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| The Medical Tech that Helps You When Your Doctor Can’t | The Medical Tech that Helps You When Your Doctor Can’t |
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| You (or your employer) pay for health insurance every month. In exchange, you assume that if you have any health-related needs, they’ll be covered. Yet there are gaps in the system that your provider may not want to pay for. Now, a wave of medical start-ups want to fill in those gaps. | You (or your employer) pay for health insurance every month. In exchange, you assume that if you have any health-related needs, they’ll be covered. Yet there are gaps in the system that your provider may not want to pay for. Now, a wave of medical start-ups want to fill in those gaps. |
| As Silicon Valley looks for the next big thing to pour money into, health care looks like an increasingly tantalizing field. According to Forbes, more than $2.8 billion worth of venture capital was invested in health care start-ups in September 2018 alone. An increase of 70 percent over the previous year. | As Silicon Valley looks for the next big thing to pour money into, health care looks like an increasingly tantalizing field. According to Forbes, more than $2.8 billion worth of venture capital was invested in health care start-ups in September 2018 alone. An increase of 70 percent over the previous year. |
| It’s not hard to understand why, either. Especially in the United States, the health care you get from your insurance provider is hardly as comprehensive as it could be. If you get injured or sick, a doctor might be able to take care of you, but for day-to-day health problems, there’s a lot to be desired. | It’s not hard to understand why, either. Especially in the United States, the health care you get from your insurance provider is hardly as comprehensive as it could be. If you get injured or sick, a doctor might be able to take care of you, but for day-to-day health problems, there’s a lot to be desired. |
| For example, in the United States, hearing aids are rarely covered by health insurance. While 48 million people in the country suffer from some form of hearing loss according to the Hearing Loss Association of America, insurance providers do not consider it a vital issue unless it occurs at a young age. As you get older, your hearing deteriorates. As far as your insurance provider is concerned, it’s not worth paying to fix. | |
| If you choose to get a hearing aid, most insurance companies consider this an elective procedure — like choosing to get plastic surgery — and won’t cover it. You’ll also have to go through a lengthy process of seeing your general practitioner, who will refer you to an ENT (ear, nose and throat) specialist, who then works in conjunction with an audiologist to determine if you should buy a hearing aid. | If you choose to get a hearing aid, most insurance companies consider this an elective procedure — like choosing to get plastic surgery — and won’t cover it. You’ll also have to go through a lengthy process of seeing your general practitioner, who will refer you to an ENT (ear, nose and throat) specialist, who then works in conjunction with an audiologist to determine if you should buy a hearing aid. |
| Once you get through that long, arduous process, the bill comes due. According to a study by the National Academies of Sciences, Engineering and Medicine, the average cost for a pair of hearing aids is $4,700, or about $2,350 per ear. A mere six companies make up 98% of the worldwide hearing aid market. Assuming your doctor even prescribes a hearing aid to begin with, you don’t have many accessible options. | Once you get through that long, arduous process, the bill comes due. According to a study by the National Academies of Sciences, Engineering and Medicine, the average cost for a pair of hearing aids is $4,700, or about $2,350 per ear. A mere six companies make up 98% of the worldwide hearing aid market. Assuming your doctor even prescribes a hearing aid to begin with, you don’t have many accessible options. |
| Eargo, a new company that walks the line between medical firm and tech start-up, wants to be one of those options, and wants to make the process easier. | Eargo, a new company that walks the line between medical firm and tech start-up, wants to be one of those options, and wants to make the process easier. |
| Eargo sells a pair of hearing aids for $1,450. You can buy them directly from the company’s website. The Eargo Max, boasts better audio quality and improved noise reduction for $2,150 per pair, and the Eargo Neo, their premium product, offers the company’s best audio quality, a more comfortable design, and fast-charging for $2,550 per pair. Even the upgraded model is around half the cost of traditional, bulkier hearing aids you may picture when you think of what hearing aids look like. If you’re (understandably) unsure about buying a hearing aid from the internet, the company offers a 45-day trial period to see if Eargo works for you. | Eargo sells a pair of hearing aids for $1,450. You can buy them directly from the company’s website. The Eargo Max, boasts better audio quality and improved noise reduction for $2,150 per pair, and the Eargo Neo, their premium product, offers the company’s best audio quality, a more comfortable design, and fast-charging for $2,550 per pair. Even the upgraded model is around half the cost of traditional, bulkier hearing aids you may picture when you think of what hearing aids look like. If you’re (understandably) unsure about buying a hearing aid from the internet, the company offers a 45-day trial period to see if Eargo works for you. |
| Unlike other over-the-counter personal sound amplifiers — which legally can’t be labeled hearing aids — the Eargo models are certified as Class 1 medical devices by the Food and Drug Administration (FDA) for treatment of light to moderate hearing loss. The company’s support team consists of hearing aid dispensers licensed in one or more states to advise customers on their hearing aid needs. Because Eargo sells its products online, rather than in physical stores, a dispenser that’s licensed in one state can sell to customers in all of them. | Unlike other over-the-counter personal sound amplifiers — which legally can’t be labeled hearing aids — the Eargo models are certified as Class 1 medical devices by the Food and Drug Administration (FDA) for treatment of light to moderate hearing loss. The company’s support team consists of hearing aid dispensers licensed in one or more states to advise customers on their hearing aid needs. Because Eargo sells its products online, rather than in physical stores, a dispenser that’s licensed in one state can sell to customers in all of them. |
| Eargo’s chief executive, Christian Gormsen, argues that this makes more sense than the current model he describes as “archaic,” where dispensers are licensed by state-level boards and can only operate within their state. “I believe in a professional that’s certified. I don’t care whether that person is certified in California or Colorado … It’s like saying you can’t drive your car outside the state where you got your driver’s license. It doesn’t make any sense.” | Eargo’s chief executive, Christian Gormsen, argues that this makes more sense than the current model he describes as “archaic,” where dispensers are licensed by state-level boards and can only operate within their state. “I believe in a professional that’s certified. I don’t care whether that person is certified in California or Colorado … It’s like saying you can’t drive your car outside the state where you got your driver’s license. It doesn’t make any sense.” |
| However, going around your doctor presents the problem of financing. Insurance companies rarely pay for hearing aids to begin with, but even at a comparatively low price, around $2,000 is not always an easy chunk of change to drop. Especially for seniors who may be on a fixed income, or patients who rely on their employer-provided Medicare, Medicaid or disability insurance to cover medical expenses. Like most hearing aids, you can ask your insurance providers if you can get reimbursed for a pair of Eargo hearing aids, but it’s unlikely to be covered. The expense will have to come out of your own pocket. | However, going around your doctor presents the problem of financing. Insurance companies rarely pay for hearing aids to begin with, but even at a comparatively low price, around $2,000 is not always an easy chunk of change to drop. Especially for seniors who may be on a fixed income, or patients who rely on their employer-provided Medicare, Medicaid or disability insurance to cover medical expenses. Like most hearing aids, you can ask your insurance providers if you can get reimbursed for a pair of Eargo hearing aids, but it’s unlikely to be covered. The expense will have to come out of your own pocket. |
| To help ease the burden, Eargo partners with both CareCredit and Synchrony to offer financing deals, often without interest if you pay it off over a relatively short time frame. In a 24-month financing deal, for example, the Eargo Max would cost a little over $100 a month, which is easier to stomach than the lump sum all at once. It’s still a lot of money, and you don’t get assistance paying for it, but financing options at least mean it doesn’t hit quite as hard. | To help ease the burden, Eargo partners with both CareCredit and Synchrony to offer financing deals, often without interest if you pay it off over a relatively short time frame. In a 24-month financing deal, for example, the Eargo Max would cost a little over $100 a month, which is easier to stomach than the lump sum all at once. It’s still a lot of money, and you don’t get assistance paying for it, but financing options at least mean it doesn’t hit quite as hard. |
| For severe hearing loss, Mr. Gormsen believes specialists will always have their place. “If we suspect there is too much hearing loss … we will always advise them to contact a specialist.” However, millions live with such minor to moderate hearing loss that it goes untreated — and uncovered by your insurance — until it gets worse. “The fundamental challenge of this industry is the stigma and if we stay medical I think our likelihood of impacting that stigma is going to be tough,” Mr. Gormsen said. | For severe hearing loss, Mr. Gormsen believes specialists will always have their place. “If we suspect there is too much hearing loss … we will always advise them to contact a specialist.” However, millions live with such minor to moderate hearing loss that it goes untreated — and uncovered by your insurance — until it gets worse. “The fundamental challenge of this industry is the stigma and if we stay medical I think our likelihood of impacting that stigma is going to be tough,” Mr. Gormsen said. |
| For most customers, Eargo eventually envisions that shopping for a hearing aid would look more like buying a phone than the more rigorous (but also time consuming) search for a medical device. “We’ve been talking to the likes of Best Buy or so on where maybe you go and talk to a blue shirt and then a blue shirt could show you how the product works. And we could train them.” | For most customers, Eargo eventually envisions that shopping for a hearing aid would look more like buying a phone than the more rigorous (but also time consuming) search for a medical device. “We’ve been talking to the likes of Best Buy or so on where maybe you go and talk to a blue shirt and then a blue shirt could show you how the product works. And we could train them.” |
| Modern Fertility is another company aiming to fill in a crack in our modern health care system. For $159, the company offers a fertility test that can help women who are trying to get pregnant — or may want to in the future — find out more about their fertility and plan ahead. It sounds like exactly the kind of basic test you could ask your OB-GYN for. | Modern Fertility is another company aiming to fill in a crack in our modern health care system. For $159, the company offers a fertility test that can help women who are trying to get pregnant — or may want to in the future — find out more about their fertility and plan ahead. It sounds like exactly the kind of basic test you could ask your OB-GYN for. |
| The reality is far more complicated. | The reality is far more complicated. |
| As Modern Fertility co-founder and chief executive Afton Vechery explained, “There’s no such thing as ‘fertility’ in the medical system today. There’s only infertility … Infertility means you have to be trying for between nine and 12 months, dependent on your age,” she said. At that point, a small number of states might recognize a legitimate concern. | As Modern Fertility co-founder and chief executive Afton Vechery explained, “There’s no such thing as ‘fertility’ in the medical system today. There’s only infertility … Infertility means you have to be trying for between nine and 12 months, dependent on your age,” she said. At that point, a small number of states might recognize a legitimate concern. |
| “Then, and only then might this testing be reimbursed,” she said. Otherwise, you’re on your own. | “Then, and only then might this testing be reimbursed,” she said. Otherwise, you’re on your own. |
| In other words, if you’re getting close to your 30s and you want to get information about your own body to plan ahead, your insurer doesn’t think that’s worth paying for. As Ms. Vechery herself found out, you can still get the testing done, but you’ll pay for it in both time and money. “Finding the time to get off work to get that testing done, going back in to my doctor, getting it interpreted, it was incredibly empowering after I got that information. But then I got a bill in the mail a few weeks later for $1,500,” she explained. | In other words, if you’re getting close to your 30s and you want to get information about your own body to plan ahead, your insurer doesn’t think that’s worth paying for. As Ms. Vechery herself found out, you can still get the testing done, but you’ll pay for it in both time and money. “Finding the time to get off work to get that testing done, going back in to my doctor, getting it interpreted, it was incredibly empowering after I got that information. But then I got a bill in the mail a few weeks later for $1,500,” she explained. |
| She started Modern Fertility to make that process accessible to everyone. The test that the company performs is the same FDA-approved test you would get at an infertility clinic, without having to go through your medical provider. You can either visit a Quest Diagnostics location to have blood drawn, or get a kit with a finger prick test. | She started Modern Fertility to make that process accessible to everyone. The test that the company performs is the same FDA-approved test you would get at an infertility clinic, without having to go through your medical provider. You can either visit a Quest Diagnostics location to have blood drawn, or get a kit with a finger prick test. |
| After your test is analyzed, Modern Fertility will pair you with an infertility nurse for a one-on-one consultation that the company employs, as part of its package so you can get a breakdown of what your test means. However, as Ms. Vechery acknowledged, your doctor or regular OB-GYN should still absolutely be part of the process. “All of our results are meant to be shared with a woman’s physician to help inform that conversation.” | After your test is analyzed, Modern Fertility will pair you with an infertility nurse for a one-on-one consultation that the company employs, as part of its package so you can get a breakdown of what your test means. However, as Ms. Vechery acknowledged, your doctor or regular OB-GYN should still absolutely be part of the process. “All of our results are meant to be shared with a woman’s physician to help inform that conversation.” |
| To help pay for the test, the company has made sure it’s Flexible Spending Account (FSA) and Health Spending Account (HSA) eligible. Your insurance provider might not pay for it, but if you’ve set aside some pretax money to spend on medical expenditures, then you can spend it on Modern Fertility’s kit. It’s extremely unlikely that your insurance will cover a test of this kind, but at least you can use your own pretax money to pay for it. | To help pay for the test, the company has made sure it’s Flexible Spending Account (FSA) and Health Spending Account (HSA) eligible. Your insurance provider might not pay for it, but if you’ve set aside some pretax money to spend on medical expenditures, then you can spend it on Modern Fertility’s kit. It’s extremely unlikely that your insurance will cover a test of this kind, but at least you can use your own pretax money to pay for it. |
| The cruel irony in the current system is that you can’t test your fertility until you’ve already proven that you can’t have a child. Which, in turn, you can’t find out until you start trying to have a child to begin with. | The cruel irony in the current system is that you can’t test your fertility until you’ve already proven that you can’t have a child. Which, in turn, you can’t find out until you start trying to have a child to begin with. |
| Unfortunately, gaps in the American health care system that companies like these are trying to fill are common, and they leave patients searching for solutions while simultaneously offering entrepreneurs new opportunities. Paying for devices and services piecemeal from independent companies is hardly ideal (in fact, it’s part of the reason we have health care providers to begin with), but for now, at least some companies are trying to take up the slack. | Unfortunately, gaps in the American health care system that companies like these are trying to fill are common, and they leave patients searching for solutions while simultaneously offering entrepreneurs new opportunities. Paying for devices and services piecemeal from independent companies is hardly ideal (in fact, it’s part of the reason we have health care providers to begin with), but for now, at least some companies are trying to take up the slack. |