Cochlear Implant for SSD- any luck with insurance?

[anapaul]

Has anyone out there had a cochlear implant for single-sided deafness due to a unilateral acoustic neuroma?  Did your insurance pay for it?  Which insurance company, and what kind of hoops did you have to jump through to get coverage?  Any advice would be helpful. 

Thanks!

[alabamajane]

I have the Cochlear BAHA hearing device ( implanted post and external processor). I got it in 2014 and have Federal Blue Cross  Blue Shield. I did not have any problems getting approval and payment. In fact I am on my second processor having updated from the 4 to the 5 power version.

I believe one problem some people encounter when getting rejected from insurance company is the coding of the device by the doctor’s office personnel. It’s not a hearing aid. It’s a prosthetic device. And there is a difference in the coding number they use. .... I don’t know all of the lingo for that process,, but I have read on here in the past that others have had that problem with their insurance.

Good luck to you,,, I hope you are successful and that this helps just a little,,,

Jane

[leapyrtwins]

If you are unilaterally deaf you should be looking into a BAHA, not a CI.  Typically CI's are for those who are bilaterally deaf.  I've had my BAHA implant since 2008 and my insurance company paid for it.  They've also paid for several upgraded devices since 2008.  My implant was covered by Guardian Insurance, my upgraded devices have been covered by BCBS-IL.

It's important to make sure your doctor's office submits the claim for the BAHA with a ICD code that indicates it's a prosthesis - NOT a hearing aid.  Most insurance companies don't cover hearing aids; they do cover prostheses. 

If you are getting your BAHA through Cochlear, they do have an insurance division that will assist you when it comes to filing your insurance claim.   

[lryan42]

Has anyone out there had a cochlear implant for single-sided deafness due to a unilateral acoustic neuroma?  Did your insurance pay for it?  Which insurance company, and what kind of hoops did you have to jump through to get coverage?  Any advice would be helpful. 

Thanks!

Yes.  Blue cross / blue shield.

Maybe because of mines particular location away from the auditory nerve I got approved.  Not certain.

FDA approved CI for SSD back in 2019 so provided your acoustic nerve is not compromised and you pass the CI evaluation you "should" be eligible.   I'm having mine done at UCSD in a couple weeks.  I'm not sure what hoops they had to jump through beyond the very well documented history of my case.

[stevehernes]

I’d also be curious to know what you guys think of gilsbar customer service. If anyone has had experience with them, I'd love to hear about it. Are they responsive and helpful? Do they handle inquiries and issues efficiently? Your feedback would be really valuable in understanding their service quality and whether they might be a good fit for my needs.

[Director]

stevehernes,

The American Cochlear Inplant Alliance has some helpful resources, including information about insurance coverage.  The link below has a helpful YouTube video.

American Cochlear Implant Alliance
www.acialliance.org
https://www.acialliance.org/page/Insurance

If you want additional CI information specific to ANs and/or want to connect with ANA volunteers that have a CI, please reach out to Melanie at the ANA. melanie@anausa.org