Category Archives: Health Insurance

Date Confirmed!

I got an e-mail from my audiologist saying that the surgery is scheduled on June 5. I have to be at the hospital at 6:30 – 7 a.m.  She warned me that about one in ten adults may feel vertigo/tinnitus for one to two weeks after surgery. She also responded to another question I had about if my health insurance will cover mapping. She said that she has never needed to ask for pre-approval for mapping except with Medicaid. I asked her some more questions about when I need to get my meningitis shot and if there was anything else I needed to do before my pre-op appointment. I also asked to go ahead and schedule my mapping appointments.


Why I Might be More Libertarian Than I Originally Thought!

The Human Fertilisation and Embryology Bill [HL] 2007-08 was introduced to the House of Lords on August 11, 2007. From what I see, it has passed through the House of Lords and has undergone its first reading in the House of Commons. It has not undergone its second reading and there is no date listed as to when that will be. It must pass both houses to become law and if the House of Commons passes the bill, it is returned to the House of Lords for them to review any changes made. It can go back and forth between the houses before being ratified. It then needs a Royal Assent which is done by the Queen which is more than likely automatic.

The reason why I am talking about this bill is that it prevents any deaf babies from being born through IVF (In Vitro Fertisation). It really means all “serious physical or mental disability, a serious illness or any other serious medical condition” babies in general, but specifically targets deaf babies in its Explanatory Notes (see second indentation below). The bill itself states(clause Clause 14/4/9):

“Persons or embryos that are known to have a gene, chromosome or mitochondrion abnormality involving a significant risk that a person with the abnormality will have or develop a serious physical or mental disability, a serious illness or any other serious medical condition must not be preferred to those that are not known to have such an abnormality.” (emphasis added)

I kind of understand why the British government might be doing this. Most of England (if not all of England) uses the National Health Services or NHS. There is private insurance but is usually used to “top up” or as an addition to the NHS. Only about eight percent have private insurance. If a deaf baby is born, then the question is does the NHS have to pay for services such as hearing aids, cochlear implants, deaf education, speech therapy, etc.? The government might be seeing this as a way to cut insurance costs. I do wonder if these deaf services can be paid for by private insurances. However, if this were the case, would it be financially penalizing deaf children for their parents’ decisions?

This is in the Explanatory Notes:

“110. Clause 14(4) contains a provision that relates to the provisions on embryo testing (see note on clause 11). New sections 13(8) to (11) amend the 1990 Act to make it a condition of a treatment licence that embryos that are known to have an abnormality (including a gender-related abnormality) are not to be preferred to embryos not known to have such an abnormality. The same restriction is also applied to the selection of persons as gamete or embryo donors. Outside the UK, the positive selection of deaf donors in order deliberately to result in a deaf child has been reported. This provision would prevent selection for a similar purpose.” (emphasis added)

I said “target deaf babies” above because it sounds like the whole reason for this bill is because someone heard about this intent to go about IVF with the result of a deaf baby.

Conveniently enough, they are excusing the Catholic representatives from the vote.

“The issues vex scientists. To date, however, the government has refused to back down, further inflaming debate. How the bill will finally emerge from the ensuing negotiations is difficult to determine. One option being discussed is for chief whip Geoff Hoon to impose a ‘soft whip’, meaning Catholic cabinet ministers such as Ruth Kelly and Paul Murphy can be conveniently absent from the vote over issues concerning abortion, rather than having to choose between their government and their consciences.”

I believe that this decision should be left to the people rather than to the government. Because then it gets into: Well, where do you draw the line? What exactly is a “serious physical or mental disability, a serious illness or any other serious medical condition”?

I believe that deaf people can lead meaningful and valuable lives, and it is sad that the British Parliament is sending a message to the deaf community that it doesn’t believe that (whether it actually intends to or not).

It would be interesting to see if the United States picks up on this and what the government decides to do (if anything). I have some concern with the idea of installing a national health care system in the United States because of what’s happening in England.

Note: I am not an attorney, nor am I a British citizen for that matter. This is what I know and understand and have thought about for the last few months that this has been in the news. For more information about what is going on, I suggest going to Grumpy Old Deafies, which is a UK Deaf blog. They have been diligently following this matter for quite some time.

Important Edit: It now sounds like references to deafness are being removed from the bill.

“Now, however, the Department of Health has agreed to cut from the Bill any reference to deafness as a serious medical condition.”

Denied, Denied… Approved!

I was in Atlanta at a conference for work this week, so I didn’t get a chance to post until tonight, however, Tuesday I was approved by my insurance company for two cochlear implant surgeries (one in each ear). It comes as no surprise to me that I got approved for both ears: I believe it’s cheaper for the insurance company. However, I highly doubt I am doing both ears – still want to just stick with implanting my bad ear. I don’t really see much of a reason to implant my good ear. I think my hearing will only improve slightly in that ear – doesn’t seem worth it – and implanting my right ear will really change how I hear.

The earliest available date that my doctor’s office has is June 5 for surgery. I haven’t done anything yet mostly because I’ve been busy this past week. So far, all I know is that I will need to be there one or two days beforehand for the doctor to make sure my overall physical health is good and ready for surgery. As always, as more information becomes available, I will post here 🙂

A Long Awaited Update

There’s a lot going on with life now, and I’ve just not had the chance to get on here. There’s not much going on either with my CI process, however there’s a lot going on in the news that I’ve been thinking about lately and I would like to post some of those thoughts on here either today or in the next few days.

According to some people, my insurance application was submitted last Monday to my insurance company. “Some people” would be my insurance advocate at Cochlear and one person at the insurance company. However, I talked to someone else at my insurance company who said they didn’t have my information and that I would need to ask my doctor to resubmit the information. Sigh. However, if it really was turned in on Monday, then they told me that it takes 30 business days to process. So that means I’ll know by April 11. Kind of a weird feeling.

On another note, the hospital that did my CT Scan is frothing at the mouth and has sent me a letter asking me to expedite the process so they can get paid. Apparently, I have a preexisting condition and my insurance company isn’t giving them the time of day. I’ve dealt with insurance mumble jumble in a large quantity before and it’s not fun.

The Wait

I hope this wait is a lot shorter than the previous one – as in something’s getting done rather than my case sitting around waiting for me to start annoying people. I think it will be. I’ve gotten a CT scan, CI eval and medical eval, the only thing left is for my old audiology office to send them my medical history and the office will “apply” to my insurance. So far everything looks fine and it sounds like I’m getting a recommendation by my surgeon. Big surprise!

I learned some new things my second time around. The biggest thing being that you can’t use regular hearing aid batteries for Cochlear (i.e. go to the grocery store when they die to pick up some new batteries). You have to order them over the Internet. The second one being the financial upkeep on the implant itself. The external warranty expires after three years (at least with the plan that my audiology place is asking for) and after that I have to pay warranty of about $700 a year per external piece. WOWee. But then again this is for me, not everyone else. I also get two external pieces so maybe I can ask for two different colors! Yay! I also understood more about programs. Each implant has a certain number of programs you can go through. I think AB has three and Cochlear has four. So that when you’re going through your mapping process and you don’t like one program or your brain has “learned” that program, you can move onto the next one. Another difference between AB and Cochlear is that Cochlear has a separate setting for T-coil (T-coil is my FRIEND) where as for AB T-coil would have to take up one of the three programs. I think AB has better (?) microphones, sort of? I didn’t really understand it other than you would have to constantly change the ear hook to get the microphone you want. Cochlear might not have as many options, but all the settings are on the external piece and you don’t really have to change out the ear hook.

My next step is balance testing which I get done on the 21st. I asked why I needed to get that done and why it wasn’t needed to request the insurance company to cover the implant, they said that they use this test as a baseline before going into surgery. Makes sense. I hope that I’m doing better than the baseline though, not below it! That would be annoying.

Other than that, not much going on. Just waiting to see when the surgery would be. They told me as early as Feb. But because my medical office is taking a long time to get them the records, I don’t think that’s going to happen.  So maybe March or April.

I also don’t get to get turned on the next day. That’s OK with me. They’re going to wait about two weeks. And then after that I’ll be going in every 2 – 3 weeks.

November is Almost Half-Way Finished

I’m getting closer to my goal of getting a CI. I’m still a bit unsure about it though. However, I’m trying to press on and get it anyway. My biggest fear is the fact that something so large and BIONIC is going to be stuck in my head. It’s a silly fear to have, but I’m sure a lot of people get it. It seems minor compared to the possible benefits that it may have. I’m also worried about the fact that it might not work for me and I won’t use it; as a result, I will have something that’s not natural and that I’m not using. I worry about feeling claustrophobic about it, in a way.

Anyways, it sounds like my cochlear implant center has all the tests it needs. Now it’s time for the waiting game. They’re talking with my health insurance company. I hope I’m “deaf enough” to get this thing. If I’m not, I’m sure I will be re-doing tests, because that would be insane if the insurance doesn’t approve it.

CI Eval. Results.. Though a Bit Discouraged

I got to my appt. 15 minutes early to fill out paperwork. I was ushered in with the audiologist. She first gave me a negative outlook on the whole thing while the audiologist I have in Texas has a really gun ho attitude. The audiologist I saw that day really wasn’t sure how well I was going to hear with a cochlear implant in the ear that I haven’t heard out of for 22 years. I know there will be a challenge; I’ve taken speech therapy before for many years. I didn’t understand why she was so negative over it. I then specifically told her that I wanted a CI evaluation. There was a lot of confusion because for some reason I was not down for a CI evaluation. They had me scheduled to see the audiologist for a hearing test and then to see an ENT. I had no idea why. Even though I explained to the audiologist what I wanted, she still sent me to see the ENT with doubts that she would have time to do the CI eval. that day. I was upset; my husband was starting to get upset. The ENT, like we had suspected, had no idea why we were in there and told us he would not bill us for the services. This was after waiting for 30 minutes just to see him after getting a hearing test. So I went back to the audiologist. I was trying to be patient, but it was starting to wear thin. I have already waited a month just to see her and my perspective of the place was that it was mostly about children and people who lost their hearing later in life. There wasn’t much room for me there. That appointment discouraged me in more ways than one. Luckily the audiologist just buckled down and did the tests without much fuss. When it came down to the results, she was once again negative. That was disappointing. Apparently, I am on the borderline. I made a 60% on two of the tests (two syllable words and sentences) but a 20% in noise and one syllable words. This makes no sense to me. Maybe someone can explain why the first two tests matter. After explaining dully that the insurance may not cover me, she pronounced me a candidate by the office’s standards. I understand that a lot of what she said that day may be things you need to tell patients, however, she went about it in such a manner that was a bit defeating and that’s what bothered me. I need someone for this process who is positive and excited. I don’t think I can succeed as well in therapy without a doctor who is encouraging. Danny Delcambre, the deaf blind individual from Louisiana who opened the Ragin Cajun restaurant in Seattle, once listed his five spices of life, the second one being that you surround yourself with positive people and to get rid of the negative people.

I think I’m going to steer clear of New Orleans’s audiologists for awhile. I asked the audiologist if she could do the mapping and she said that very rarely that they take a patient who has gotten surgery elsewhere. This makes no sense to me. I’ve heard of this happening with other people – they will go get the surgery done somewhere, but the mapping process done closer to home. She did give me some room in there to argue with her, but jeez I would much rather work with a positive audiologists than with someone who has less hope on how I will turn out with it.

On a positive note, I did get the tests done, so hopefully I will never have to do that again. And I got to see and touch an implant. It was a bit bigger than I thought it would be. It’s heavier than a hearing aid and it felt so strange on my left ear. If I do get it, I wouldn’t be surprised if I try to put in on my right ear. Also, the electrode coil is tiny. I didn’t realize a cochlea was that small. It felt weird that this was such a small part of my body that they needed this equipment for – equipment that was probably 100 times larger than it was. I think the cochlea was just a tiny bit larger than this -> o . FYI, the blue color for the external part is really BLUE. I think I’m going to not get that one. But the silver one was slightly-blue looking which I liked. I am also looking at the brown one since it blends in with my hair.

I learned something interesting: they’re actually inserting two electrodes. One is the electrode into the cochlea and the other is the “grounding” electrode. It doesn’t go anywhere; it’s mostly because you’re dealing with electricity. It probably goes somewhere between the skull and the skin.

I did hear from my surgeon’s office. They want the tests results, which should be on its way this week. Then we’ll see if I actually can get insurance coverage or if I have to fight tooth and nail for it.

I’m a bit worried because I’m starting to lose my excitement about it and am wondering once again if I’m making the best decision for myself. I don’t feel I have found my niche in New Orleans yet and because of that my difficulties with my deafness surface a lot more often. I have seen the numbers: there are probably only about 150 deaf people in New Orleans. So the community isn’t as strong as it once was and maybe not as strong as I need it to be (which is where I think my niche lies: in making it stronger, I just don’t know my role yet).

Another thing I wonder about, am I OK with needing a strong community near my place of residence? There may be times in my life where I may find myself in a situation like this one.