Insurance for CI?

WildHunt

Member
Just wondering what different kinds of insurance DO cover CI/surgery/etc?
 

LTHFAdvocate

New Member
88 % of private insurers include some kind of coverage for cochlear implants. Medicare covers CIs, Medicaid coverage differs on a state-by-state basis -- all states cover them if you are under 21, but not all cover adults.

If you are looking for an individual plan that provides CI coverage and you don't have insurance right now, you are going to be in a world of hurt. Even if the plan normally covers CIs, your ability to get that coverage will likely be extremely (and permanetly) limited based on a pre-existing condition, and that's assuming they will insure you at all.

Group plans (like through work) cannot deny you coverage based on a pre-existing condition. They can, however, put in an exclusionary time period that they won't cover pre-existing conditions if you were previously uninsured, I think the limit is 18 months. So it is a temporary limit, but you will get coverage eventually.

What, who, and how much will be covered is extremely variable and totally based on your plan and individual circumstances. Some of the things it depends on include whether your facility and surgeon are in our outside of the insurers network, and what types of co-insurance and deductibles you have to pay, and what your coverage is for durable medical equipment.

Hope this helps, best of luck, let me know if you have any other questions
 

R2D2

New Member
Insurance will only cover you for a CI if you are unable to benefit reasonably well from hearing aids e.g. your loss is too big, you suffer from recruitment etc. They give speech tests to ascertain this. If it can be proven that you aren't getting the benefit with hearing aids but show good potential for understanding speech with a CI (e.g. good lipreading skills, audio memory from the past etc) then you are more likely to get approval.

The other thing with a CI is that once you have the surgery, it would be mostly impossible to go back to using hearing aids. So if you don't like the CI, that's it. I got my CI surgery done when my hearing loss increased significantly and I was unable to use hearing aids. So, I had nothing to lose basically.
 

purplecatty

Active Member
Depends on what your company offer for insurance. I works for Government. My work offer 100% coverage (Aenta) on CI cuz it's part of prothsetic implant. Only pay $250 for hospital stay(my wife had CI surgery that time). My old insurance, Conventry covers 80% what it says but my Audiologist have worked out with my insurer and after my CI surgery, I only pay $50 copay while Ins pays the rest. So that's why it all depend on company negotation w/ insurer.
 

VamPyroX

bloody phreak from hell
I don't really know. A lot of my friends got various kinds of coverage for their cochlear implants. Some got full and some got partial. I guess it depends. :dunno:
 
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