Insurance issues with CI

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sassy

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Hello! I am new to this web-site and am having a consultation at Stanford in 2 weeks for CI. I have been profound for many years. I was diagnosed at age 5. I work in the medical field and I have to hear better than I do now or I won't be able to continue in my field in the next few years. My father was profound and my sister is being seen at Stanford the same day as myself. Anyway, I have 2 main questions. What are some questions for the doctor that I may not have thought about? And I have Blue Shields PPO. What luck have you had with getting both covered? My sister said we may have to sue the insurance company to get both. I'm game! And one more thing. Reasonably how long until I can function normally at work after CI surgery? I have to be able to understand my patients. Thanks!
 
Question number one doesn't just involve your insurance, it has a lot to do with you and your medical history and your doctor. In my case, I am due for a CI in less than two weeks and my doctor will only do one. In his words, I am still young enough to wait (I am almost 52) in case there are advancements in the next 10 years or so. Since I have to rely on military insurance, that is as far as I will get at this point in time. Other other doctors may have other opinions, but hey...anything is better than what I have now (profound and also no speech recognition).
As for the second, that depends on how well the surgery goes, how invasive the implant was and your own healing. My doctor thinks I should be able to return to work in just over a week, barring complications.
I am sure there are others here who will have more info, but that is how it stands for me.
 
I would ask your CI surgeon how many CIs they have performed, what the recovery process is like for most CI users and what you can expect once your CI has been activated.

As for recovery from surgery, it only took me a week to recover following both of my surgeries. Following my first surgery, I experienced tinnitus and felt extremely tired, but by the fourth day, I felt pretty much like myself. After my second surgery, I woke up in recovery with a migraine (I'm a migraine sufferer), a stiff neck and tinnitus. On day 3, my entire body felt as if it had been run over by a truck. On day 4, I felt pretty close to normal.

In my case, I used a hearing aid in my nonimplanted ear for 6 months post activation. However, over time, the hearing aid became weaker and more distorted until I could no longer tell if it was on or off. After my CI and former hearing aid audi made all of the possible adjustments they could to my hearing aid, my CI surgeon recommended I get bilateral CIs. (I'm totally deafblind, so my personal safety and safety while traveling outdoors had to be taken under consideration). Long story short, I couldn't be happier with my decision to receive bilateral CIs!

As for your insurance, your CI audi and surgeon will know how to write the appropriate documentation (i.e. letter of medical necessity) in order to receive insurance approval.

Hope this information helps!
 
sassy said:
Hello! I am new to this web-site and am having a consultation at Stanford in 2 weeks for CI. I have been profound for many years. I was diagnosed at age 5. I work in the medical field and I have to hear better than I do now or I won't be able to continue in my field in the next few years. My father was profound and my sister is being seen at Stanford the same day as myself. Anyway, I have 2 main questions. What are some questions for the doctor that I may not have thought about? And I have Blue Shields PPO. What luck have you had with getting both covered? My sister said we may have to sue the insurance company to get both. I'm game! And one more thing. Reasonably how long until I can function normally at work after CI surgery? I have to be able to understand my patients. Thanks!
Click to expand...

While I am not a CI user myself (but am planning on it, my first CI audiologist appointment at the U of M is November 20th!) I have been told and also have read everywhere that activation does not normally take place for about 3 to 4 weeks after surgery (for the incision to heal), and then there's the mapping period. So if you're concerned about being able to understand your patients, that is a good question for you to address with your audiologist and doctor.

There are MANY threads in this section that may answer many of your questions and give you ideas of questions you want to ask your doctor. Good luck with your appointment!
 
Thanks for the information. I will keep reading. Sorry so long to respond I was having computer problems. It sound like I will have my hearing aid hearing for a while before switching over to CI.

Also I know what you mean about not being able to tell if the weaker side is on. I recently had to send in my digital and was using my old analog. I kept tapping the analog because I wasn't sure it was on!! Sucks.
 
Make sure the insurance company covers everything and it is in writing. I am sure you dont want to wake up to a $100,000 medical bill. And yes it have happened to some people.

As for the length of time to "recover" it can vary from person to person, I recovered within 10 days after surgery. Now, the time it takes to be able to " hear" with the CI, that can be as many as 6 mappings.

I requested infor from all 3 CI companies in the USofA and I researched and called the companies and made my own decision. The surgeon and audie will make their suggestions. Remember it is YOUR ears. I chosed the MedEl for the nifty remote control and the ceramic housing for my coil.

Again good luck and keep in touch.

Feel free to send me messages if you want.
 
My surgeon and audi didn't suggest what CI brand I should get.

In fact, when I asked my audi about each CI brand she said they all were excellent.

The ony exception was Med-El since their BTE processor wasn't accessible to me as a totally blind person, so that brand was immediately ruled out.
 
It sound like I will have my hearing aid hearing for a while before switching over to CI.
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Well I think unless you're deep profound, that it's worth it to experiment with a bimodal approach first, and THEN wait and see. I have to say that I think that the bimodal vs. bilateral sucesses tend to be akin to the analog vs. digital debate with hearing aids.
 
deafdyke said:
Well I think unless you're deep profound, that it's worth it to experiment with a bimodal approach first, and THEN wait and see. I have to say that I think that the bimodal vs. bilateral sucesses tend to be akin to the analog vs. digital debate with hearing aids.
Click to expand...

Lets let someone who actually has experience with bilateral CI's give their opinion. We wouldn't want any confusion.
 
deafdyke said:
Well I think unless you're deep profound, that it's worth it to experiment with a bimodal approach first, and THEN wait and see. I have to say that I think that the bimodal vs. bilateral sucesses tend to be akin to the analog vs. digital debate with hearing aids.
Click to expand...

DD,

How is someone choosing to receive bilateral CIs comparable to the analog vs. digital debate?

I don't want to start an argument here, but no two people hear the same.

For example, when I received my first CI, I had severe-profound hearing loss and speech perception of 22% in my right ear and 8% in my left ear (aided).

I think it's unfair to say that only people who have hearing loss of 110 dB or more across all frequencies should qualify for a CI.

If CI centers didn't think people with lesser degress of hearing loss (i.e. moderately-severe to profound or severe-profound) could benefit from an implant, they wouldn't accept them as candidates.
 
Well as you said, no two people respond the same to hearing technology.
I'm not against bilateral at all....I think there are some cases where it's blatently needed. I have no beef whatsoever with those cases. BUT, in cases where hearing is still somewhat aidable, they should wait six months just to see if a bimodal approach helps them. I mean the benifits of bilateral are basicly "easier time localizing sound" and "ease of hearing in crowds." Even unilateral dhh folks have those issues.
Some people who are ambigious canidates (and don't have tintitas or recruitment) may find that a bimodal approach helps them just as much as bilateral. See what I mean?
 
Well I had my visit today and yes they said I am a candidate. The doc said possibly both together but say's that one at a time is somtimes better. The audiologist thinks that I should do one and then the next in 6 months. It sounds like have my hearing aid hearing in one ear will help the process. Some synergistic stuff. Sorry I'm a terrible speller!! I liked the Med-El but a little nervous about the water issue. We boat a lot and they haven't said if the CI is water resistant. I know none are water proof, but resistant would be nice. I am kinda scared. All the talk about how I might have to high of expectations. But what I am reading on this site says hearing is way better with CI. I'm going to join a group in SF to talk to CI users first hand. Any more suggestions?
 
deafdyke said:
Well as you said, no two people respond the same to hearing technology.
I'm not against bilateral at all....I think there are some cases where it's blatently needed. I have no beef whatsoever with those cases. BUT, in cases where hearing is still somewhat aidable, they should wait six months just to see if a bimodal approach helps them. I mean the benifits of bilateral are basicly "easier time localizing sound" and "ease of hearing in crowds." Even unilateral dhh folks have those issues.
Some people who are ambigious canidates (and don't have tintitas or recruitment) may find that a bimodal approach helps them just as much as bilateral. See what I mean?
Click to expand...

DD,

I'm of the opinion that if someone qualifies for a CI, then they deserve to have the right to decide if bilateral implantation is right for them. While a bimodal approach may help some people, it does not help everyone.
 
can someone tell me what bimodal is?? I'm not up on all the lingo used on the site.*Adam
 
When I first got my CI which I am using Med-EL CI, my insurance cover it all so far. I think it all denpend on what type of insurance that willing to cover all of the cost of surgery, stay in the hospital, the CI parts, and medications as well. I know it very expensive. But they did say if you want to remove CI, insurance won t pay for removeal.
 
GarnetTigerMom said:
When I first got my CI which I am using Med-EL CI, my insurance cover it all so far. I think it all denpend on what type of insurance that willing to cover all of the cost of surgery, stay in the hospital, the CI parts, and medications as well. I know it very expensive. But they did say if you want to remove CI, insurance won t pay for removeal.
Click to expand...

Actually, insurance will pay for a CI removal as long as there is a medical reason for doing so (i.e. irresolveable pain at implant site, extreme dizziness, headaches, etc.).
 
Sassy,

I live in the SF area ( peninsula)and I have had a CI for over a year. If you would like you can send me a PM.
 
I don't know what PM is. Sorry! But that would be great. Just tell me how to do that.

Denise
 
Sassy,

PM is private message. To send a private message Log in and you should see Private messages at the bottom left of the "log in" box. Click on Private messages. Scroll down and at the left of the screen you will see Private messages and just below that you will see send a new message, click on send a message. Hope this helps!
 
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