Single sided deaf and on Medicare? Clinical trial for CI

[Mary Beth]

https://clinicaltrials.gov/ct2/show/NCT05250414?term=Med-el&draw=3&rank=12

[Eric in Tulsa]

Thanks for the post Mart Beth. I looked but they aren’t interested in anyone who has had a loss for more than ten years. Mine is just over 25 years. I guess they think that learning to use one after that long is too big a hill to climb. 

[Mary Beth]

@Eric in Tulsa

Last I heard Medicare was not approving cochlear implants for people who have typical hearing in the other ear (single sided deaf).  Other insurance plans are now approving cochlear implantation for single sided deaf ages 5 and older.

[Eric in Tulsa]

Well that bites for me. I have Medicare with United Healthcare Supplement through AARP. Two years ago, Medicare said they would pay 80% and UHC was going to pick up the other 20%, so it wasn’t going to cost me anything out of pocket. 

[Mary Beth]

@Eric in Tulsa

Insurance rules change all the time.  Keep us posted.  Maybe this has changed for the better.

[Eric in Tulsa]

I went for my CI evaluation test last week and was disappointed yet again. I did not qualify under Medicare for a CI, but I do qualify for a bone implant system. 
Here is the skinny on Medicare for a CI and SSD. If you have one good ear and one ear that comprehends less than 40% of the spoken word, you qualify for a CI.
Unfortunately, the way they tested me, my bad ear appeared to comprehend 70%. I say appeared because I don’t believe they isolated my good ear well enough and I think my good ear was picking up the words through bone conduction and through leakage through the ear plugs. I’m going to talk to the Audi about retesting with white noise in my good ear. I think the outcome will be a world of difference. 
 

[Tim]

@Eric in Tulsa Good luck. 

I started losing hearing about 15 years ago in my left ear, spent 7 years with a bone conduction system when insurance first (and repeatedly) denied the CI due to not yet being approved for SSD.

Last year, my Audi was careful to test appropriately to make the case for insurance approval as strong as possible.  She called me back for a followup for a test that she missed before submitting to insurance. (She talked with a CI company representative that gave advice on insurance approval.) I think my WRS score was down to just 11%.  Approval took just a couple of weeks. 

Let me know if I can be of help.

 

[Dianna]

Hiya! I was getting approved for ci just prior to my 65th birthday 2021 at U of Iowa and received into a trial. My insurance at that time was from the marketplace (obamacare) i was approved, implanted with med-el. At that time in covid world i also had "extra help" medicaid. I paid zero out of pocket as the "extra help" paid deductables. Just after, at 65, started social security and medical.

I dont believe my current plan would cover ci now, I am still reading the 2024 SS booklet!! Plus with budget fighting right now in the congress, who knows what actual coverage in 2024 will be? Democrats are for and republicans against social security spending

So what i am saying is folks who live in state paid medicaid may be losing the federal funded extra help that was available during covid.

Plus government in USA is fighting over budgeted social security as we discuss this right now. 

Last years cola increase was so big it knocked a lot of folks out of the range qualifying for medicaid.

So it all comes down to what state in the US one resides in. Rules for ci qualification may be good, however payment may be higher out of pocket.