On this page:
- How is the external transmitter held in place correctly?
- Can the sound processor be removed at night?
- Can I use the implant while playing sports?
- Will the cochlear implant help me control the loudness of my voice?
- Do those who have an implant system use it?
- Insurance Questions
- Do I pay for the repairs?
- Do insurance companies pay for cochlear implants?
- My health plan has denied coverage for a cochlear implant. How can I appeal?
- My health plan informs me that I have exhausted my rehabilitation benefits. How can I appeal this decision and obtain coverage for additional audiology or speech therapy services?
- How can I insure my external parts against theft, damage or loss?
Usually, the transmitter and receiver contain magnets, which attract each other to stay aligned.
Yes. But you should turn it off to save the battery. Some users wear the sound processor all night so they can hear.
Probably. Most implants are durable enough to allow playing sports. However, the external parts of most are not waterproof, so you would have to remove them before swimming or other water sports. Deep water diving may harm the internal implant due to the high water pressure.
It depends a lot on you and your rehabilitation group. It depends on how long you have been without hearing. It depends on whether you could speak well before you lost your hearing. Usually, there is a rapid rise in your ability to interpret the sounds after receiving an implant. This rapid rise slows after about 3 months but continues.
You will probably hear most sounds of medium-to-high loudness. Patients often report that they can hear footsteps, slamming of doors, ringing telephones car engines, barking dogs, lawn mowers, and various other environmental sounds. You may hear some softer sounds too.
Yes. The cochlear implant usually helps the wearer control the loudness because you can hear your voice in relation to background sounds.
Yes. Most people use their processors routinely from morning to night. Adults who have never been able to hear have the most difficult time learning spoken language and dealing with the sensation of hearing. Some of these adults may give up and stop using their implant.
Because cochlear implants are recognized as standard treatment for severe-to-profound nerve deafness, most insurance companies cover them. In 2004, Medicare, Medicaid, the Veteran's Administration and other public health care plans cover cochlear implants. In 2004, more than 90 percent of all commercial health plans cover cochlear implants. Cochlear implant centers usually take the responsibility of obtaining prior authorization from the appropriate insurance company before proceeding with surgery.
Maybe. You will not have to pay for repairs if they are covered by a warranty or if you have insurance that covers repairs. Many health plans do not include specific benefits to cover repairs and replacement of parts for cochlear implants. However, the policy may have durable medical equipment (DME) benefits that can be applied. Read your benefits booklet for DME or prosthetic repair benefits, or check with the health plan.
First, determine specifically why the cochlear implant was denied. Make sure you have the denial in writing. If you do not receive a written denial, ask for one. An appeal is most effective when structured in response to the specific reason for denial of coverage. If a specific denial reason is not provided, contact the plan and ask for clarification. Second, contact your cochlear implant center and advocacy groups and ask for help.
My health plan informs me that I have exhausted my rehabilitation benefits. How can I appeal this decision and obtain coverage for additional audiology or speech therapy services?
Many health plans have limited rehabilitation services. They have a predetermined cut-off point for post-operative cochlear implant services. However, you may be able to get extended medical benefits based on your need for more services by having your clinician argue your case. You may have an easier case if your child is the implant user. The manufacturer of your implant may help your clinician develop the case.
External parts, if purchased new, probably carry a warranty from the manufacturer against defects and materials. Usually, under such warranties, equipment lost, damaged beyond repair, or stolen will be replaced one time at no cost.
After the warranty expires, you may have some options, such as
- buying a service contract from the implant manufacturer
- getting repair and replacement coverage through your health plan
- getting coverage through your personal home property and casualty or homeowner's policy