Cost of BAHA?/insurance won't cover it

[gms]

 Does anyone know what the cost of a BAHA would be. Found out my insurance won't  cover the BAHA.

[dalern]

It may be different in different places, but I was told the full cost at UCSD was around $25,000.  I am sure they would do a discounted cash price if need be.  Also, did you find that your insurance would not cover it because YOU called them, or the doctor's office called to verify benefits?  I think it is best to let the physician's office call because they know exactly what codes to use to get approval.  If you approach the insurance company with something that just sounds like a hearing device, most will deny coverage, though not all.  Let your doctor's office intervene.  In addition, Cochlear will intervene as well.  Their website is:  www.cochlearamericas.com. 

Hope that helps.
~Dale

[leapyrtwins]

Cost varies - but includes both the cost of the implant surgery and the cost of the device/processor (aka tiny hearing aid).

If your insurance company has refused coverage, don't give up.  Most insurance companies turn down first requests, but will change their minds if you are persistent.

It is important to stress that the BAHA is an implant or prosthesis - not a conventional hearing aid.

Also find out if your insurance policy covers Cochlear Implants.  If it does, you cannot be denied BAHA coverage (CIs are for unilaterally deaf people; BAHAs are for bilaterally deaf people).

Here is some information/tips from the Cochlear website http://anausa.org/forum/index.php?topic=11751.0

Hope this helps,

Jan

[teffaz]

My Baha surgery was one year ago. Insurance did not cover it, even after several appeals, including one by Cochlear America.

My out-of-pocket costs were nearly $8300. This was for the out-patient surgery at a hospital and the Baha sound processor, a BP100, which I began wearing three months later.

Good luck!

Best,
Brenda

[dalern]

I do think most hospitals and doctors will give you a discounted price if you are paying cash.  Do check with the billing department in your surgeon's office and the facility where the procedure is done.
~Dale

[dano5785]

  So I had the surgery on 3/14/2011 at UCSD and am recovering nicely. UCSD was great, my Dr. is the best, staff is fantastic.

The problem: on 3/17/2011 I received a COBRA insurance letter dated, 3/14 that i am canceled, as of 2/1/2011! Had I known I was being canceled, obviously I would have postponed until i got insurance figured out. So that means pre-op, surgery, anesthesia, and post op, all of which i thought was covered, is now not at all covered. So far I have called my employer, parent company, hmo, federal COBRA regulators... and have gotten the collective it sucks to be you speech from everyone. I imagine my retirement account will now be used to cover some of the fees but no way the bulk of it.

I read on another blog the appx cost is $25,000 and on another $60,000! Is there anybody, anybody who can help me? Guide me in the right direction?

[leapyrtwins]

Cost of BAHA implant surgery varies due to a lot of different factors - doctor's fee, hospital fee, whether you use an anesthesiologist or not (if you have local, you don't need an anesthesiologist).  My insurance company was billed somewhere in the neighborhood of $50,000 from what I recall (my surgery was 3 years ago; done as an outpatient with local, and lasted all of 90 minutes from start to finish), but they discounted it DEEPLY and neither my doc nor the hospital got anywhere close to what the original bill was.

The cost of the processor is typically set by your doctor and it varies.  Sometimes the processor is included in the hospital bill, sometimes it isn't.

I'm not a lawyer, but what your insurance company did to you doesn't sound legal.  I'd take Jim's suggestion and contact your state insurance company. 

Most doctors will not even agree to schedule a BAHA implant surgery until they have proof of coverage from a patient's insurance company - since there are still a lot of insurance companies out there that don't cover BAHAs.

In the end if you do have to foot the bill yourself, see if you can work out a payment plan with the hospital and ask the doctor to give you his professional discount.  Docs mark up their services, as well as the cost of the processor.  If your doc did the surgery without proof of insurance, IMO, he should "eat" some of his profit.

Jan

[tenai98]

Wow
These thousands of dollars baffle me...My BAHA cost me a total sum of $1.000.00 which was reimbursed by CHAMPVA....I continue to shake my head.
Jo

[Brewers7]

Someone posted today a trial going on in NY that would cover the costs. 

[Denise S]

Like Jo, I'm shaking my head!!!    But Jo....are you in the U.S.??   That must be your portion of the bill?? 

 I researched this a lot a year ago and am looking into it again.      I did everything I was supposed to & got denied......fought the battle for months in 2010, but once again told there may be another change to my insurance so thinking of trying again (not sure I want the stress I went through last year)       I have been told by multiple places the processor alone costs about $4,500-$5000.      The surgical part can vary big time due to things like stated by posts above.

Good luck......I too seen post for NY, a bit to far for me to travel, darn!!

[tenai98]

Denise,
I'm in Canada, so the cost of the surgery was covered under our health care system..the cost of the BAHA only cost me a grand as Cochlear was having a promotion at the hospital. Overall it only cost me my time as the unit was covered under my US CHAMPVA (late hubby was vietnam vet)...In the future, I'm sure the unit will cost me alot more, but under our health care, they cover up to 2,000 to help out and the rest CHAMPVA should...Counting my blessings here
JO