ANA Discussion Forum

General Category => Hearing Issues => Topic started by: Static on September 08, 2008, 03:27:13 pm

Title: How to get insurance to pay for transear??
Post by: Static on September 08, 2008, 03:27:13 pm
I was wondering, since my insurance won't cover an aid, even though my hearing was lost in a critical surgery, I have found out that they will cover a cochlear implant.  I don't want a baha, I want a transear.  Any ideas?
Title: Re: How to get insurance to pay for transear??
Post by: leapyrtwins on September 08, 2008, 08:06:49 pm
Wish I had some ideas, but in my experience, insurance companies don't typically cover hearing aids.  The BAHA is generally covered because technically it's an implant.

I do have a question though.  Why don't you want a BAHA?

I'm just wondering if you might have some reservations or questions about the BAHA that some of us users might be able to address and in doing so we could add to your comfort level.

I don't mean to put you on the spot, or make you answer a question that is uncomfortable for you - so if you'd rather not answer, or you'd rather send me a PM, I totally understand.  The BAHA isn't for everyone; it's most definitely a personal choice, so if you just don't think it's right for you that's understandable.

Jan
Title: Re: How to get insurance to pay for transear??
Post by: sgerrard on September 09, 2008, 07:57:59 am
It's not a hearing aid, it's a prosthetic hearing device.  ;)

Seriously, sometimes just changing the treatment code submitted to insurance companies can make a difference.

Steve
Title: Re: How to get insurance to pay for transear??
Post by: ixta on September 09, 2008, 10:40:43 am
I agree steve, thats what they put for me, to help with balance and quality of life. I still had to pay about half of it.
Unfortunately I don't use it and am considering baha.
Title: Re: How to get insurance to pay for transear??
Post by: Static on September 09, 2008, 12:05:07 pm
Jan, I am not a candidate for a baha.  My incision site was closed with titanium mesh, I've already discussed this with my doctor.  I also do not want a baha.  Am not a fan of having another surgery or a post sticking out of my head.  Steve, I already tried the prosthetic device approach.  My personal choice normally covers these devices, but my dh employer excludes that from something they cover.  I've finally found someone in my area who does transear, but there is no way I can even think of affording one.  Apparently my quality of life is unimportant to everyone but me :/
~Karen
Title: Re: How to get insurance to pay for transear??
Post by: saralynn143 on September 09, 2008, 12:44:36 pm
Do you think your doctor would write a letter explaining why BAHA is not an option for you and suggesting TransEar as an alternative? Every insurance company has an appeal process that you can go through when they turn down a claim.

Sara
Title: Re: How to get insurance to pay for transear??
Post by: leapyrtwins on September 09, 2008, 02:25:32 pm
Karen -

thanks for the response.  Sorry to hear you aren't a BAHA candidate, although it doesn't sounds like you'd want one anyway.  As I said in my previous post, they aren't for everyone.

I've heard the TransEar is an excellent solution to SSD.  Maybe as Sara suggested asking your doctor to write a letter to your insurance company might entice them to cover it.

Jan
Title: Re: How to get insurance to pay for transear??
Post by: Static on September 09, 2008, 08:54:21 pm
I suppose I could, but then, of course, I  wonder what my doctor charges for that sort of thing.  Everybody wants your dollar these days, nothing is free.  I already took a second part time job just so we can get by but extras... what are they again?  It's pathetic! Thanks for all of your advice!
Title: Re: How to get insurance to pay for transear??
Post by: leapyrtwins on September 09, 2008, 10:29:53 pm
Karen -

IMO your doctor wouldn't charge you anything to write a letter to your insurance company.  I've had numerous doctors write letters to my insurance company over the years and haven't been charge anything.  Most of them are glad to do it - plus, they probably turf the deed to one of their staff members anyway  ;)

I say give it a shot; you have nothing to lose and a lot to gain.

Jan
Title: Re: How to get insurance to pay for transear??
Post by: Omaschwannoma on September 10, 2008, 05:09:51 am
....hmmmm, just a thought here  if insurance pays for Viagra, why wouldn't they pay for hearing aides?  ED certainly isn't more life altering than SSD--or is it? 
Title: Re: How to get insurance to pay for transear??
Post by: saralynn143 on September 10, 2008, 06:23:54 am
You can also offer to write the letter yourself for his/her signature, that way the points you want to include are sure to be there.

But my experience is the same as Jan's. A doctor should not charge for writing a letter on a patient's behalf. That's part of their job.

Sara
Title: Re: How to get insurance to pay for transear??
Post by: Debbi on September 10, 2008, 07:41:12 am
Okay, just to digress for a moment - did anyone else notice Ixta's profile "video?" (above)  That is absolutely hilarious!

Debbi
Title: Re: How to get insurance to pay for transear??
Post by: leapyrtwins on September 10, 2008, 11:22:08 am
Debbi -I did notice the "video" and thought it was hilarious also!

To comment on Arushi's point regarding Viagra, I always found it interesting that most insurance companies cover it, but not birth control pills.  Go figure  ::)

I personal think that hearing aids should be covered by insurance.  Hearing is an essential thing IMO, and I personally consider being SSD or having diminished hearing to be a medical issue - although I'm not sure everyone else does. 

Anyone know why insurance companies typically don't cover hearing aids  ???  It seems to be a pretty universal practice and I guess I'm wondering what the logic is behind it.  I know not all insurance policies cover vision, but it's usually an add-on.  Couldn't hearing aids be an add-on, too?

Jan
Title: Re: How to get insurance to pay for transear??
Post by: Omaschwannoma on September 11, 2008, 04:02:52 am
"Ditto" Jan's post!!!!!!  I signed a petition going around to send to Washington for just this purpose, hope we get this passed! 
Title: Re: How to get insurance to pay for transear??
Post by: Static on September 11, 2008, 09:06:19 am
I live in PA and in most of my doctor's offices, there are signs that say that there will be a charge for filling out forms which I think totally sucks!  Medicine isn't the same as it used to be.  It's big business these days and doctors are half afraid to do things for fear of being sued.  My theory on why viagra is covered and other, more important IMO things are not, is because its another big business run by men, specifically the government, and they all want to be able to have sex because that's what is important to them! 
Actually, my insurance company explained the hearing aid issue to me this way............ normally it would be covered if listed as a prosthetic device and only if the hearing loss is the result of a life threatening injury or surgery (exactly what the AN surgery was for me), not from hearing damage caused through a degenerative process (like listening to loud music or abusing your ears) BUT, the company my hubby works for says not to cover them.  So if I lost my legs or arms in an accident, through no fault of my own, the insurance we have would NOT cover any prosthetic devices for me. 
This came about the last time their contract was renewed (union bull****).
Title: Re: How to get insurance to pay for transear??
Post by: Omaschwannoma on September 12, 2008, 06:48:23 am
Static,

Really doubt insurance would pay for your hearing device due to AN because they'd probably tell you something to the effect you still have some hearing in the good ear right?  So, I guess until the good ear is a gonner due to what.... another AN, virus, autoimmune disease, exploding ear from pressure in airplane (my explanation), you and probably me are up the creek.  I haven't looked into a hear aid yet, but since I'm asking my husband more and more to repeat himself I'm beginning to open these doors and take a peek. 

I just had (yesterday) another hearing test on my good ear and since the last one I only lost a teensy (my medical explanation) bit more in the high end. 
Title: Re: How to get insurance to pay for transear??
Post by: Captain Deb on September 12, 2008, 07:48:59 pm
Karen, If you do decide you can afford the transear, the inventors office is about a 1 1/2 hour drive from me and you could have it fitted by him and buy it directly from him without the mark-up from the docs. I think the cost is around $2500- 3000. Just a thought.

Capt Deb(http://i235.photobucket.com/albums/ee60/Captdeb_photos/pirate2.gif)
Title: Re: How to get insurance to pay for transear??
Post by: Static on September 14, 2008, 05:13:58 pm
Hi Deb! LTNS!  How's that little Sadie of yours?  So the doc told me that I could get the baha and it would just have to be placed away from the titanium mesh.  Still don't want the rod sticking out of my head, it's just not for me.  With my luck, I'd get zapped by lightning.... then again, maybe that's not a bad idea!  Anywho, can't afford the trans ear and will have to just go on pretending to hear things and/or pissing people off because I keep asking them to repeat themselves.  God forbid anybody go out of their way for me!  But thanks for all the suggestions and comments.  I've been away from the group for awhile, trying to see if my problems would go away too, but no such luck!  Maybe I just have a bad outlook, but I don't see me every having a full recovery to my old self/life which was suggested to me by several doctors.  Now the name they have given me for it is fibromyalgia.  I think they just haven't been able to figure out anything else or are afraid to blame it on something I might sue someone over.  BTW, I'm not that kind of person, or I would be able to afford the aid 10X over!  TTFN