Insurance - yeah right

soulchill

Well-Known Member
From my insurance coverage booklet - Hearing aids are covered up to 2500 per impaired ear as covered by The PLAN.

The fine print -
Hearing Aids
The PLAN now provides coverage for MEDICALLY NECESSARY hearing aids and related services that are ordered by a DOCTOR or a licensed audiologist for each MEMBER under the age of 22. Benefits are provided for one hearing aid per hearing-impaired ear, and replacement hearing aids when alterations to an existing hearing aid are not adequate to meet the MEMBER'S needs. This benefit is limited to once every 36 months. Benefits are also provided for the evaluation, fitting, and adjustments of hearing aids or replacement of hearing aids, and for supplies, including ear molds.

I suppose they also argue MEDICALLY NECESSARY since you can live without hearing.
 

Anij

Well-Known Member
Wirelessly posted (Blackberry Bold )

Mine has stated that for years - I just get letters from my MD and Audilogist stating I am Hoh and required HAs. Easy peasy (and my coverage only was $500)
 
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lovezebras

New Member
wow you're complaining about that?
My insurance coverage is up to 500 per ear every 3 years so to only have to have a letter from your Dr and Audi for up to 2500 each year is amazing...
 

ambrosia

Well-Known Member
Premium Member
wow you're complaining about that?
My insurance coverage is up to 500 per ear every 3 years so to only have to have a letter from your Dr and Audi for up to 2500 each year is amazing...
That is nice.....but it's only for people under 22. So if one of your kids needs HA you're golden, if you, the adult and the one paying for the insurance, are over 22, well then you're SOL.

Bet you were all excited for a minute there Soulchill!! I know I would have been, then Ida been all wtff???
 

soulchill

Well-Known Member
Exactly. Not that people under 22 don't need hearing aids, but wow. I think a lot of it is my company doing things to save money. Our insurance cost hasn't really changed much since I've been there, and cutting back on things like this is probably why.
 

soulchill

Well-Known Member
Usually they cover things really well, just sucks I'm over 22. Some people at work complain about the employee cost, but the company pays more than my last couple of jobs did. I'm glad I caught this, because all the doctors do is run a code, and this probably would have squeaked through and I'd get a bill down the line.
 

deafdyke

Well-Known Member
I think they refuse to cover hearing aids for adults, b/c they are afraid that if they DO, the adults will sock it to the insurers with the dinky aids, and stuff like the Esteem implants etc.
 

lovezebras

New Member
That is nice.....but it's only for people under 22. So if one of your kids needs HA you're golden, if you, the adult and the one paying for the insurance, are over 22, well then you're SOL.

Bet you were all excited for a minute there Soulchill!! I know I would have been, then Ida been all wtff???
I didn't think this applied to the OP since it wasn't bolded in the main post...lol my bad! that sucks about the under 22 thing...and what a strange age..lol like you'd think it would be under 25 or 30 ...22 is so random
 

soulchill

Well-Known Member
I didn't think this applied to the OP since it wasn't bolded in the main post...lol my bad! that sucks about the under 22 thing...and what a strange age..lol like you'd think it would be under 25 or 30 ...22 is so random
Yeah, I'm still getting used to the forum and forget the quotes. Sorry about that.
 

drphil

Active Member
:wave:Here in Ontario we have a government assisted programme called Assistive Devices programme which is not age related but "problem related". Even helps with Cochlear implants.
:wave: Aside: I used it 2 years ago and got the entire external implant duplicated. Cost. then-$3204.00 CDN.

What other provinces/countries provide unknown to me- personally.
 

Smithtr

G.G.H.T
Premium Member
:wave:Here in Ontario we have a government assisted programme called Assistive Devices programme which is not age related but "problem related". Even helps with Cochlear implants.
:wave: Aside: I used it 2 years ago and got the entire external implant duplicated. Cost. then-$3204.00 CDN.

What other provinces/countries provide unknown to me- personally.
Really sound cost expensive whoa :shock:

I didn't remember CDA is 3204.00 is cover implant expensive pretty cost! cost!
 

drphil

Active Member
The total cost was $8,848. It covers for 3 year. Thus any part will be replaced within the 3 year period. At the present time I have TWO complete sets of external. Mic/rechargeable batteries. recharging unit etc I still have another year to go before year 6- decision time.

One can purchase insurance from Advanced Bionics for ONE year- the external processor ONLY for 500/600$ US.- I believe.

The other alternative-no insurance- is to fix when something happens-pay the repair charge.

Important what I have said is only applicable to Ontario. What other provinces cover unknown to me.

Again OHIP (Ontario Health Insurance Plan) pickups the entire cost of Cochlear Implant IF approved for 3 years. This includes Insurance.

Thus what decision- insurance wise- is up to each individual at the end of year 3.

aside: the numbers are for Advanced Bionics-Harmony which I have.


Travis to answer your question specifically- I don't know what your province-Saskatchewan-does in the area of Cochlear Implant through the provincial health plan?

aside: the total cost of my Cochlear Implant was $55,000.00 CDN. Surgeon fees/hospital care/audiological service-before / after the operation and the Implant itself. This was 5 years ago. Fully covered by OHIP.
 
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soulchill

Well-Known Member
Just found out that I might qualify for hearing aid through VA at no cost. Really had some bad experiences with VA doctors and staff in past. Free is great, and an option if I can't work something else out. It's not my favorite option though, really more of a bail out.
 

GrayEagle

New Member
Good luck with your insurance paying for them or the VA if you can get quality service from them. I have never had insurance that covered aids. Hearing tests only. Since I started losing my hearing 20 years ago, I've had to get loans to get 4 sets of aids over the years as my hearing drops. Funny, but the insurance would cover a CI, because it's surgery, and would still cover the hardware for it. I don't qualify w/ sufficient loss for that, though... I hope you can get them covered!
 

soulchill

Well-Known Member
Good luck with your insurance paying for them or the VA if you can get quality service from them. I have never had insurance that covered aids. Hearing tests only. Since I started losing my hearing 20 years ago, I've had to get loans to get 4 sets of aids over the years as my hearing drops. Funny, but the insurance would cover a CI, because it's surgery, and would still cover the hardware for it. I don't qualify w/ sufficient loss for that, though... I hope you can get them covered!
Yeah, I'm pretty sure insurance won't cover it or even fittings. Unless they are clever with codes. I'm going to go to the ENT and demo followup, but not make any decisions for a couple of weeks after I see the person from health services about options. There's just too much I don't know and not going to let them rush me. Hoping to keep VA in my back pocket and use it in price negotiations.
 
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