums of clients. Thus its a ponzi scheme.

The getting new pieces of info was a delay tactic to circumvent the 30 day pay requirement.

point is if they wait the full 30 days or more to pay it is most likely a ponzi scheme.

An Honest insurance company would have a large cash holdings in a bank account to pay on claims. thus they don't need a lot of time to pay on time.

by the way the ponzi scheme insurance I had was one for contract for USA government. private contractor. Not a government insurance plan.

core of insurance profit comes from NOT PAYING LEGIT/non-legit CLAIMS.

So if you actually have the money don't mess with the insurance companies. They will just ruin your credit.

right now I am actually on government insurance and as far as I know they haven't delayed payment. At least hospitals never been coming after me hee hee.

[corey]

I have United Health Care. After my ENT examined me, he sent me to his Audi to look at hearing aids. She warned me about the hassles of insurance. So, I called United Health twice and talked to different people and they both gave me the same answer.

With an out-of-network provider, I have a $6,000 deductible and then they pay 70% of the balance.

With a preferred provider my deductible was $3,000 (our company HSA deductible) and then they would pay 90% up to $2,500 United contribution - the rest was mine. In my city there is only one Preferred Provider - HearingLife - which has offices around the country. They supply Sonic HAs (Oticon). Under their arrangement, they work with Epic, an insurance claim company - to handle the paperwork. As a Preferred Provider, they must discount to the Insurance Company in the same way that Doctors' offices do. Epic handles the claim, and I pay them my out of pocket amount, and they pay the Audi. The Audi is able to deliver the HAs based on the eligibility statement provided by Epic. The Audi says they are slow sometimes, but they always pay, so it doesn't slow down my process.

I have a pair of Sonics on order with a fitting on January 6. I talked to the folks at Epic and they are a go. However, we're delaying the transaction until January 3, when I'll give them a credit card for my out of pocket (from my HSA account). That way my entire 2012 medical deduction will be met and my insurance coverage is in place for the rest of the year. So, with the $3,000 out of pocket paid on the 3rd, I get full coverage for the year - so I'll actually be out much less than the $3k I'm paying up front.

My Audi, United and Epic have been very easy to deal with. It is imperative that you communicate with your insurance company in advance and find out who their preferred providers are. Then contact the Audi and communicate your insurance information immediately. I'm going to end up paying over $3,000 LESS because I had all of the communication in order before the order was placed for my HA. I still get the 45 day money back guarantee. BTW, coverage does not extend to remotes or bluetooth devices, just the hearing aids.

My choice in hearing aids is limited, but the insurance part of it is doable. Just check it out first - and make sure everyone is on the same page.

Mark

If I am reading this right a set of aids that cost $12,000 non-network you would pay 6000$+(30% of $6000)= $7800 paid by you as long as you haven't used insurance for anything else.

a set of aids costing 12,000 through preferred would be 3000+((12,000-3000)-2500)= $9500

either something with your description is off or you got scammed.

I am going to assume you got it right Because I can see the scam right off the back.

They are using the 3000$ deductible vs the 6000 deductible and the 90% to "WOW" you in to thinking your getting a sweet deal. at first glance I almost thought it was a deal till I actually ran the numbers.

see the 90% is pure mis-direction 90% alone is out of context which is easy to do in that they pay 90% but what your over looking is when its in context they are in actuality paying maximum 2500$ and no more.

what isn't specified in your description is whether you get to use the 90% up to 2500 for each claim. or if its a one time deal for the whole year.

know the deductible is a one time deal for year.

What I am curious about if you paid the 6000 deductible for non preferred would you also have to pay the 3000 preferred? If you did you got scammed twice in the same plan. But not enough info provided to confirm

The second scam would be related to the 7800$ non-preferred vs the 9500 preferred on first use in that by forcing you to pay both deductibles you can't save money by going to non preferred buyer right off as first claim. If you went non prefered first and they made you pay the preffered deductible on the second claim as well then you lost the 1500$ and got penilized for trying to save money by going non preferred the first time around.

if you didn't have to pay both deductibles then you save 1700$ first time. if the claim was $12,000

My numbers are entirely based on your info given so far If there is something you haven't shared like whether if you went non preferred first would you have to pay the preferred deductible too. on the second claim.

What you left out will determine if it turns your insurance in to a NON-SCAM

As it stands The numbers say you got SCAMMED based on what is the info you have given so far.

no matter how you run the numbers they will nail you. its kind of like the probability game but the its set to favor house at all times to maximize profits. They have mathimaticians sit down and crunch these numbers so that way no matter how you work the preferred and non preferred the house comes out ahead.

[corey]

providers don't trust insurance because they know most of them are ponzi schemes.

That is one of the big reasons for the advance pay to ensure that the provider doesn't get duped by the insurance if the panzi scheme balks at lost profits and decides not to pay on time.

providers forbidden to say if insurance is ponzi scheme because insurance will nail them for hearsay and libel, even when the provider is telling the truth. lack of physical proof in hand is the insurance excuse for the libel charge. I don't think number crunching is considered proof to show the variables and etc that are classic footprints of the ponzi scheme.

[Big Al]

I am a first time Hearing Aid purchaser, and the process has been quite fascinating. I have United Health Care in Florida, and can only use their benefit in network. My benefit is up to $10,000, every three years, and I am responsible for a ten percent copay and my deductible.

I found an ENT and an audiologist in network, but their office told me that they have no contracts with any insurance companies for HA's. That was technically correct, but they didn't give me the workaround.

I also called UHC about this to find a network provider. First, they couldn't explain why my ENT and audi were in network for all of my testing, but not for providing the HA's. I was very disappointed, because I already have a lot of confidence in my ENT and my audi.

When you call UHC asking for a network provider, I was instructed to search for DME companies and then call each one to see of they do HA's. Of course, none of them do. That was a wild goose chase.

When I finally got to a "supervisor," she mentioned that EPIC was the only UHC in network provider. Since the benefit is so large, I decided to use EPIC, but I entered into the relationship very skeptically. I am pleased to report that there seems to be nothing to worry about.

EPIC carries all of the major brands and models, far beyond the capability of any single audiologist. There is some initial paperwork and pre-authorization, but so far it has been painless. EPIC handles all of the financial portion of the transaction. I am expected to pay my deductible, and the ten percent co-pay in advance. Then they will order the HA's and ship them to the audi for fitting etc.

I am unaware of any limits placed by EPIC on my audi, other than justifying that the HA's are medically necessary. So far I have been very pleased with EPIC. If that changes, I will certainly post an update.

The only problem that I have had is getting information about EPIC from UHC and from my audi. Once I got that, everything since has been smooth sailing.

I am interested whether providers are happy or unhappy with EPIC. It seems like an unnecessary intermediary for them. On the other hand, I guess the benefit to UHC is consistency in price; they only to negotiate with one provider.

[Don]

It would be interesting to hear the price from Epic on the specific model recommended. How much is the deductible?

[SweetCheeks]

if your aids via EPIC are $6000, then you would pay $600 plus your deductible which is ? The deductible is for aids or for your total health care cycle? Both could be paid out of FSA funds.

[Big Al]

My copay is 10% with my plan, so $6000 aids would be a $600 co-pay. I have a $350 deductible, but I have already used that, so my cost for HA's will be just 10% of the total cost of the HA's.
I will gladly post the EPIC price in this thread when I receive it, as well as any negatives in dealing with them.

[Cosmo]

EPIC is a good program if you have to use them for your insurance benefit. True they use all labs, however each office will limit it to what they fit. There prices are competitive. It would be fairer if UHC would let the member choose where they want to go and take the benefit with them.

[Don]

My copay is 10% with my plan, so $6000 aids would be a $600 co-pay. I have a $350 deductible, but I have already used that, so my cost for HA's will be just 10% of the total cost of the HA's.
I will gladly post the EPIC price in this thread when I receive it, as well as any negatives in dealing with them.

Sounds good! Yes, let us know how it turns out.

[Pleiades]

I am a first time Hearing Aid purchaser, and the process has been quite fascinating. I have United Health Care in Florida, and can only use their benefit in network. My benefit is up to $10,000, every three years, and I am responsible for a ten percent copay and my deductible.

I found an ENT and an audiologist in network, but their office told me that they have no contracts with any insurance companies for HA's. That was technically correct, but they didn't give me the workaround.

I also called UHC about this to find a network provider. First, they couldn't explain why my ENT and audi were in network for all of my testing, but not for providing the HA's. I was very disappointed, because I already have a lot of confidence in my ENT and my audi.

When you call UHC asking for a network provider, I was instructed to search for DME companies and then call each one to see of they do HA's. Of course, none of them do. That was a wild goose chase.

When I finally got to a "supervisor," she mentioned that EPIC was the only UHC in network provider. Since the benefit is so large, I decided to use EPIC, but I entered into the relationship very skeptically. I am pleased to report that there seems to be nothing to worry about.

EPIC carries all of the major brands and models, far beyond the capability of any single audiologist. There is some initial paperwork and pre-authorization, but so far it has been painless. EPIC handles all of the financial portion of the transaction. I am expected to pay my deductible, and the ten percent co-pay in advance. Then they will order the HA's and ship them to the audi for fitting etc.

I am unaware of any limits placed by EPIC on my audi, other than justifying that the HA's are medically necessary. So far I have been very pleased with EPIC. If that changes, I will certainly post an update.

The only problem that I have had is getting information about EPIC from UHC and from my audi. Once I got that, everything since has been smooth sailing.

I am interested whether providers are happy or unhappy with EPIC. It seems like an unnecessary intermediary for them. On the other hand, I guess the benefit to UHC is consistency in price; they only to negotiate with one provider.

Big Al, I am very interested in learning more about your experience. I am also a first time hearing aid purchaser with United Health Care in Florida. I recently purchased hearing aids from the hearing instrument specialist in my ENT's office. They told me I'd need to file directly with United to get reimbursed, that they wouldn't do it on my behalf. When I called United this week to find out the process for doing that, I learned that even though the ENT is in network with United, the hearing instrument specialist is not. This puzzled me since they share the same office space, but apparently it is not uncommon. Since I have no out of network benefits, I'm going to have to return the hearing aids (still within my 30-day trial period) and start over elsewhere. I don't know where to begin to look to find someplace that United will cover. Can you provide any additional details about EPIC? Thank you!

[Big Al]

Big Al, I am very interested in learning more about your experience. I am also a first time hearing aid purchaser with United Health Care in Florida. I recently purchased hearing aids from the hearing instrument specialist in my ENT's office. They told me I'd need to file directly with United to get reimbursed, that they wouldn't do it on my behalf. When I called United this week to find out the process for doing that, I learned that even though the ENT is in network with United, the hearing instrument specialist is not. This puzzled me since they share the same office space, but apparently it is not uncommon. Since I have no out of network benefits, I'm going to have to return the hearing aids (still within my 30-day trial period) and start over elsewhere. I don't know where to begin to look to find someplace that United will cover. Can you provide any additional details about EPIC? Thank you!

I'll be happy to tell you what I know, although it may be incomplete and I can't vouch for accuracy. I was told the same thing by my ENT's office, and while that was technically true, there MAY be a way around that.

I was told by UHC that EPIC is their only in network hearing aid provider. Since EPIC is a national company, carries all of the major brands and models, has a lot of ENT offices in network, it is not as bad as it first sounded.

The best thing for you to do is call EPIC first, and see whether your ENT's hearing instrument specialist is in their network. Mine was, so I was able to keep my ENT and my audiologist. Even the ENT's billing office failed to make the connection between EPIC and UHC.

If your hearing instrument specialist is out of network for EPIC, then you will have to get a list of specialists from EPIC who are in the EPIC network and pick one of them in order to take advantage of your benefit. If you need a referral of an excellent ENT and audi in Boca, I'll be happy to provide it to you.

Another alternative if you live in a remote area with no EPIC provider then you can possibly get GAP coverage, where they will preauthorize a local provider. That depends on your specific situation.

The customer service at EPIC so far has been excellent. When I called them, they first require you to register (a fairly simple process). After that, they will answer all of your questions. Although I am early in the process, I have been very pleased so far.

Here is the EPIC phone number: 866.956.5400. I haven't posted enough to be allowed to post their URL, but you can search for EPIC Healthcare and find it easily.

Feel free to post or PM me with anything else I can help with. I am still learning about HA's and hearing loss. This forum has been a great help and a great find.

And I miss ZCT already.

[adamchrst]

Some of you think you cannot afford a personal health insurance plan. But with all the options available today you just may be surprised. Depending on whether it is a HMO or PPO and the deductible amounts, you will see that at least one plan will fit your budget.

[m0t0rcade]

Hello everyone,

I am a hearing instrument dispenser. Maybe I can help. Someone said we require payment up front because we don't trust United Healthcare to pay. That is absolutely TRUE.

On January 1st, 2010 we had a law in my state that was passed (Arkansas) requiring insurance companies to pay a minimum of $1400 PER EAR every 3 years if you have hearing aid coverage. I thought, "Great! Some of my patients are going to be very pleased to have some of the coverage they need to get better hearing aids."

Wrong. This is an absolute nightmare and it is all because of UHC. I don't have many problems with BCBS, Aetna, etc. Only UHC. 6 months ago I changed my policy to requiring payment up front. As of last week I have just decided I am not going to file period with United Healthcare.

They do not follow the law, they change their story everytime I call to check on a patient's benefits, and they have their system set up for automatic denial. I cannot get someone in their customer service department that can speak English or do anything besides say, "Please resubmit you claim for review" which I do with the same results.

For each patient they do this with I am spending an average of 3-4 hours on the phone with United Healthcare. I don't have the time or energy to deal with those scam artists anymore. And I can't take the losses.

I hope that explains why we can't hand out hearing aids expecting United Healthcare to pay.

[seb]

motorcade,
Forget calling United Healthcare and just call you states insurance commissioner or your states attorney generals office and file a complaint against the insurance co.

[m0t0rcade]

motorcade,
Forget calling United Healthcare and just call you states insurance commissioner or your states attorney generals office and file a complaint against the insurance co.

We are trying to do that right now!

They are almost as hard to deal with as an insurance company though!

Also, when we file our claims with UHC we send in a copy of the state law with that so they are fully aware that they are violating the law.

[seb]

I didn't say it was going to be easy! Any state agency is a pain to deal with. Here in Ca, we are dealing with the state retirement system: my mom passed away in early November and they keep depositing her retirement into her bank account each month and this is after sending them the official death certificate and 3 copies, one each month after receiving notice of the deposit. We should have closed the bank accounts the week she died but we were told not to by the bank and then by the state after the second check was deposited and they told us to wait 6 months! So, on the day after the 6 months is up the accounts are going to be closed weather they have retrieved their money or not.

[jab]

What kind of policy do you have with UHC? Because I have a UHC policy (Med Sup) and the rep said they would pay $500.

[jab]

What kind of h/a does EPIC cover? Or is that the name of a manufacturer? I am new at this, having had my first interaction with a h/a specialist yesterday who gave me prices on a Siemens. She was at Miracle Ear and I told her I was UHC covered. Through this forum I learned I may have coverage and when I called them they said I had $500 coverage but when I got to store, she said I had much more than that and she had a printed out schedule of costs from $5,200 (which she said was normally $7800) to $1990 a pair. This is part of the HearUSA program and she said I was the first person to come in under this program. I am going to look at Costco on the 24th but I don't believe they take insurance. They said Rexton was made by Siemens so I was going to try looking into that. Still confused on manufacturers, providers and my own insurance coverage. Mor ework to do.:(

[seb]

It might be worth a phone call to the insurance Co. to see if you can be reimbursed if you buy from Costco. Someone on this Forum was able to get reimbursed for their HA's purchased at Costco but I can't remember who they were covered with.

[Big Al]

What kind of h/a does EPIC cover? Or is that the name of a manufacturer? I am new at this, having had my first interaction with a h/a specialist yesterday who gave me prices on a Siemens. She was at Miracle Ear and I told her I was UHC covered. Through this forum I learned I may have coverage and when I called them they said I had $500 coverage but when I got to store, she said I had much more than that and she had a printed out schedule of costs from $5,200 (which she said was normally $7800) to $1990 a pair. This is part of the HearUSA program and she said I was the first person to come in under this program. I am going to look at Costco on the 24th but I don't believe they take insurance. They said Rexton was made by Siemens so I was going to try looking into that. Still confused on manufacturers, providers and my own insurance coverage. Mor ework to do.:(

EPIC carries most if not all of the major brands. You have to go through one of their in network audiologists, though, and Costco is not in their network. EPIC has been great to deal with. Call them and they will give you more information. You can ask them specifically whether the aids you are seeking are offered by them, their price, and where to find a network audiologist near you. Here is their number: 1-866-956-5400.