Insurance Denying Bilateral Implants

More and more we hearing how insurance companies are giving a hard time with approving bilateral implants. In the beginning, when getting a second implant was not so popular, the insurance companies usually gave approval without much hassle. Now, as it gains in popularity, it seems that many companies are trying to deny as many cases as possible.

This is especially true with state funded insurance companies, such as Medicaid. In New York, for example, Medicaid will only pay for the cost of the bilateral implant after surgery, when the progress can be evaluated! Understandably, hospitals will refuse to perform the procedure, as they don’t know if they will be reimbursed. Canada’s Health System also refuses to grant approval for many children who wish to receive a second implant.

Read a recent article about a family in Canada who were denied coverage for their daughter’s bilateral implants.

Let them Hear is an organization dedicated to fighting insurance company denials for the hearing impaired. They have a dedicated website where one can submit an application to have their denial appealed by their professional staff. They review applications on Tuesdays and Fridays.

Read more about these and other issues on the Hearing Pocket Articles page.

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4 Comments »

  1. […] under bilateral implants, insurance reimbursement Expect the issue of Bilateral Implants and the practice of many insurance companies to deny reimbursement for them to feature prominently in an upocming […]

  2. Lynda said

    Indeed, after a period of being oblivious to bilateral implants (and approving them without perhaps realizing what they were doing) followed by a period of cracking down and denying requests for bilateral implants, many insurance companies are now ADDING COVERAGE of bilateral implants, and writing into their policies that bilateral implants are medically necessary. Due in part to pressure from the Let Them Hear Foundation, and also after talking with surgeons and audiologists about the benefits of bilateral implants, Blue Cross Blue Shield now makes its national policy to cover bilateral cochlear implants. Many subsidiaries of Blue Cross Blue Shield cover bilaterals, as well as many other major insurance companies as well now officially consider bilaterals medically necessary. This change happened well before Sicko came out. The tide has turned. (Aas of this writing, one of the last hold-outs that still denies bilaterals is Aetna. Visit author Michael Chorost’s website to follow hiw battle with Aetna: http://www.michaelchorost.com )

    To see if your insurance company covers bilaterals, you can go to their web site and find the section where the “medical policies” are. Often these are in the section for Providers, but can be accessed by anyone. You can find the policy on cochlear implants by searching or looking through the list of policies. Even though the general policy of your insurance company may be to cover bilaterals, yoru specific policy or plan may differ.

  3. […] noted in a previous post, many people are having a hard time getting approval for coverage of a bilateral implant. Although […]

  4. […] girl, one cannot blame the insurance company for this denial. Although insurance companies tend to misbehave in these coverages, especially regarding bilateral implants, this case is justified. I don’t agree with those who claim that the denial is a violation of […]

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