WIS.: 1st State to Require Ins. to Cover CI

[rockin'robin]

MADISON, Wis. – Wisconsin could become the first state requiring private insurance companies to cover cochlear implants for children with severe hearing problems.

The state Legislature passed a bill Thursday requiring private health insurance plans to cover cochlear implants, hearing aids and related treatment for those under the age of 18. Gov. Jim Doyle has promised to sign it into law.

While hearing aids help some children with hearing loss, those with more severe problems may be candidates for cochlear implants. The devices turn sound into electrical impulses that activate the hearing nerve, allowing the deaf to hear.

Supporters say some families with deaf children cannot afford to pay for implants that cost $50,000 or more when excluded by insurance policies. They say getting the devices early is critical to help children develop their language skills.

"This bill is going to allow children to keep their hearing, to become members of society, to go to school and keep a job," said state Rep. David Cullen, D-Milwaukee.

Several states already require insurance companies to cover some hearing aid costs, but advocates said Wisconsin would be the first to extend the mandate to cochlear implants.

The measure, which allows insurers to apply cost-sharing provisions for the procedures, passed the Senate on a voice vote and by an 80-16 margin in the Assembly.

Opponents, which included some Republicans and business groups, said the mandate would drive up costs for small businesses and employees struggling to afford health care costs.

The potential cost of the mandate is unclear and will vary widely by company, said Phil Dougherty, senior executive officer of the Wisconsin Association of Health Plans.

Roughly 1.6 million residents with private insurance would be affected by the bill. Others in self-funded plans will not be bound by the mandate, and most government-funded plans such as Medicaid already cover the devices.

Wis. could be first to require cochlear implants

 

[deafdude1]

As long as insurance does not approve CI willy-nilly, such as to those who could benefit from HAs, only a tiny fraction of a percent who are truly deaf would get CIs. Insurance companies need to make sure anyone who asks for a CI is wearing the best HAs(or get a trial for them) and has them programmed correctly by an expert audiologist. I am glad insurance finally will pay for HAs!

 

[LuciaDisturbed]

Finally.

Unfortunately, it will only cover children under 18. But at least Medicaid will cover for all ages there, I think, but there is always going to be that place where you are too well-off to qualify for Medicaid, but you are also too poor to afford the CIs and do not have any insurance at all either because you are self-employed or your job just does not provide insurance. I never got to go through the candidacy process for a CI in Milwaukee, Wisconsin and the CI option was offered to me back in around 1990 so I don't really know, and my friends from Wisconsin who got the CI, the ones who got them as kids, I do not know how their CIs were paid for, I will have to ask one of them later, and the other friend, he got his CI paid for by Medicaid entirely when he was already an adult.

 

[Lighthouse77]

I thought they were already required to pay? I mean my insurance did, and I guess because of lawsuits.

 

[LuciaDisturbed]

As long as insurance does not approve CI willy-nilly, such as to those who could benefit from HAs, only a tiny fraction of a percent who are truly deaf would get CIs. Insurance companies need to make sure anyone who asks for a CI is wearing the best HAs(or get a trial for them) and has them programmed correctly by an expert audiologist. I am glad insurance finally will pay for HAs!

Some people just can't afford the BEST HA EVER THAT EXISTS simply because not all insurance companies nor Medicaid/Medicare will cover HAs but they will cover CIs. Although private insurance companies will now be required to pay for HAs, there is still going to be a lot of resistance from insurance companies like there is with Medicaid and Medicare. Also, no insurance will pay for every single brand/amplification level of HAs that exists out there that you are wanting them to try before even thinking of getting a CI...there is too many brands and too many amplification levels, and it would cost the insurance companies so much money and then the premiums, of which people are ALREADY complaining about) would go even much higher. They would probably pay for ONE or MAYBE TWO pairs of HAs before a CI. Most insurance companies most certainly ain't gonna be willy nilly about paying for ALL the damn HAs that are out there. If you did the math it would cost the insurance company a colossal amount of money.

If only the audiologists would offer 100% FREE trials with NO risk of any kind except a legal contract where you sign to promise to return the HAs by the deadline (even if it is only a 1 week trial per HA brand/amplification level) without requiring credit cards and bank account numbers and other ways to access your money, then it would be so much easier for many Deaf people to try all the HAs out there without paying a colossal amount of money to find out which one is the right one and then when they do find the right one they can go ahead and pay for that right pair of HAs or if they find their hearing loss is too profound to benefit from the best HA that ever exist, they can now know that their next option is a CI if they want to go for one, or to just go without anything. It would be so much easier for all Deaf people in the long run.

Or at least audiologists should keep a whole bunch of different HAs with different amplification levels out on display where Deaf people can try them out on the spot and play around with them (doing different things like using the phone, talking to people, trying it out in the parking lot to see how well the HA does in environmental noise, etc...) to find the right pair for them like one would when one goes to a cell phone store and play around with the cell phone to see if they find one they liked best. I never see that at a HA clinic.

Too many places offer free trials for various products but still require you to provide your credit card numbers etc which is RISKY because if you either do not return the product in time and undamaged you're fucked (no matter how much they claim that the trial is "risk-free" - read the small print!) or you just cannot do a trial at all because you just do not have good credit or have no credit at all to start with and therefore do not qualify for free trials, which really gets me! I do not like to do trials with products where their company has access to my money which they can fuck me over with, I cannot trust them - just the other day I got an offer in the mail for a "risk-free 90 days trial" for the Tempur-Pedic bed - my favorite kind of bed - and as much as I would love to do the trial there is no way in hell I am risking my money to try out a bed only to have it possibly damaged by my cats or whatever and then when I decide I do not want it and I return it I still get charged anyway for the damage - there is no such thing as "risk-free").

 

[deafdude1]

If insurance companies are happy to fork over $50,000 for CI, why the resistance to fork over $1500-$3000 per HA? I know people who can't afford HA but for them CI is free so they go out and get a CI even though they would rather have HAs and avoid the surgery and other risks. So it's logical that insurance should pay for HAs otherwise those people will go for CI(even though many prefer HAs)

One good brand is enough. My Phonak Naida V UP is among the best HAs and for someone who's HL was so profound they didn't benefit from the Phonak Naida V UP, they only need to try one or two other brands, maybe one analog model as well. They don't have to buy those HAs, just rent them then return or buy if they decide to keep.

There is no such thing as a risk free trial. 3 years ago I went to a HA dispenser with dad and we refused the trial because we knew the dispenser would not want those HAs back or he would charge like $500 when I return the HAs. I did get to try them for 10 minutes while in the office(something that's the least anyone can do) and they weren't any better than my old Widex from 1998. My audiologist who sold me those Phonaks told me that this HA dispenser doesn't know how to program HAs properly and he does. When I get them reprogrammed they should be even better than they are now.

Finally, there are audiologists and dispensers online that can sell good HAs for as low as $1000 and my Phonak HAs can be had online for $1500 to $1800 each. It shouldn't be that hard to save up enough in a few months or especially in a year to buy one or a pair of those HAs. Youd be surprised at the silly things people rack up debt over such as $50 pair of pants or $100 to eat out in a fancy restaurant. Live frugally and the savings will really add up. Some people can even take a loan from the bank(if their credit is good) for the cost of HAs and pay the bank back every month for 24, 36, 48 months, etc.

 

[deafdyke]

Or maybe a good idea might be to have an In Booth Intensive Hearing Aid trial, with a bunch of different devices. Then the person could try out the device which worked well in the booth, in the real world.

 

[LuciaDisturbed]

If insurance companies are happy to fork over $50,000 for CI, why the resistance to fork over $1500-$3000 per HA? I know people who can't afford HA but for them CI is free so they go out and get a CI even though they would rather have HAs and avoid the surgery and other risks. So it's logical that insurance should pay for HAs otherwise those people will go for CI(even though many prefer HAs)

One good brand is enough. My Phonak Naida V UP is among the best HAs and for someone who's HL was so profound they didn't benefit from the Phonak Naida V UP, they only need to try one or two other brands, maybe one analog model as well. They don't have to buy those HAs, just rent them then return or buy if they decide to keep.

There is no such thing as a risk free trial. 3 years ago I went to a HA dispenser with dad and we refused the trial because we knew the dispenser would not want those HAs back or he would charge like $500 when I return the HAs. I did get to try them for 10 minutes while in the office(something that's the least anyone can do) and they weren't any better than my old Widex from 1998. My audiologist who sold me those Phonaks told me that this HA dispenser doesn't know how to program HAs properly and he does. When I get them reprogrammed they should be even better than they are now.

Finally, there are audiologists and dispensers online that can sell good HAs for as low as $1000 and my Phonak HAs can be had online for $1500 to $1800 each. It shouldn't be that hard to save up enough in a few months or especially in a year to buy one or a pair of those HAs. Youd be surprised at the silly things people rack up debt over such as $50 pair of pants or $100 to eat out in a fancy restaurant. Live frugally and the savings will really add up. Some people can even take a loan from the bank(if their credit is good) for the cost of HAs and pay the bank back every month for 24, 36, 48 months, etc.

Pray tell me, how the hell would I save for a HA (supposively I was not profound deaf) if I am on SSI/SS due to health problem? After rent and the bills and the cat food and litter, I have about $20 left for the rest of the month, and that goes to city bus transit. How would I save up? Please.

I am grateful that I am profound deaf and that Medicare and Medicaid paid for my CI completely. The whole thing was $60+ grand but Medicaid and Medicare negotiated with the hospital and the CI clinic and Cochlear Americas and got everything reduced to $20 grand and then paid the entire $20 grand and I did not even have to pay ONE RED CENT.

I do wish Medicaid would cover HAs here in Texas for my fiance but they don't. Fortunately my fiance is able to get his HAs through the VR department here in Texas every few years.

Ask the insurance companies why they are so resistant to pay for HAs but are willing to fork over $60+ grand for a CI, because it doesn't make sense to me either.

There are tons of people with bad credit thanks to assholes who live off of their stolen identities that never get caught. How in the hell would they ever be approved for a loan from the bank let alone get a bank account?

I do not even know anybody that buys $50 pairs of pants or go out and eat at a restaurant for a $100 meal. I and most of my friends are on government assistance or have low paying jobs or other crappy things and we all live check to check, most of us are not even one check away from losing our apartments or homes if we lose a job or the SSI check does not come on time. I buy almost all my clothes from the local thrift store. I live in a crappy apartment in a crappy neighborhood where people like to shit on my porch (yes, someone DID shit on my porch a few weeks ago!!!) and there are graffiti everywhere even though we have new owners and the entire apartment complex has just been repainted but stupid teenagers still go around and spray graffiti on our building again and again and again and there are trash everywhere, and the asshole who lives on the third floor smokes on his balcony and then tosses his cigarette butts out on the ground in front of my porch). And we have had two robberies, one right across the breezeway from me a couple months ago and another in the next building about six months ago, and the original management office burnt down last year (I suspect some disgruntled tenant torched it). We are not rich. We do not have money to "save up" for hearing aids. Our rent are going up. Plus, have you forgotten the current state of the economy here in the US?

 

[deafdude1]

This is why I am agreeing insurance should pay for HAs(and CIs) to those who can't afford it.

 

[rockin'robin]

Pray tell me, how the hell would I save for a HA (supposively I was not profound deaf) if I am on SSI/SS due to health problem? After rent and the bills and the cat food and litter, I have about $20 left for the rest of the month, and that goes to city bus transit. How would I save up? Please.

I am grateful that I am profound deaf and that Medicare and Medicaid paid for my CI completely. The whole thing was $60+ grand but Medicaid and Medicare negotiated with the hospital and the CI clinic and Cochlear Americas and got everything reduced to $20 grand and then paid the entire $20 grand and I did not even have to pay ONE RED CENT.

I do wish Medicaid would cover HAs here in Texas for my fiance but they don't. Fortunately my fiance is able to get his HAs through the VR department here in Texas every few years.

Ask the insurance companies why they are so resistant to pay for HAs but are willing to fork over $60+ grand for a CI, because it doesn't make sense to me either.

There are tons of people with bad credit thanks to assholes who live off of their stolen identities that never get caught. How in the hell would they ever be approved for a loan from the bank let alone get a bank account?

I do not even know anybody that buys $50 pairs of pants or go out and eat at a restaurant for a $100 meal. I and most of my friends are on government assistance or have low paying jobs or other crappy things and we all live check to check, most of us are not even one check away from losing our apartments or homes if we lose a job or the SSI check does not come on time. I buy almost all my clothes from the local thrift store. I live in a crappy apartment in a crappy neighborhood where people like to shit on my porch (yes, someone DID shit on my porch a few weeks ago!!!) and there are graffiti everywhere even though we have new owners and the entire apartment complex has just been repainted but stupid teenagers still go around and spray graffiti on our building again and again and again and there are trash everywhere, and the asshole who lives on the third floor smokes on his balcony and then tosses his cigarette butts out on the ground in front of my porch). And we have had two robberies, one right across the breezeway from me a couple months ago and another in the next building about six months ago, and the original management office burnt down last year (I suspect some disgruntled tenant torched it). We are not rich. We do not have money to "save up" for hearing aids. Our rent are going up. Plus, have you forgotten the current state of the economy here in the US?

Unbelievable!! How can/could you live this way? Hopefully, you don't have a child/children....Maybe finding a "room for rent" or a garage apt. would be better for you? In a better neighborhood. I'm a single parent of 3 boys and no way would I live in a place as you described....I would go to the YMCA before that!...Even look for a roommate on a better side of town!

I'm sorry to hear about ur dilemma. My boys mow lawns, pick up trash, wash cars, etc., for extra $$...I also babysit time to time to help. And if you go to Church (?)...I'm sure there are some good people there that would be able to help you find a better place to live. Even help with food/elec., if necessary.

We do have crime in my neighborhood, but when we do, we petition the management to evict those who do not keep their yards clean, or domestic violence, stealing, etc.

Good luck! I don't mean any offense by what I said.

 

[LuciaDisturbed]

Unbelievable!! How can/could you live this way? Hopefully, you don't have a child/children....Maybe finding a "room for rent" or a garage apt. would be better for you? In a better neighborhood. I'm a single parent of 3 boys and no way would I live in a place as you described....I would go to the YMCA before that!...Even look for a roommate on a better side of town!

I'm sorry to hear about ur dilemma. My boys mow lawns, pick up trash, wash cars, etc., for extra $$...I also babysit time to time to help. And if you go to Church (?)...I'm sure there are some good people there that would be able to help you find a better place to live. Even help with food/elec., if necessary.

We do have crime in my neighborhood, but when we do, we petition the management to evict those who do not keep their yards clean, or domestic violence, stealing, etc.

Good luck! I don't mean any offense by what I said.

Nope, I don't have any children.

When I first moved here in April of 2006 the neighborhood was pretty nice, and the complex looked excellent. I thought I had it made, with 2 swimming pools and a whirlpool and a fitness room and central AC/heating and our own balconies and sliding doors...this type of place would cost $800+ a month in Milwaukee and more in Madison but here it is (currently) $460 but the rent is going up soon. But, in the 3 years since I have moved in, the complex AND the neighborhood have pretty much quickly deteriorated to the point where it now has the "ghetto" status (meaning it looks bad now - trash all over the place, apartments in bad conditions, etc). I would very much like to move out and I and my fiance would like to rent a house from my fiance's dad's landlord and live in my fiance's neighborhood and split the rent with my fiance but my fiance needs a car of his own FIRST so he can commute to and from work. So, for now I am stuck as I do not have the $ to come up with the security deposit and the first month's rent. I can't do a garage apt as I cannot do stairs anymore thanks to my hip dysplasia. The next apartment or house has to be 100% accessible. I do not want roommates ever again as I have had horrible drama with ex-roommates in the past where the ex-roommates successfully conspired to have me kicked out by the cops even though my name was on the lease and I ended up homeless and living on a farm with 7 other weird people and ONE bathroom way out in Bumfuck, MN until I was able to save up $ to move down here. (really long story) I want none of that ever again. My biggest fear is becoming homeless again.

I do not go to church as I have too much bad experiences with churches and always end up coming home feeling humiliated, and I do not need that.

There is a program that helps with the electricity and I use that program sometimes, but they can only help you once a year.

I don't do "room for rent" because I have cats and it would not be fair to the cats to be contained to one room and not have room to run around and roam and play. And I will not give up my cats as the pet shelters here are constantly overcrowded thus they have to put many animals to sleep all the time and I don't want that to happen to my cats. I have had my cats for a really long time and will NOT let go of them.

However, I am used to this. I grew up in Milwaukee, I have lived in much worse neighborhoods than the one I am currently living in - I lived very near North 27th and Wells street back in Milwaukee and Hear Again can vouch for that when she is unbanned. That area is the #1 WORST ghetto in the entire city, and I lived there. I've also lived on South 15th Place and Becher, and that is a bad neighborhood too, and I lived there for a few weeks when I was 13 years old before my dad just tossed me to the state and I ended up in foster care hell. I often visited friends on Spaulding and on Teutonia Ave and these are bad neighborhoods and so I am used to it.

 

[rockin'robin]

Wishing you the best of luck finding a better place to live! You seem to have a lot of drive....so when the going gets "tough" the "tough" get going....Sad about everything that's happened to you, it's not often that I see/hear someone being so straight-forward and honest about themselves, such as you! Keep the faith, and let a little sunshine in everyday! Will be thinking of you!

 

[LuciaDisturbed]

Wishing you the best of luck finding a better place to live! You seem to have a lot of drive....so when the going gets "tough" the "tough" get going....Sad about everything that's happened to you, it's not often that I see/hear someone being so straight-forward and honest about themselves, such as you! Keep the faith, and let a little sunshine in everyday! Will be thinking of you!

Thank you.

 

[deafdyke]

Lucia, that sucks that your area has degraded. It always happens when the ecnomy is really shitty. About churches..........have you tried a Unitarian chuch? Those are very welcoming

Ask the insurance companies why they are so resistant to pay for HAs but are willing to fork over $60+ grand for a CI, because it doesn't make sense to me either.

I know.........it's possible they did that b/c while the operation is expensive relatively few people were eligable for it. I have a feeling that with the crop of ambigious canidates widinging, they might chose to pay for HAs instead of CIs.

 

[LuciaDisturbed]

Lucia, that sucks that your area has degraded. It always happens when the ecnomy is really shitty. About churches..........have you tried a Unitarian chuch? Those are very welcoming

I know.........it's possible they did that b/c while the operation is expensive relatively few people were eligable for it. I have a feeling that with the crop of ambigious canidates widinging, they might chose to pay for HAs instead of CIs.

I used to live around the block from an Unitarian church back in 1999 but I did not know that back then. This was in Milwaukee. I live in San Antonio, TX now and have not seen a single Unitarian church around here as this city is just predominantly Catholic, all my friends around me here in San Antonio are Catholic, even my fiance is Catholic. So I just don't go to church. I don't really want any more issues with churches and religions. Only church I know that would be welcoming of everybody and not looking down on everybody is Dignity and well I'm sure you know what Dignity is. I am Bi but just am not up to going to any churches. I like to be free from any religion for now. I just feel better not belonging to a certain religion or denomination right now. Besides, I'm not a morning person anyway and like to sleep in a lot.

 

[rockin'robin]

You can be at peace with God, whatever you conceive Him to be....And whatever ur labors and aspirations, in the noisy confusion of life...keep peace in ur soul!...With all it's sham, drudgery and broken dreams, it's still a beautiful world! Be cheerful. Strive to be happy......Part of "Desiderata" by Max Ehrmann/1927.

 

[Lighthouse77]

I used to live around the block from an Unitarian church back in 1999 but I did not know that back then. This was in Milwaukee. I live in San Antonio, TX now and have not seen a single Unitarian church around here as this city is just predominantly Catholic, all my friends around me here in San Antonio are Catholic, even my fiance is Catholic. So I just don't go to church. I don't really want any more issues with churches and religions. Only church I know that would be welcoming of everybody and not looking down on everybody is Dignity and well I'm sure you know what Dignity is. I am Bi but just am not up to going to any churches. I like to be free from any religion for now. I just feel better not belonging to a certain religion or denomination right now. Besides, I'm not a morning person anyway and like to sleep in a lot.

Try to remember, they are just human like you who just happened to have a belief and who love to help. I don't think you would turn your back on Red Cross or Samaritan Purse, salvation army if they wanted to help as well.

 

[LuciaDisturbed]

Try to remember, they are just human like you who just happened to have a belief and who love to help. I don't think you would turn your back on Red Cross or Samaritan Purse, salvation army if they wanted to help as well.

I don't think Red Cross is a religious organization...at least it does not ring of one as its name does not indicate a religion of any kind, just that it means it's a organization that helps these in need, including medical needs (donating blood, etc - the Red Cross symbol reminds me of the cross that some emergency rooms use and ambulances use - something about the color red indicating blood/medical help and the cross indicating "help"). As far as Samaritan Purse, never heard of that one, but I do shop at Salvation Army when I am in the downtown area which is a great thrift store that does not have much of a religion attached to it (or at least they do not make their religious agenda obvious and do not preach to me at all).

When I lived in MN I got almost my entire wardrobe and 1/2 of my groceries every month from Catholic Charities. They're great - they give you unlimited amounts of clothes (at least they did up in St. Cloud) that you can choose from what you want, no amount limit. And as far as the food, they give PLENTY...more than I ever needed. They gave me like $150-$200 worth of groceries every month. And they never preached. Too bad we do not have that organization near where I live now, because sometimes they do get exotic foods that most food banks do not get - sometimes real nice restaurants donate their unused food to Catholic Charities at the end of the day and that is how I got a very big box of very large portobello mushrooms one time! And I loooooooove portobello mushrooms! Those mushrooms were the perfect size for large vegetarian burgers - I am not a vegetarian but I LOVE Portobello Mushroom Burgers!

 

[deafdyke]

I am Bi but just am not up to going to any churches. I like to be free from any religion for now. I just feel better not belonging to a certain religion or denomination right now. Besides, I'm not a morning person anyway and like to sleep in a lot.

Oh ok....just thought that you might find Unitarinism helpful....it's not really about being part of a specific religion or deonomination.......more like "all or nothing" They are very openminded and libral....awesome!

 

[LuciaDisturbed]

You can be at peace with God, whatever you conceive Him to be....And whatever ur labors and aspirations, in the noisy confusion of life...keep peace in ur soul!...With all it's sham, drudgery and broken dreams, it's still a beautiful world! Be cheerful. Strive to be happy......Part of "Desiderata" by Max Ehrmann/1927.

I do strive to be happy, just in my own way. I do not follow others. I have a path of my own that I have paved for myself. I may not have reached my ultimate goal, but I will get there eventually. Right now I have to take care of my health, as I will not be able to reach my ultimate goal if I do not take care of myself.