medcaid or medicare

Frisky Feline

Frisky Feline

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I understand that medicare or medicaid do cover somr of CI.

If you lose your CI so will medicare or medicard help to pay for another CI?
 
Good question. I wouldn't know, but isn't it like any other hearing aid, like you can get a new one every 3 years or so?

Anyone have an answer to Frisky's question?
 
Alex said:
Good question. I wouldn't know, but isn't it like any other hearing aid, like you can get a new one every 3 years or so?

Anyone have an answer to Frisky's question?
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LOL

thanks!!

My hub lost his CI and our insurance refused to pay for it. :mad2: I am curious about medicare and medicaid. If they would be covered it then it is something off about it.
 
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Frisky Feline said:
LOL

thanks!!

My hub lost his CI and our insurance refused to pay for it. :mad2: I am curious about medicare and medicaid. If so, then it is unfair.
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I don't know about replacement, but I do know that Medicare and Medicaid will pay for kids to have two implants. Private insurance won't cover it.
 
I don't know the answer. I am on Medicaid (they won't cover the CI for me, I don't meet their requirements of 40% or worse with the HINT testing portion), and my Medicare starts in November, but don't know much of Medicare's CI coverage policy. No clue what either one does in terms of replacements/upgrades/etc... I think for upgrades, if the former CI processor was old enough and the CI center writes a note of medical necessity, the upgrade will happen. As for replacement, not sure. Has your husband contacted his CI center or CI manufacture about a replacement, informing them insurance won't cover it?
 
i have insurance governement limit strict cochlear implant! otherwise doctor team!

I am honest to hear on my audiology told me mental team work serious!

can't handle to me
audiology is very job reason important powerful!
 
jillio said:
I don't know about replacement, but I do know that Medicare and Medicaid will pay for kids to have two implants. Private insurance won't cover it.
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WHAT? That's kind of effed up. I do think that if a kid has deep profound hearing loss, or poor speech perception with one implant, they should automaticly qualify for bilateral implants. But that seems like it would be open to exploitation. Then again, I bet they're going to crack down majorly b/c of the finincial crisis....
 
medicare

I'm still a minor. But my parents have Medicare because they work at a hospital and their hospital only gives medicare. But I went on a site about medicare and cochlear implants, and I found this:

2. Repair or replacement of cochlear implant device components

Repair or replacement of all cochlear implant device components are a covered benefit under Medicare Part B.

Medicare covers all "supplies that are necessary for the effective us of a prosthetic device", as well as "services necessary to design the device, select materials and components, measure, fit, and align the device, and instructions to the patient [42 CFR 410.11(f)(2)]." For example, fitting and programming of the external components of a cochlear implant are Medicare-covered services, as is aural rehabilitation subsequent to implantation, so long as it is provided outside the 90-day period following surgery (services within 90 days are included in the global payment for the surgical procedure.)

Medicare covers replacements of any item of DMEPOS that has been in continuous use by a beneficiary and is beyond its useful lifetime, or is lost or irreparably damaged. Unless HCFA has established a useful lifetime for an item, Medicare carriers have discretion to set a useful lifetime which is at least five years or greater [42 CFR §414.210(f)].

Medicare requires all cochlear implant manufacturers to enroll in Medicare Part B, and meet all standards for DMEPOS suppliers. As a result, repair or replacement of cochlear implant device components are billed by the manufacturer and not the audiologist (either directly or through the physician). Since January 1, 1996, repair or replacement of the cochlear implant speech processor is billed by the manufacturer using HCPCS code L8619, and currently reimbursed between $5,650 and $7,533 by Medicare according the Part B fee schedule for 2000.

Since January 1, 1996, local Medicare carriers do not cover upgrades to new generation cochlear implant speech processors unless these criteria are met. Replacement speech processors are only covered if the equipment is lost or irreparably damaged.

If a Medicare beneficiary’s device is serviced by a manufacturer, the manufacturer must submit a claim on to Medicare on behalf of the beneficiary within 12 months from the date of service, regardless of the level of service performed, as mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1989 and 1990 [Social Security Act §1848(g)(4)]. The manufacturer may not charge the beneficiary any fee for completing or filing the claims.

The manufacturer may elect to accept assignment and bill the beneficiary the applicable Part B coinsurance. Or it may not accept assignment, and bill the beneficiary up to the limiting charge. However, the manufacturer may not bill the beneficiary a pre-determined flat repair fee regardless of the actual expenses incurred.



hope this helps!
 
I am not sure to answer your question but if you have renters insurance or own your home, house insurance it is a good idea to tell them the serial # and have them list them as property and if you misplace or damage them say in your home you can likely get it covered. Would have never thought of this but my audi told me to do this with my hearing aid and sure enough when it got damaged by my son it was covered!
 
You can still try but most insurances will say you have to have them listed before you can make a claim on them. Doesn't cost extra just have to have them listed.
 
I am only interested in seeing what medicare and medicaid offers compare with the private insurance.

I found it unbelieveable that doctors force parents to have their babies to have CI right away. They totally forget if their kids become adults and can they afford CIs? so For example, My hub decided to get a CI becasue of doctor says that tinnius will reduce so he went for it. The result is that the CI DID NOT reduce his tinnius. He does like CI but he regrets of having CI due to pay the amount of crazy costs for one CI. :roll: He has to pay for batteries, he has to pay for visiting to the audiology and goes on.

I found it so unbelieveable.


again, the bottom line is that i d like to see kids with ci users need to take ASL once they become adults and find themselve cant afford CIs then they have alternative is ASL. :dunno2:
 
Frisky Feline said:
I am only interested in seeing what medicare and medicaid offers compare with the private insurance.

I found it unbelieveable that doctors force parents to have their babies to have CI right away. They totally forget if their kids become adults and can they afford CIs? so For example, My hub decided to get a CI becasue of doctor says that tinnius will reduce so he went for it. The result is that the CI DID NOT reduce his tinnius. He does like CI but he regrets of having CI due to pay the amount of crazy costs for one CI. :roll: He has to pay for batteries, he has to pay for visiting to the audiology and goes on.

I found it so unbelieveable.


again, the bottom line is that i d like to see kids with ci users need to take ASL once they become adults and find themselve cant afford CIs then they have alternative is ASL. :dunno2:
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True dat. There will be a lot of out-of-pocket expenses with CI's. I know many people who regret having them implanted. Just saying.
 
Frisky Feline said:
I am only interested in seeing what medicare and medicaid offers compare with the private insurance.

I found it unbelieveable that doctors force parents to have their babies to have CI right away. They totally forget if their kids become adults and can they afford CIs? so For example, My hub decided to get a CI becasue of doctor says that tinnius will reduce so he went for it. The result is that the CI DID NOT reduce his tinnius. He does like CI but he regrets of having CI due to pay the amount of crazy costs for one CI. :roll: He has to pay for batteries, he has to pay for visiting to the audiology and goes on.

I found it so unbelieveable.


again, the bottom line is that i d like to see kids with ci users need to take ASL once they become adults and find themselve cant afford CIs then they have alternative is ASL. :dunno2:
Click to expand...
Frisky, exactly. You hit it on the head.
CI also = very high out of pocket health care costs. It's a moneymaker.....get kids dependent on a device, and they can't function without it, and the supportive costs are high?
And yes, me too. I really think that if deaf schools and programs offered outreach to dhh oral and hoh kids, like " You can be bilingal and learn ASL" and function both with and without your HA/CI, their enrollment would be BOOMING. And the number of sign off deafies would be tiny LOL.
 
Just checked my Humana Gold Plus plan book for Medicare. they do not cover CI's but will cover HA's, up to $1000 ($500 for each)towards the purchase of approved hearing aids once every 12 months.

When my kids were on Missouri Medicaid, it covered HA's but not CI's. Florida MEdicaid was the same, HA's, but not CI's.
 
Medicare's going to cover 80% of the CI costs for me in March (with Wyo Medicaid kicking in with the remaining 20%).
 
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