Guest guest Posted April 25, 2003 Report Share Posted April 25, 2003 I used to work for an insurance company. That is for " routine hearing care " and you need to find another page in your booklet or policy. See if you can find the exclusions page... Remember, if you had a different problem with hearing that is correctable by surgery (such as some of the middle ear surgeries) it is not under that clause you are referring to. Most policies either exclude it completely or it is a paid benefit. Try calling your insurance company but do not ask about this line...ask if cochlear implant SURGERY is a covered benefit. If they say no, then ask where it says it is excluded. Sherry, Prelingual CII Surgery: 4.11.02 Hookup: 5.1.02 HiRes: 2.27.03 <My insurance states in the exclusions " Services for routine hearing care, including hearing examination, diagnostic screening and for hearing aids or other devices to improve hearing sharpness " > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2003 Report Share Posted April 25, 2003 Dodie, Remember too, the ci is not a device to sharpen hearing. those getting a ci are legally deaf and no device is going to sharpen it. the thing insurance companies don't understand.. as well as a lot of other people is that with the ci, you are no longer hearing with your ear, but rather with your brain. The ci is more a prothesis rather than a hearing device. Does your insurance cover prothesis such as artificial limbs? Good luck and keep us posted. Hugs Silly Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2003 Report Share Posted April 25, 2003 Actually SIlly, most policies cover CI's as a DME. (durable medical equipment) They don't consider it a prothesis because it is not a replacement for a missing part. Just one of the quirks I learned while working for the insurance company. :-) Makes you realize why insurance companies are such a pill to work with at times. Quite often not even those who WORK for the insurance company understand the policy so it is always a good idea to get more than one opinion from the company if you do not get an answer you want. Sherry, Prelingual CII Surgery: 4.11.02 Hookup: 5.1.02 HiRes: 2.27.03 <The ci is more a prothesis rather than a hearing device. Does your insurance cover prothesis such as artificial limbs? Good luck and keep us posted.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2003 Report Share Posted April 25, 2003 Sherry, Thanks, that's interesting to know. I'm so glad I didn't have to struggle with my husbands insurance company like some folks do.. A few years ago, before his shop switched insurances though and I was just investigating the possibility of getting a ci, his insurance said NO GO.. that a ci was nothing more than a glorified hearing aid..If they only knew... Once his company switched to BC/BS, there was not evan a hesitation to getting my ci covered. These insurance companies surely do need educating. Hugs Silly In , " Sherry " <borgqueen@s...> wrote: > Actually SIlly, most policies cover CI's as a DME. (durable medical equipment) They don't consider it a prothesis because it is not a replacement for a missing part. Just one of the quirks I learned while working for the insurance company. :-) Makes you realize why insurance companies are such a pill to work with at times. Quite often not even those who WORK for the insurance company understand the policy so it is always a good idea to get more than one opinion from the company if you do not get an answer you want. ] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2003 Report Share Posted April 25, 2003 <These insurance companies surely do need educating.> I agree with you, Silly! And so the policyholders...they need educating too. Quite often when you call the insurance company you may be setting yourself up for a denial just by your choice of words. For example, " Are hearing aid batteries a covered benefit? " is NOT a question I'd ask if I was trying to get the insurance company to buy disposable 675's. I'd ask, " are batteries for DME, specifically a cochlear implant a covered benefit? " .... Sometimes a change in wording will get you your benefit. I was one of the lucky ones- my insurance company approved me on the same day I had my eval. My surgery was two weeks later. It isn't usual tho. Sherry, Prelingual CII Surgery: 4.11.02 Hookup: 5.1.02 HiRes: 2.27.03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 5, 2008 Report Share Posted January 5, 2008 Does anyone know if blue sheild of california hmo covers the helmet? thanks in advance, kriaten Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2008 Report Share Posted January 6, 2008 I'm still waiting on an answer from BCBS of CA. The claim has been pending for two months. They pre-authorized with CT, but are moving very slowly with processing. When I hear something, I'll let you know. Staci -----Original Message-----From: Plagiocephaly [mailto:Plagiocephaly ]On Behalf Of Sent: Saturday, January 05, 2008 10:21 PMPlagiocephaly Subject: Question about insurance Does anyone know if blue sheild of california hmo covers the helmet? thanks in advance,kriaten Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2010 Report Share Posted January 30, 2010 Hi - Very interesting question! I just had my N5 surgery 1/19 and think I've learned to ask a lot of question regarding insurance. Here's a few just off the top of my head: #1 - Make sure your doctor/hospital or surgery center are providers! Verify it with your insurance company. #2 - There is a difference between insurance companies PREAPPROVING surgery and PREDETERMINATION. #3. If you have more than one choice of hospitals/surgery centers: Ask about any co-pays and compare. Ask them if you are going to get one processor or two. I don't know about anyone else, but I would have been willing to change doctors, hospital/surgery center, etc. in order to save a huge chunk on co-pay amount and especially to get two processors instead of one! wrote: Anybody ever gone thru a deal to where your Surgeon has your date setup for surgery then come to find out the firm he is with is no longer contracted with the insurance company? Quote Link to comment Share on other sites More sharing options...
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