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No CI in my future


Eric in Tulsa
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I just left the surgical consult and I’ve gone from an all time high to the lowest of lows back up part way toward the high. 
The surgeon said that Medicare would like not pay for my CI surgery and that there was a high degree of probability that the implant would not work for me due to 25 years of no stimulation to that side of my brain. Bummer!

Then he hauls out this bone conduction tester and puts it on my head. My wife talks to my dead ear side and I magically hear her on my right as if I’m wearing a cros hearing aid. So, what good does this do? Medicare, in their infinite wisdom will pay for this. 
so I don’t get rid of the tinnitus, and I don’t get sound location. But I do get 100% guaranteed speech recognition from my left side. 

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After having the day to think on it, watch several MedEl videos, and read several postings and articles I’m about ready to make the leap. The 5mm deep crater in my mastoid bone isn’t too exciting, but other than that, it’s not a lot different than a CI implant. 
I have an Audiology Consult September 24, at which point I guess I’ll need to make a decision. 

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Oh @Eric in Tulsa I'm sorry it's not what you expected!  I didn't think that the 25 years would make that much difference to not be recommended. I've certainly heard of people benefitting in similar situations. But you'll have to trust your health professionals (and get enough opinions to be sure.)

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@Eric in Tulsa


Quite a surprise for you I am sure.

It is not surprising about Medicare because at the moment people in the US are having varied experiences getting their private insurance plans to approve a CI for single sided deafness.  It seems to be in part connected to which CI center they use and in part connected to which insurance plan they have.  Medicare has more strict qualifying rules than private insurance plans for CIs even for people with bilateral hearing loss.  Organizations like American Cochlear Implant Alliance are working hard to change that.

The surgery, recovery and experience at hook up and going forward are very different between CI and BoneBridge. I hope you stay active in HearPeers and share your BoneBridge journey.

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This morning I awoke quite depressed over this whole situation. I about ready to just accept that I can’t hear out of my left ear and never will. I can’t get anyone to guarantee that Medicare will cover Bonebridge and it makes no sense to me that they would. I mean, why would they. I have no reason that I can’t wear a CROS or BICROS hearing aid. The only reason I don’t is that I can’t justify the cost. I don’t believe that is a justification to Medicare. 
im about ready to throw in the towel. I just can’t take the chance of having an expensive procedure done and then be told that I have to pay for it. 

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I’ve made an appointment with my hearing aid specialist and I still have the appointment with the Bonebridge specialist. I’m going to pursue both avenues at this point and get the opinion of my longstanding audiologist on the Bonebridge system. I’m just not sure that Bonebridge offers me anything that a CROS or BICROS system doesn’t. 

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Hi @Eric in Tulsa

I redirected the September HP GoogleMeet topic so we do not confuse people.

If I was in your situation, I would give myself some time to sort through everything and I would most definitely seek several opinions.  
 

I am sorry insurance is an obstacle.  This journey is tough enough without added complications from insurance.

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21 hours ago, Eric in Tulsa said:

This morning I awoke quite depressed over this whole situation. I about ready to just accept that I can’t hear out of my left ear and never will. I can’t get anyone to guarantee that Medicare will cover Bonebridge and it makes no sense to me that they would. I mean, why would they. I have no reason that I can’t wear a CROS or BICROS hearing aid. The only reason I don’t is that I can’t justify the cost. I don’t believe that is a justification to Medicare. 
im about ready to throw in the towel. I just can’t take the chance of having an expensive procedure done and then be told that I have to pay for it. 

Usually, hospitals submit a pre-authorization and that’ll tell you whether or not it’ll be covered.  I’ve read good things about the Bonebridge system but admit not knowing too too much about them except that or BAHAs no longer have the protruding thing from the skull according to Audi.  If it’s an option, then no reasons not to pursue it.  
 

And yes, Medicare is a fickle thing.  They have one of the stricter qualifier to be approved for a CI at like 40% Word understanding vs most other Insurance 50-60%.  It’s weird and stressful for sure.
 

Doesn’t MedEl have a department that helps navigate insurances?  It’s early and I lack caffeine so I may be thinking of various HA companies instead.  May not be a bad idea to get Surgeon (if you’ve met them), Audi and MedEl to go to bat with your insurance to cover things.  

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Medicare won’t do prequalification, so you take your chances and could end up with the bill. Yes, MedEl is researching what the requirements for Medicare to pay for Bonebridge are in my case. I suspect they are going to find I don’t qualify. 

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I had a nice phone conversation with Kevin Vukovich yesterday. He is MedEl’s Director of Bone Conduction Systems. From what I understand he is the guru of bone conduction period. 
I sent him my audiogram and after reviewing it, he encouraged me to give CROS hearing aids another try. He is concerned that my expectation from Bonebridge is too high and that once it’s done, it’s done. With hearing aids, I can at least try them and turn them back if I don’t like them and Bonebridge will still be an option. 
today, I’m researching my CROS hearing aid options and scheduling an appointment with my audiologist for the purpose of fitting a trial pair. 

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@Eric in Tulsa

Terrific!  I attended a presentation given by Kevin Vukovich and learned a lot about BoneBridge.  I am glad you spoke with him.

Keep us posted on your journey.

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13 minutes ago, Mary Beth said:

@Eric in Tulsa

Terrific!  I attended a presentation given by Kevin Vukovich and learned a lot about BoneBridge.  I am glad you spoke with him.

Keep us posted on your journey.

We’re you the one that sent him my email address? If so, thank you very much. It was an enlightening conversation. I am amazed at how caring and concerned everyone at MedEl is for the well being of their patients and potential patients. I may never be a MedEl patient, but that has not mattered one whit to every MedEl person that I have spoken to. 
 

I wish that they made CROS hearing aids. 

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