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By Jamie Berke, About.com Guide to Deafness since 1997

Live in Utah? Forget About a Second Implant.

Saturday December 13, 2008
KSL.com has an article about a deaf girl in Utah who wants a second implant (bilateral) but the insurance company won't pay for it. According to the article, "Utah is one of the few states where insurance companies don't pay for what are called bilateral cochlear implants." The insurance company's justification is that bilateral implants are still considered "experimental."

I learned more from reading the comments as well. It seems the principle of "adverse selection" is at work here. That is, the insurance companies won't cover a certain procedure because they fear that if they cover the procedure while their competitors in the state do not, they will attract all the customers who want that particular procedure, thereby costing them more money. Conversely if one insurance company decides to cover a particular procedure, other insurance companies will follow because they don't want to be at a competitive disadvantage.

So what is the answer to solve the problem in Utah? The answer is that instead of focusing on one insurance company, an effort must be made to get all insurance companies in Utah to cover bilateral implants.

Comments

December 14, 2008 at 2:29 am
(1) Christina says:

I am glad the insurance wouldnt pay for the second one because one is too much on a young child, as a nurse and worked with deaf kids who had such implants, they sure have had problems and I dont think having two is even moral for such young ages. The implants could have its better design in the future that it wouldnt impact on the side effects and the side effects are more serious than they are letting it on..

December 14, 2008 at 6:01 am
(2) JD says:

I am glad, too! It is totally unnecessary for insurance companies to pay for implants. Deaf people are perfectly fine without implants. I have seen implanted people still needing interpreters and so forth. Implants do not make Deaf people more “functioning”. Deaf people can pay for their own implants. I hope insurance companies read this!

December 14, 2008 at 11:58 am
(3) Utah Got It Right says:

Utah Got It Right. America is in debt due to ridiculous spending and one of them is having insurances to pay for CI when it either doesn’t work or is no better than the latest digital hearing aids. Other states need to stop and follow Utah’s stand on CI.

December 14, 2008 at 11:59 am
(4) Go Utah says:

Utah Got It Right. America is in debt due to ridiculous spending and one of them is having insurances to pay for CI when it either doesn’t work or is no better than the latest digital hearing aids. Other states need to stop and follow Utah’s stand on CI.

December 14, 2008 at 8:47 pm
(5) Dianrez says:

Stepping back and considering the full picture: it may be wiser to hold off a second implant for some more years until the science is improved and the device more reliable.

Insurance is only obligated to bring a person to a basic state of health; it is not meant to make one perfect at the expense of other insurees who may need more critical life-saving procedures and devices.

With the limited funds, skyrocketing medical costs, and needs just to stay alive, the insurance companies have to balance things or increase premiums so that a larger proportion of the nation cannot afford any insurance at all.

March 8, 2009 at 12:09 am
(6) Miss Kat's Mom says:

You guys are full of it! It is absurd that Utah doesn’t cover bilaterals. I live here, and that means my daughter ends up with 1 CI, inferior services, and no choices for education. WooHoo Utah. CI’s have been proven safe and very effective. 2 is even better

September 28, 2009 at 12:56 am
(7) Mom of hearing impaired child says:

I can not believe the attitudes of some people. Try living in a “hearing” world and not being able to communicate with people. May you or someone you know nevef have to live in both worlds. As a mom of a deaf child and watching her go through life is hard. And when insureance companies not paying for hearing aids what other choice does a child have. Think about it. How would you feel if it was you or someone you know.

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