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Author Topic: Blue Cross and BAHA  (Read 18162 times)

Nancy T

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Blue Cross and BAHA
« on: April 12, 2007, 11:21:09 pm »
Anyone have any idea on whether Blue Cross will ever come around to paying for the BAHA? I live in Oregon and my insurance won't pay.

I was told by an audiologist that after Medicare started paying for the BAHA (this was more than a year ago, I think) that BC would probably fall in line eventually, but that's not happening.

I'm hoping I'll be able to change insurance and get a BAHA.

Nancy T.
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Sudden sensorineural hearing loss, left side, 1999 (no acoustic neuroma)
Baha Intenso, 2008

1wareagle

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Re: Blue Cross and BAHA
« Reply #1 on: April 13, 2007, 08:10:20 am »
Hi Nancy,

Sorry to hear about your problem. I have Blue Cross and Blue Shield of MS and they paid everything but the out of pocket expense and deductiable. The reason I think mine went so well is I had my BAHA operation at the same time of my AN surgery. It was all included together and they paid.

Ellis
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Ellis- Age 50- Mississippi
3.2 cm AN Translab w/ BAHA Surgery
@ House Ear Clinic - LA - 01/04/07    Dr. Brackmann, Dr. Hilselberger, Dr. Stefan
Platinum weight in right eye-Dr. Roberts
Right side facial paralysis (slowly getting movements)

Brendalu

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Re: Blue Cross and BAHA
« Reply #2 on: April 13, 2007, 09:38:22 am »
I think there is a quality of life thing with insurance companies.  If you can get your doctor to wite a letter to the insurance carrier that having the Baha would give you a better quality of life the insurance company will more than likely pay for it.  I have been told that most insurance companies deny things like that and things like gastric bypass, plastic surgeries etc. unless the doctors feel that it will enable you to have the quality of life previous to the loss.  It is worth a try.
Good luck.  You might also check out the trans ear.  There are a lot of posts about that.
BrendaO
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Brenda Oberholtzer
AN surgery 7/28/05
Peyman Pakzaban, NS
Chester Strunk, ENT

Nancy T

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Re: Blue Cross and BAHA
« Reply #3 on: April 13, 2007, 07:55:30 pm »
Thanks, Ellis & Brenda! I thought my doctor was going to write a letter to the insurance, but I have no idea whether he ever did. I am seeing him regularly and we discuss the BAHA at every visit--I know he would like to do it, he's a surgeon after all!--but he said something like it would probably take a lawsuit before the insurance company decides to cover it.

I don't think they make exceptions for certain cases--their policy states that they don't cover it unless you have a middle or outer ear problem that prevents you from wearing a hearing aid. Even though I'm just as deaf as someone with an outer or middle ear problem, they won't cover it because my deafness is inner ear! Dumb. It's illogical--just a way for them to cut costs. I suppose their logic is that I could wear a CROS aid, but all the professionals I've seen--audiologists and neurotologists--say I probably wouldn't like it because it would occlude my good ear.

However, I can't complain about BC otherwise--they have covered all my tests and expensive medications that some other insurances don't cover.

Nancy T.
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Sudden sensorineural hearing loss, left side, 1999 (no acoustic neuroma)
Baha Intenso, 2008

harrylewis01

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Re: Blue Cross and BAHA
« Reply #4 on: April 19, 2007, 01:25:16 pm »
What is BAHA?
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ppearl214

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Re: Blue Cross and BAHA
« Reply #5 on: April 19, 2007, 01:30:06 pm »
Quote from: harrylewis01 on April 19, 2007, 01:25:16 pm
What is BAHA?


Hi Harry and welcome,

Here is a great link re: BAHA (Bone-Anchor Hearing Aid), with pictures of JoeF and his BAHA, as well as a terrific link about BAHA...

http://anausa.org/forum/index.php?topic=2677.0

Also, if you do a "Search" on this website for BAHA, you will find MANY threads re: discussions for BAHA, such as insurance/Medicare coverages, pros and cons of the device and other add'l info.

Hope that helps.
Phyl
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"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

jimmy r

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Re: Blue Cross and BAHA
« Reply #6 on: April 30, 2007, 01:07:04 pm »
Aetna denied my BAHA request even at the same time as surgery.
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Translab HEI 1987. Retro-sigmoid Mass General 6/19/2007. 7 hour surgery by Barker and Mekena. No nerve damage. Not all the tumor removed.

ixta

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Re: Blue Cross and BAHA
« Reply #7 on: July 02, 2007, 05:35:26 pm »
can one go swimming with the baha?
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5cm left AN from IAC to cerebellum/brainstem.
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Boppie

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Re: Blue Cross and BAHA
« Reply #8 on: July 02, 2007, 06:05:49 pm »
Nancy, ask your provider if the BAHA can be coded as a necessity of having had your "hearing nerve amputated during tumor excision".
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Boppie

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Re: Blue Cross and BAHA
« Reply #9 on: July 02, 2007, 06:17:25 pm »
Ixta,
One may never swim nor shower with the BAHA unit snapped onto the bone abutment. The bone abutment stays with your skull all of the time. The BAHA unit, (the electronics part) is extremely sensitive to getting wet, bathing and swimming.  Check out the BAHA site.

Can't swin with a TransEar either.

On another point though, there is a Cros hearing instrument that works inside a football helmet!  ::) How's that for sweat?
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Laurie

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Re: Blue Cross and BAHA
« Reply #10 on: July 09, 2007, 08:24:35 am »
I had my BAHA imipant on January 3rd 2007.  It is just amazing.  It justs snaps on so quickly.  My Insurance CareFirst BC/BS of Virginia paid the Dr., hospital and imlpant, but did not pay for the device which makes no sense.  Why would they approve and pay for the surgery and implant and not the device.  The surgery is pointless without the use of the device.  I have been appealing this decision and will continue to.  I am working with a BC/BS rep in my area and the Audiologist at John's Hopkins medical center.  I have a letter  fror my Dr. too.
The Insurance says, "we don't pay for hearing aids".  As you know this is not just a hearing aid.  So I will continue to fight them.
Medicare does pay, but why wait until you are that age and miss out on hearing.  The cost for the device was $4200, but worth it.


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Battyp

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Re: Blue Cross and BAHA
« Reply #11 on: July 19, 2007, 10:50:51 pm »
ixta you snap off the hearing device and can swim, dive, shower etc....

Laurie the device itself cost 4200?  I know they quoted the overall price around 10-12K....
I'm wondering how much just the headband device is.


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Nancy T

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Re: Blue Cross and BAHA
« Reply #12 on: August 08, 2007, 10:42:34 pm »
Hi Boppie, thanks for the advice. However, I never had an AN. I had a sudden hearing loss when I sneezed. No cause was ever found, but my speech discrimination is 25-40 percent (depending) and my hearing loss is in the severe-to-profound range from 750 Hz up. So, I'm essentially deaf in that ear.

Blue Cross in Oregon just reviewed their policy and still won't pay for the BAHA. Actually it never occurred to me that they might pay for the SURGERY but not the aid. I should double-check with my neurotologist, but I know I'm on his BAHA list, so I'm sure they would have let me know if the insurance would pay for it.

Nancy
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Sudden sensorineural hearing loss, left side, 1999 (no acoustic neuroma)
Baha Intenso, 2008

Lamsue23

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Re: Blue Cross and BAHA
« Reply #13 on: August 09, 2007, 06:11:58 am »
     I'm 63, on Blue Cross Blue Shield of Ma. very good insurance but I have been out of work for 1 year due to a knee replacement and a work injury,  I have taken over paying my premiums so that I wouldn't lose this ins.  I'm a watch and wait right now and looking into all my possibilities.l  The doctors advise me to have surgery after three MRI's since Feb.  I'm scheduled for another MRI inn Nov.  My AN is only 1.2cm x 5.4mm.  My question to everyone is if I retire soon and I lose this insurance will Medicare pay for this surgery and all that goes with this AN.  Has anyone had this done on Medicare.  I hate to have to decide on surgery based on Insurance. MY AN is on the 8th cranial nerve and the 7th is enlarged.  I have lost almost all of my hearing on the left ear and have balance and vertrigo issues.

Thank you for all of your great input in helping all of us Newbie's.  There is so much to consider and I'm thankful that I have time to completely digest all these options.

Sue/NH
 
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SueL/from NH
Retrosigmoid Surgery 8/6/2008 DHMC, Lebanon, NH 7.5 hrs.
Dr. Erkmen - neurosurgeon
Dr. Morrisson - neuro-ostology
Loss of hearing 70% in left ear.
Vision and Balance issues...Taste!!

Boppie

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Re: Blue Cross and BAHA
« Reply #14 on: August 09, 2007, 10:16:16 am »
Sue, If you wait until you are on Medicare you will get ziltch, zero, nada, for any type of hearing device.  I had my surgery at 64 and my TransEar by 64 and 10 months.  United Health Care paid for my TransEar based on hearing nerve amputation, not on the code that it was a hearing aid.  "Hearing Aid" for Medicare means you pay, no exceptions I was told, not even amputation of nerve. 

I am on Medicare now and cannot believe the difference in "what you get".  I should not be surprised but I am still young in my mind. ;D  The good old days of UHC are gone as primary provider for me. 
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