The insurance won't cover CI for 5 years son

Foxrac

Well-Known Member
Premium Member
Joined
Mar 23, 2005
Messages
44,482
Reaction score
448
Our five year old son Carson was born with a hearing impairment called Auditory Neuropathy which affects the auditory nerve and has caused him to be legally deaf. We were thrilled to learn from his doctors that with a common surgery called cochlear implants, Carson would start kindergarten with the ability to hear clearly for the first time. However, our insurance provider, Coventry Health Care of Georgia, has a written exclusion for cochlear implants.

The cost of the surgery without insurance is approximately $125,000 per ear- we don’t have that kind of money, and we’re shocked and saddened to learn that Coventry Health Care won’t cover this surgery. We found out that more than 90% of commercial health plans in the country do cover cochlear implant surgery - and Coventry Health Care is one of the largest health care companies in the United States.

For Carson, the surgery would be life changing. When he starts kindergarten in the fall, he’s not going to be able to hear his teachers and he already has trouble interacting with other kids at social events because he has difficulty hearing and speaking. With the surgery, he’ll be able to hear his own voice. We know that the cochlear implants aren’t a magic pill - Carson will need auditory verbal therapy after the surgery, but as his parents, we feel this is the best path for him.

According to the FDA, cochlear implants are now recognized as the standard treatment for severe-to-profound nerve deafness, and that’s why most insurance companies cover them. The National Institute of Health says about 210,000 children and adults around the world have received these implants. In the United States roughly 42,600 adults and 28,400 children have received them. Coventry Health Care should cover this procedure for families who decide that cochlear implant surgery is the right choice for them and their doctor.

Coventry Health Care should change their policy and allow Carson, and other children like him, to have the gift of hearing.

https://www.change.org/petitions/co...8371&utm_medium=email&utm_source=action_alert

Oh wow, I have heard about some insurance companies won't cover on CI - but those movement is pretty rare.

For my opinion, 5 years old is pretty late for speech language development and hopefully boy's parent won't abandon the ASL as option, also ASL is pretty last option if unable to use oral language primarily. If he receives CI at several months after born so the chance with speech development will be successful. Now, he will have some struggle like rest of deaf people.

If insurance still refuse to cover, there are some option - getting interpreter in mainstream school, send to day deaf school (Atlanta has one - Atlanta Area School for the Deaf - AASD) or send to Georgia School for Deaf - GSD.

There is petition to sign if you are interested to support his family.

Remember: That's sensitive topic - please discuss in civil mater. :ty:
 
What about looking for a company that would cover cost of surgery? Not everyone will cover it.
 
For my opinion, 5 years old is pretty late for speech language development

I didn't learn to speak until age six...and with only one hearing aid at the time. He'll be fine as long as he's encouraged to speak, read to by his parents and often, and interacts with people where speaking is encouraged. I had all those including speech therapy three times a week, and I speak as normally as any hearing person except for a slight deaf accent....which can't be avoided for obvious reasons.....

Laura
 
The reason the insurance won't cover it is because it is still unclear if it really works for auditory neuropathy, which is not actually deafness.
 
https://www.change.org/petitions/co...8371&utm_medium=email&utm_source=action_alert

Oh wow, I have heard about some insurance companies won't cover on CI - but those movement is pretty rare.

For my opinion, 5 years old is pretty late for speech language development and hopefully boy's parent won't abandon the ASL as option, also ASL is pretty last option if unable to use oral language primarily. If he receives CI at several months after born so the chance with speech development will be successful. Now, he will have some struggle like rest of deaf people.

If insurance still refuse to cover, there are some option - getting interpreter in mainstream school, send to day deaf school (Atlanta has one - Atlanta Area School for the Deaf - AASD) or send to Georgia School for Deaf - GSD.

There is petition to sign if you are interested to support his family.

Remember: That's sensitive topic - please discuss in civil mater. :ty:

Coventry Health Care: Health insurance reviews and ratings for Coventry Health Care

I found this list of complaints against your insurance company. If you do decides to get another insurance company it would be a good idea to read people reviews on lines . I am not suprises your insurance does not pay for the CI , how do you think they got so big in the first place?
 
The reason the insurance won't cover it is because it is still unclear if it really works for auditory neuropathy, which is not actually deafness.

I am not sure when they got their policy in relation to the child's birth etc. I can tell you my experience which started quite some time ago. I would need to look up the exact date but the point is that when I had to get an individual policy in the 1980's the best deal overall was one that had my "pre-existing" hearing problems as a complete exclusion! They would NOT pay for ANYTHING hearing related.
 
Well, as a child, fortunately there are many great charities and people out there willing to help. But, like Botti said, this is a case where the child may not benefit.
 
What about looking for a company that would cover cost of surgery? Not everyone will cover it.

It will require to change the job to have other health insurance. Most employers only have 1-2 health insurances as choice and parent's employer may only have one. That only left for them to fight as possible.

I didn't learn to speak until age six...and with only one hearing aid at the time. He'll be fine as long as he's encouraged to speak, read to by his parents and often, and interacts with people where speaking is encouraged. I had all those including speech therapy three times a week, and I speak as normally as any hearing person except for a slight deaf accent....which can't be avoided for obvious reasons.....

Laura

Sure, there are some people use CI for pleasure to explore for different sounds and not worried about language development.

I had speech therapy for 10 years and it was unsuccessfully for me.
 
The reason the insurance won't cover it is because it is still unclear if it really works for auditory neuropathy, which is not actually deafness.

Oh, I don't know that and it will be scared; and wasteful if CI doesn't work. It is better for this boy to have one CI to see if works before get second CI.

Coventry Health Care: Health insurance reviews and ratings for Coventry Health Care

I found this list of complaints against your insurance company. If you do decides to get another insurance company it would be a good idea to read people reviews on lines . I am not suprises your insurance does not pay for the CI , how do you think they got so big in the first place?

No, he's not my son. I'm shared with you that I received from email.

Like I said to Derek, most jobs usually have 1 health insurance as choice and it is very expensive to buy own insurance for those family.
 
The reason the insurance won't cover it is because it is still unclear if it really works for auditory neuropathy, which is not actually deafness.

Cite? I'm curious about this....I do remmy The Excitement in Volta Voices about how AN was responding to implantation.........or was that the usual Excitement Over a New Thing?
I am with everyone. The kid is OLD for an implant, and he has a condition where it's unclear if it will work or not. Just hook the kid up with local Deaf Ed resources... Mainstream ed in Georgia is pretty bad anyway.
 
Cite? I'm curious about this....I do remmy The Excitement in Volta Voices about how AN was responding to implantation.........or was that the usual Excitement Over a New Thing?
I am with everyone. The kid is OLD for an implant, and he has a condition where it's unclear if it will work or not. Just hook the kid up with local Deaf Ed resources... Mainstream ed in Georgia is pretty bad anyway.

Yup, that what I was concerned.

AASD is good school and I know some students graduated from AASD, that graduated from college with college degree.

GSD is much improving and you can graduate with regular degree, after meet strict GA guideline, however GSD is isolated and not easy access from interstate.
 
Cite? I'm curious about this....I do remmy The Excitement in Volta Voices about how AN was responding to implantation.........or was that the usual Excitement Over a New Thing?
I am with everyone. The kid is OLD for an implant, and he has a condition where it's unclear if it will work or not. Just hook the kid up with local Deaf Ed resources... Mainstream ed in Georgia is pretty bad anyway.

Upon reading Coventry's policy, they apparently just don't cover CI for any reason.
 
Some health insurances don't cover chiropractic. Some do.
Some of them include a dental plan. Some don't.

Always read its policy before purchasing.

The insurers can change their health benefit during open season.
 
The reason the insurance won't cover it is because it is still unclear if it really works for auditory neuropathy, which is not actually deafness.

My daughter has auditory neuropathy. She's deaf. Some days she can hear better than others, but there's still a loss there.

The CI helps her out - she says she likes it better than her hearing aid, but it certainly isn't a perfect fix.
 
Ci is more like a personal choice instead heal. Health insurance mean to cover whatever they're injury and fix...
 
@OP, I'd look into switching insurances and see if you can get coverage somehow. Perhaps talk to an audiologist about possible avenues to pursue. Don't loose hope. I always said that insurance companies are the real mafia....

Laura
 
@OP, I'd look into switching insurances and see if you can get coverage somehow. Perhaps talk to an audiologist about possible avenues to pursue. Don't loose hope. I always said that insurance companies are the real mafia....

Laura
Luckily the OP has no kids. He is just commenting on someone he read about. Like me be needs to be on the national DO NOT SPAWN list
 
I've had Coventry before and They did cover my CI 7 years ago but then one year later, they stopped service coverage for Remapping. I was pissed and switched over to Aenta. I like Aenta now and they covered my CI processor replacement 100% !! 100% dang man not even a penny paid for it!! I had Cochlear N24 processor and now have new Cochler N5 and I love it very much! My word of advice, be sure to have appointment with CI audiologist for pre-authorize for surgery or processor replacement, Then the Insurance will cover it.

Covenrty is now known playing dirty with customers. Even they listed that it covered but in fact they don't. That's why I dropped Coventry and switched over to Aenta.

Catty
 
won't refund insurnace costly, approximately $70,000 also plus on surgery addition serious spending to really costly, replace expensive to cochlear implant lots of cost insurance,

wont' approval. it is very serious. IMO, I am very pretty lots of you reading, policy limit is very strict ! cannot refund or whom is very trustee, pretty. look likes really costly.
doesn't work help cost refund! impossible!

Canada is very limit on very strict more reason authority on reason audio-gist team specialist. I understand, I reading to policy, I perceptive to cochlear implant. I knew on already Cochlear Implant..
 
Back
Top