getting Cros aid covered by Kaiser HMO

[carriekartman]

Has anyone had luck getting their insurance to pay for their Cros system? I'm so frustrated that an implant (BAHA, Cochlear etc.), surgery, testing, you name it, is covered but a Cros is not. I'm urging my employer to let our benefits plan cover it (they have one that pays our deductibles up to the limit--very good plan overall), but although Kaiser has prescribed it, will be fitting it etc. the full payment is on me (out of pocket), and not applied to the deductible.

Related: I got no benefit from Cros systems in the past that I tried (Phonak, Oticon . . ), but I'm trying the new Phonak Eon, as my audiologist said there is new tech, and it is considered better at pulling the speaker's voice out of the background, than previous hearing aids. It's very $$ ($5100.). Have you tried one, or the newest from Oticon? Like many of you, I am SSD with normal range hearing in my good ear. So it's a trick to find something with benefit.

[donjehle]

Hi carriekartman,

I will be receiving my new Oticon Reveal CROS system on Monday, so I can tell you better after that how it works for me.  With the dual AI feature built in(one for sounds and the other for voices), it is supposed to work much better than their previous systems did, but we'll see.

The top of the line Oticon CROS system at my audiologist is $5,500.  My current insurance will pay $4,400 towards that cost.  That leaves a balance of $1,100.  In addition, my audiologist credits $700 for my former Oticon CROS system.  So, my portion is only $400 -- which is not bad considering the expense of the system.  I am sad that Kaiser is expecting you to pay the full cost.  Someone there needs to realize that some insurance companies do pay for hearing aids and for CROS systems.

Please let us know how you like the Phonak Eon.  And best wishes in your future journey!
Don

[DanFouratt]

Please share what you find out.  Don let me know if the new one works better.  I have agreed with my ENT to start a serious review of hearing aids improvement this December.  The more real people information i have the better I will be prepared. Has anyone had experience with Medicare paying for any of this?

Thanks,
Dan

[donjehle]

Hi Dan,

You asked whether Medicare pays for hearing aids.  I don't believe that Medicare itself pays for the hearing aids (I don't know if they pay any of the testing).  I have a Medicare supplement for DVH (Dental, Vision, & Hearing).  The Medicare DVH pays a portion of dental work, eyeglasses, and hearing aids.  DVH is an additional supplement you pay for.  And there is a HUGE difference in how much is covered.  Some plans only cover dental.  My current DVH covers $4,400 towards my CROS hearing aids.  But I am switching to a plan next year which only covers dental.  My financial advisor encouraged me to switch to a plan without hearing coverage for the next couple of years to save money (since full DVH plans cost more and since I will be receiving new hearing aids today with a two-year warranty so I will have no need for hearing coverage).

States are different in the DVH plans that are offered, and carriers are different in their monthly cost and coverage.  It pays to shop around.

I hope this is helpful.

Best wishes in your exploration!
Don