Author Topic: Does Insurance Cover Anything or Are We On Our Own?  (Read 3123 times)

Dog Lover

  • Sr. Member
  • ****
  • Posts: 271
  • My little Sammie Roo.
Does Insurance Cover Anything or Are We On Our Own?
« on: January 26, 2009, 10:20:02 pm »
Just curious. Had anyone's insurance covered hearing aids for the hearing loss due to your AN? Was just curious if a hearing loss due to an AN is treated any differently. If it's not, doesn't seem quite fair.

Cathy
Cathy
9mm x 3mm Left Side AN
Mid Fossa Aug. 21, 2008
Dr. Gantz / Dr. Woodson
Univ. of Iowa Hospitals and Clinics
No facial issues, hearing saved, I keep active and feel back to normal.

leapyrtwins

  • Hero Member
  • *****
  • Posts: 10826
  • I am a success story!
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #1 on: January 26, 2009, 10:43:23 pm »
Cathy -

From what I know of insurance companies and hearing aids, 99.9% don't cover them - regardless of the reason for the hearing loss.

BAHAs may or may not be covered by insurance; it depends on the terms of the policy.   BAHAs "get around" the hearing aid classification because technically they are considered implants.

Jan

Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #2 on: January 27, 2009, 10:52:08 am »
FYI, my insurance says in their benefits book that there is an $1,000 maximum benefit every 36 months towards hearing aids.  That is BlueCross BlueShield - Texas PPO Blue.

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #3 on: January 27, 2009, 02:43:06 pm »
Cathy:

I can't speak from personal experience but I don't believe there is a definitive answer to your question because each insurance company has different rules and interpretations of their policy language.  The general consensus seems to be: 'no'.  However, I would suggest you dig out your policy and look for 'exclusions' to see if hearing aids are totally excluded or partially covered, as Brian's policy does.  You might be one of the lucky ones but if not, at least you'll know.  Good luck!  :)

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Syl

  • Hero Member
  • *****
  • Posts: 765
  • Forgive me. I'm having an AN moment.
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #4 on: January 27, 2009, 02:53:31 pm »
The way it was explained to me is that my employer didn't purchase coverage for a hearing aid.

Syl
1.5cm AN rt side; Retrosig June 16, 2008; preserved facial and hearing nerves;
FINALLY FREE OF CHRONIC HEADACHES 4.5 years post-op!!!!!!!
Drs. Kato, Blumenfeld, and Cheung.

Dog Lover

  • Sr. Member
  • ****
  • Posts: 271
  • My little Sammie Roo.
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #5 on: January 27, 2009, 06:36:55 pm »
I just looked it up. Drat - not covered at all on my policy.. :(...
Cathy
9mm x 3mm Left Side AN
Mid Fossa Aug. 21, 2008
Dr. Gantz / Dr. Woodson
Univ. of Iowa Hospitals and Clinics
No facial issues, hearing saved, I keep active and feel back to normal.

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #6 on: January 27, 2009, 08:38:32 pm »
I wonder if it could be coded in such a way that it's deemed "medically necessary" and possibly covered?  My insurance company has told me that I need to get a letter from my doctor saying that it was medically necessary..  Just a thought?

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Dog Lover

  • Sr. Member
  • ****
  • Posts: 271
  • My little Sammie Roo.
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #7 on: January 28, 2009, 06:41:06 pm »
After looking up my insurance coverage last night I decided what the heck - and I wrote an email to them. They responded today.

Quote
THANK YOU FOR YOUR INQUIRY. YOUR POLICY DOES NOT PROVIDE BENEFITS FOR HEARING AIDS. HOWEVER, IT WOULD BE RECOMMENDED TO HAVE YOUR PHYSICIAN SUBMIT DOCUMENTATION INDICATING THE MEDICAL CONDITION ASSOCIATED WITH THE HEARING LOSS TO DETERMINE IF THIS MAY BE COVERED UNDER THE PLAN

So, I'm gonna give it a shot. It wouldn't be the first time I've persued getting insurance to cover something that they initially said they wouldn't and end up getting it covered.

Stay tuned...

Cathy
Cathy
9mm x 3mm Left Side AN
Mid Fossa Aug. 21, 2008
Dr. Gantz / Dr. Woodson
Univ. of Iowa Hospitals and Clinics
No facial issues, hearing saved, I keep active and feel back to normal.

leapyrtwins

  • Hero Member
  • *****
  • Posts: 10826
  • I am a success story!
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #8 on: January 28, 2009, 10:27:15 pm »
Cathy -

this sounds like it is definitely worth pursuing.  All they can say is no - and if they say yes, so much the better.

Good luck!

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

sgerrard

  • Hero Member
  • *****
  • Posts: 3475
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #9 on: January 28, 2009, 10:32:02 pm »
Cathy,

I agree, it is worth a shot. My experience was that insurance works best when it is done with all the right paper work going through all the right channels. They basically say no to anything unless they have documentation in front of them that provides a basis for extending coverage. Get them some audiograms that show significant unilateral hearing loss due to a benign neoplasm of the brain/nervous-system (insurance speak for having an AN). It just might work.

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: Does Insurance Cover Anything or Are We On Our Own?
« Reply #10 on: January 29, 2009, 04:26:12 pm »
Cathy:

I concur with the opinions of others to pursue an insurance claim for a medically necessary hearing aid.  My wife has battled with Blue Cross over claims (hers and mine) and has often ended up getting the coverage she sought, after much back-and-forth with multiple phone calls and reams of documentation.  The 'secret' is to know what your policy says and if you think you may have a reasonable shot, as you do, be both patient and tenacious.  It's worth it.  I wish you complete success in your quest for hearing aid coverage.  :)

Jim

4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.