Members of MAC’s Patient Information and Advocacy Committee met with representatives from TruHearing, BCBS and the MAHCP by conference call on September 12, 2017. The purpose of the call was to gain additional information on the upcoming change in benefits pertaining to the Teachers’ Union previously shared with MAC members on August 24, 2017.
As a recap, the hearing aid benefit for MPSERS members currently administered by Blue Cross Blue Shield of Michigan will change and be administered solely by TruHearing effective January 1, 2018.
The meeting provided the following clarifications:
- Applies only to MSPERS members enrolled in Medicare or Non Medicare Plus BCBS of Michigan group plan living in or out of state.
- This change is ONLY BCBS and does NOT affect any other insurance groups (MESSA, Priority Health, BCN)
- BCBS Medicare Advantage PPO have a prefix of XYL, and BCBS non-Medicare PPO members have a prefix of MSR. The group number is 59000 for both
- The contract is final. All changes take place January 1, 2018
- The contract runs through December 31, 2020.
- Members may use existing benefits until the end of the year.
- A Notice of Change in benefits will be sent to members in September by MPSERS.
- Members who contact TruHearing before the end of the year will be scheduled for appointments after December 15th for January dates.
- MSPERS members will be covered under the TruHearing “Select” plan. While new to Michigan this plan has been available in other states.
- Annual Exam co-pay $45 to the provider (no payment to Tru)
- Benefit is 36 months
- There is no longer an option of a completely covered/benefit-paid hearing aid.
- Members may choose between 2 levels of technology.
- The co-pay amount is $499 (Flyte 700) or $799 (Flyte 900) per hearing instrument without exception. (Binaural $998 or $1598 co pay)
- Flyte is a private label product from Resound. (Resound Linx² 7 and Linx² 9)
- Purchase includes 45-day trial, fitting and 2 follow-up appointments, 48 batteries, 3 year warranty.
- Loss and damage is $125 per aid. The provider can charge $125 for reprogramming per occurrence.
- Should the patient require/choose/request any model outside the Flyte 700 or 900, the patient is required to waive their “Select” benefit and choose a model from the TruHearing “Choice Discount” program.
- The provider is responsible to collect payment for the hearing aid and enter in the TruHearing Portal (Echo).
- After the 45 day trial period, the provider is issued a professional fee of $325 (Flyte 700) or $400 (Flyte 900) per aid
- Should a patient need to return an order after fitting, a Return Fee of $125(total) is collected by the provider. Full Co-Pay is refunded by TruHearing to patient after return fee is collected.
The Michigan Audiology Coalition strongly advises members to assess the hourly operational costs of their practice prior to becoming a member of any 3rd party administered health plan. It is also advised the practices establish a written and consistent fee schedule to implement should the practice work with a 3rd party which unbundles the costs.