How to get insurance to pay for transear??

[Static]

I was wondering, since my insurance won't cover an aid, even though my hearing was lost in a critical surgery, I have found out that they will cover a cochlear implant.  I don't want a baha, I want a transear.  Any ideas?

[leapyrtwins]

Wish I had some ideas, but in my experience, insurance companies don't typically cover hearing aids.  The BAHA is generally covered because technically it's an implant.

I do have a question though.  Why don't you want a BAHA?

I'm just wondering if you might have some reservations or questions about the BAHA that some of us users might be able to address and in doing so we could add to your comfort level.

I don't mean to put you on the spot, or make you answer a question that is uncomfortable for you - so if you'd rather not answer, or you'd rather send me a PM, I totally understand.  The BAHA isn't for everyone; it's most definitely a personal choice, so if you just don't think it's right for you that's understandable.

Jan

[sgerrard]

It's not a hearing aid, it's a prosthetic hearing device. 

Seriously, sometimes just changing the treatment code submitted to insurance companies can make a difference.

Steve

[ixta]

I agree steve, thats what they put for me, to help with balance and quality of life. I still had to pay about half of it.
Unfortunately I don't use it and am considering baha.

[Static]

Jan, I am not a candidate for a baha.  My incision site was closed with titanium mesh, I've already discussed this with my doctor.  I also do not want a baha.  Am not a fan of having another surgery or a post sticking out of my head.  Steve, I already tried the prosthetic device approach.  My personal choice normally covers these devices, but my dh employer excludes that from something they cover.  I've finally found someone in my area who does transear, but there is no way I can even think of affording one.  Apparently my quality of life is unimportant to everyone but me :/
~Karen

[saralynn143]

Do you think your doctor would write a letter explaining why BAHA is not an option for you and suggesting TransEar as an alternative? Every insurance company has an appeal process that you can go through when they turn down a claim.

Sara

[leapyrtwins]

Karen -

thanks for the response.  Sorry to hear you aren't a BAHA candidate, although it doesn't sounds like you'd want one anyway.  As I said in my previous post, they aren't for everyone.

I've heard the TransEar is an excellent solution to SSD.  Maybe as Sara suggested asking your doctor to write a letter to your insurance company might entice them to cover it.

Jan

[Static]

I suppose I could, but then, of course, I  wonder what my doctor charges for that sort of thing.  Everybody wants your dollar these days, nothing is free.  I already took a second part time job just so we can get by but extras... what are they again?  It's pathetic! Thanks for all of your advice!

[leapyrtwins]

Karen -

IMO your doctor wouldn't charge you anything to write a letter to your insurance company.  I've had numerous doctors write letters to my insurance company over the years and haven't been charge anything.  Most of them are glad to do it - plus, they probably turf the deed to one of their staff members anyway 

I say give it a shot; you have nothing to lose and a lot to gain.

Jan

[Omaschwannoma]

....hmmmm, just a thought here  if insurance pays for Viagra, why wouldn't they pay for hearing aides?  ED certainly isn't more life altering than SSD--or is it? 

[saralynn143]

You can also offer to write the letter yourself for his/her signature, that way the points you want to include are sure to be there.

But my experience is the same as Jan's. A doctor should not charge for writing a letter on a patient's behalf. That's part of their job.

Sara

[Debbi]

Okay, just to digress for a moment - did anyone else notice Ixta's profile "video?" (above)  That is absolutely hilarious!

Debbi

[leapyrtwins]

Debbi -I did notice the "video" and thought it was hilarious also!

To comment on Arushi's point regarding Viagra, I always found it interesting that most insurance companies cover it, but not birth control pills.  Go figure 

I personal think that hearing aids should be covered by insurance.  Hearing is an essential thing IMO, and I personally consider being SSD or having diminished hearing to be a medical issue - although I'm not sure everyone else does. 

Anyone know why insurance companies typically don't cover hearing aids    It seems to be a pretty universal practice and I guess I'm wondering what the logic is behind it.  I know not all insurance policies cover vision, but it's usually an add-on.  Couldn't hearing aids be an add-on, too?

Jan

[Omaschwannoma]

"Ditto" Jan's post!!!!!!  I signed a petition going around to send to Washington for just this purpose, hope we get this passed! 

[Static]

I live in PA and in most of my doctor's offices, there are signs that say that there will be a charge for filling out forms which I think totally sucks!  Medicine isn't the same as it used to be.  It's big business these days and doctors are half afraid to do things for fear of being sued.  My theory on why viagra is covered and other, more important IMO things are not, is because its another big business run by men, specifically the government, and they all want to be able to have sex because that's what is important to them! 
Actually, my insurance company explained the hearing aid issue to me this way............ normally it would be covered if listed as a prosthetic device and only if the hearing loss is the result of a life threatening injury or surgery (exactly what the AN surgery was for me), not from hearing damage caused through a degenerative process (like listening to loud music or abusing your ears) BUT, the company my hubby works for says not to cover them.  So if I lost my legs or arms in an accident, through no fault of my own, the insurance we have would NOT cover any prosthetic devices for me. 
This came about the last time their contract was renewed (union bull****).