wtm@bunker.uucp (Bill Mcgarry) (11/28/90)
Index Number: 11970 Alexander, my son, recently got two Opticon hearing aids for a total cost of approximately $ 1400. Our company insurance is Aetna Insurance and apparently, there is a clause in the plan that says that hearing aids are not covered. I'm in the process of trying to fight this since in my son's case, his hearing loss is considered "life-threatening" (Alexander has Down Syndrome). The personnel department in my company have not been very supportive since they feel that most insurance plans do NOT cover hearing aids. Yet, his doctors, therapists and the hearing aid center all are shocked that the aids are not covered. So I need some input from you folks -- does your insurance company cover hearing aids? Has anyone here managed to fight the insurance company for hearing aids and won? Company names would also be appreciated (both the company that you work for and the insurance company). (I also have the feeling that they will not be paying for hearing tests so that will be the next fight.) Thanks, Bill
Jack.O'keeffe@f26.n129.z1.fidonet.org (Jack O'keeffe) (11/28/90)
Index Number: 12003
[This is from the Silent Talk Conference]
BM> Alexander, my son, recently got two Opticon hearing aids for a
BM> total cost of approximately $ 1400. Our company insurance is
BM> Aetna Insurance and apparently, there is a clause in the plan
BM> that says that hearing aids are not covered.
I wish you all the best in getting Alexander's hearing aids covered
by your insurance, Bill. But I cannot be very encouraging about the
prospect. Some employer's plans will cover aids for the employee if
the hearing loss is work related, but not for dependents. My own
insurance was with Metropolitan and later PA Blue Shield. Neither
would cover hearing aids, but I didn't fight them on it because I
was able to get my aids from the Veteran's Administration.
Even Medicare doesn't cover them. Medicaid DOES in some states but
not in others (one of the remarkable curiosities about a Federally
funded plan). Others covering hearing aids are the VA (in my case
where hearing loss is service related) and state departments of
education and/or vocational rehabilitation.
BM> (I also have the feeling that they will not be paying for
BM> hearing tests so that will be the next fight.)
Coverage of hearing tests seems to depend on how the test is described
to the insurance carrier. If the tests are for fitting of hearing aids
it is unlikely they will be covered. But if the tests are to diagnose
a disorder, or to rule out a disorder, they often are covered. This is
a fine distinction, and an experienced audiologist can often determine
whether testing will or will not be covered by how they write it up.
One of the problems is that cost of testing is often "bundled" into the
cost of the hearing aids. Testing should be priced separately, with an
appropriate reduction in the price of the hardware.
If you were billed separately for Alexander's testing and also $1400
for two hearing aids, I think you were overcharged. Price of hearing
aids is one of the more outrageous of healthcare ripoffs.
Please keep us posted on your progress. This could develop into one
of the most valuable threads to hit the SilentTalk Echo.
Good luck. Jack.
... Caveat Emptor!
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!129!26!Jack.O'keeffe
Internet: Jack.O'keeffe@f26.n129.z1.fidonet.orgBill.McGarry@hnews.fidonet.org (Bill Mcgarry) (11/28/90)
Index Number: 12011 [This is from the Silent Talk Conference] Hi Jack, Thanks for the answer, depressing as it may be. The $1400 was for both the hearing tests and the hearing aids themselves (and the molds). The charge for the first hearing aid was $800 and then when Alexander was doing so well with it and we got the second one, it was only (!) $600. The difference of $200 was apparently the cost of the hearing tests so I may have them bill me separately for the hearing tests and try submitting that to the insurance company. (Thanks for the idea on that angle.) Take care, Bill
James.Womack@f14.n300.z1.fidonet.org (James Womack) (11/30/90)
Index Number: 12050
Though I am a deafie, I don't use hearing aids. However, insurance
companies traditionally do not cover hearing aids. i believe you may
be able to enlist the aid of your congressman/woman. Usually, hearing
aids are classified as comestics. They aren't. They are medical necessities
in a strict definition. Find out why the company refuses to insure
aids. Then attack from the basis they give you especially if they claim
aids are comestic. If recall right, they don't insure glasses either.
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!300!14!James.Womack
Internet: James.Womack@f14.n300.z1.fidonet.orgJeff.Best@f71.n135.z1.fidonet.org (Jeff Best) (11/30/90)
Index Number: 12051
I have a son also who is deaf and has 2 hearing aids I have not been able to
find an insurance company that will pay for hearing aids or hearing test to
date I have been looking for 3 1/2 years now all I can tell you is if the
doctor or person selling you the hearing aids is so shocked your company
doesn't pay then ask them what company has paid for 1 of their previous
clients hearing aids? also make sure you buy insurance on the HEARING AIDS
it is a wise investment around 85.00 to 105.00 per aid for 3 years for 100%
coverage includes replacement if lost however if replaced you have to pay
the full premimun again still alot cheaper than buying a new aid some people
lose there aid about every 2 1/2 years I have been told because the life
expectancy is 3 years! hope this is of some help to you .
CHOW FOR NOW !
/-*=JEFF=*-\
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!135!71!Jeff.Best
Internet: Jeff.Best@f71.n135.z1.fidonet.orgGary.Greiner@f21.n272.z1.fidonet.org (Gary Greiner) (11/30/90)
Index Number: 12056
Bill, our company's major medical insurance does not cover hearing
aids. Most do not, to my understanding. However, for the last 5 years
or so we had a so called Personal Health Account. It was $200 a year,
this year $300, next year goes to $500 (i.e. they recently improved the
plan). Now, this amount is per family per year and covers any of the
following: eyeglasses, hearing aids, contact lenses, immunizations,
checkups (non-follow-ups to illnesses, just "ordinary" checkups). 80%
of the cost of any of these items is paid, subject to the above
mentioned limit per year per family.
Cheers,
George
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!272!21!Gary.Greiner
Internet: Gary.Greiner@f21.n272.z1.fidonet.orgDaniel.Laflin@p3.f6.n3610.z1.fidonet.org (Daniel Laflin) (12/01/90)
Index Number: 12094
Bill, i am surprised about the fact companys would not cover
hearing aids, etc, you did not say what kind of insurance it was,
homeowners, health? or?
You might consider seeing a Lawyer about if the insurance companys
are violating FEDERAL law, such as ADA, and perhaps a check with
your states DEOPT of REHAB, HRS<Health and Rehabitalition services>
can tell if any STATE laws are being violated, Insurance can be
tricky, it depends on if the state the company is in , laws , are
ones that are followed or your state laws, Myself if you were
living in FLA your son would have quite a case as FLA bill of
rights has handicap in there with race,religion etc, and so in fla
such a thing would have the company barred from business in my
state, however i do not know what your state laws say, which is why
you should see a lawyer and your states agencys, ONE thing i do
know , when the ADA law becomes effective, any company doing that
will be violating FEDERAL CIVIL RIGHTS LAW PERIOD.
Again i suggest consult a lawyer, in fact two would be best, you
may have a nice discrimination suit on them, depending on laws.
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!3610!6.3!Daniel.Laflin
Internet: Daniel.Laflin@p3.f6.n3610.z1.fidonet.orgGALLUA.BITNET (Pete Davis) (12/03/90)
Index Number: 12123
Sorry about this vague subject line; our system is *having
troubles* today. This is actually a reply to Hearing Aids and
Insurance.
Here at Gallaudet University, it seems that almost everyone's aids
are at least partially, if not entirely, paid for by their state
Vocational Rehabilitation agency. I'm afraid I did not catch your
son's age, and I do not know what the relevant AR age requirements
are, but at least this may offer some hope for the future.
Have fun!
Pete DavisDaniel.Laflin@p3.f6.n3610.z1.fidonet.org (Daniel Laflin) (12/04/90)
Index Number: 12191
JW> Though I am a deafie, I don't use hearing aids. However, insurance
JW> companies traditionally do not cover hearing aids. i believe you may
JW> be able to enlist the aid of your congressman/woman. Usually,
JW> hearing aids are classified as comestics. They aren't. They are
JW> medical necessities in a strict definition. Find out why the company
JW> refuses to insure aids. Then attack from the basis they give you
JW> especially if they claim aids are comestic. If recall right, they
JW> don't insure glasses either.
Interesting facts, im deaf too, however a aids useless, as my loss
is too great, however i am sure the companys will have to change
once the ADA fully becomes law, plus as i told him<original
poster>, he should check his state laws, fla has handicapped in
bill of rights which means if one lives in fla and contests it,
that fact is a powerful weapon, one could ask for a injuction on
the company doing business in fla till the case is settled, and so
that fact would have the company wanting to make a exception,
anyway, once ADA is fully law, we can expect more action to prohibt
such discrimination, which it is, ill bet you you dont find them
calling crutchs, and other special equiptment cosmetics, a attack
on them via that difference would be strong.
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!3610!6.3!Daniel.Laflin
Internet: Daniel.Laflin@p3.f6.n3610.z1.fidonet.orgDaniel.Laflin@p3.f6.n3610.z1.fidonet.org (Daniel Laflin) (12/04/90)
Index Number: 12192
JB> I have a son also who is deaf and has 2 hearing aids I have not been
JB> able to find an insurance company that will pay for hearing aids or
JB> hearing test to date I have been looking for 3 1/2 years now all I
JB> can tell you is if the doctor or person selling you the hearing aids
JB> is so shocked your company doesn't pay then ask them what company
JB> has paid for 1 of their previous clients hearing aids? also make
JB> CHOW FOR NOW !
JB> /-*=JEFF=*-\
Jeff i noticed you live in Fla as do I and have you ever gone to
HRS about this? the state of FLA bill of rights states no one may
be discriminated on due to race,religion,HANDICAP,etc.
If insurance companys do not as a matter of course cover hearing
aids, etc, while they do crutchs, and other medicial aids, its
discrimination, and they could be told to stop selling insurance in
our state.
Im deaf, but dont use a aid, as it never helped, i can understand a
insurance company requiring insurance on specific items as they do
like jewelry, etc, however depending on what they cover if they
cover as a matter of course certain medicial equiptment but not
aids...
My only question is if its helth insurance, home owners or such ?
I have special insurance for my computers, however if the
homeowners excludes aids but covers say wheel chairs you could go
to the STATE and demand action vs company as that would be
discrimination.
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!3610!6.3!Daniel.Laflin
Internet: Daniel.Laflin@p3.f6.n3610.z1.fidonet.org