Got Good Speech? No CI for You.
Thursday November 12, 2009
Over the years, I've seen a variety of reasons that a cochlear implant sometimes gets denied. This one takes the cake: good speech. Since when does the quality of one's speech have anything to do with the level of one's hearing and need for a cochlear implant?? Based on the reasoning for denial cited in CD's Ear Blog, I should have been denied for a cochlear implant by my own insurance company.
Has anyone else ever been denied a cochlear implant for merely having good speech? Any other stupid, indefensible reasons?
I got the CI in 2003 and wasn’t turned down for speech. In fact, my doctor said my speech was going downhill because I was losing speech understanding with hearing aids and that was what made me quilify for it in the first place. I’m disappointed that insurances won’t cover CI because speech is too good. I’m fluent in English (don’t get me wrong, my language level is not where it should be) but good enough to get by in life, regardless if I have the CI or hearing aids.
Yes, I have profound hearing loss in my left and severe in my right but because my speech is understandable….no CI for me. Last evening, I discussed my predicament with my college professor and he suggested looking into having a CI operation in India.
Kind of reminds me of the time I was at my son’s elementary school. One of his teachers came up to me and introduced herself. I responded by just saying, “Hello, how are you doing?” She responded by saying, “Well, you speak really good. I’m impressed.”
I don’t know maybe she works for the insurance company now…Bottom line, it is very frustrating but I am not going to let it stop me. Don’t give in, and don’t give up.
Yes, Utah Medicaid had a similar policy in 2001 that was successfully appealed by the state Disability Law Center. ASHA, HLAA, or the manufacturers should be able to readily tell you what other states have since implemented similar criteria.
It appears that Equality Care may have confused the coverage criteria for speech-generating devices (SGDs) with cochlear implants. For example, persons with strokes who cannot speak or have full use of their extremites would fit the Medicare and FDA criteria for SGDs because they are unable to communicate through other means.
These criteria don’t make sense for cochlear implants, as the best candidates are post-lingual.
So this may be a denial you can resolve just be talking to a policy person at Equality Care itself, and not its ACS contractor. I looked at a few current state CI policies so far and have yet to find this SGD criteria in theirs.
No CI for good Speech?? Exactly Who Made that idiotic desision??? That is WRONG!!! That person needs to go back and be persistant..With the Doctors and everybody..Somebody goofed in their paperwork..Sounds like they just looked at one thing and said “NOPE”…I don’t know where this person lives.. I live in Ohio.. I just got a CI.. I totally lost my hearing 4 years ago.. and My speech is still pretty good.. It did deteriorate some..But My Speech had NOTHING to do with getting my CI…Goe to a diffirent Doctor.. Or med center..If Cincinnati Didn’t do it for me I was Planning on going to Cleveland..This does not sound right.. Fight for it.. DO NOT Take “NO” For an Answer..BULL!!!!
My son had an evaluation at the childrens hospital in Boston, Mass they denied him a CI because he was 10 to old for the CI is what was told to my exhusband myself. He lost his hearing completely when he was 18months old still haven’t a clue as to how or why. About 4 yrs ago is when he started signing Very stubborn! he is now in school for the deaf and regular school. Was doing much better when he had a dedicated staff member with him that he truly enjoyed being with. I am hoping that when he gets older if he decides to get the CI he can.
10 is not too old. Can you go to another implant center? I know of teenagers who got the CI and did fine.