Part 6 – Wrangling with Insurance

This is a series that documents my journey to getting a cochlear implant. These posts are honest and vulnerable. Please refrain from posting negative comments. These are my experiences and each CI journey is different for everyone involved. 

Written July 26th

This is exactly what it sounds like: difficult, frustrating and at times very irritating. It is not my intention to criticize health insurance companies, but I believe that it needs to be shared how difficult it is to get health insurance to cover these procedures.

When I went for the candidacy appointment back in May, we sent all of my scores from the speech perception testing to the insurance for pre-approval. We got a denial two weeks later because we didn’t submit specific ear testing. The scores that we sent the first time were in my best-aided condition: both hearing aids.

So then I went back in mid-June to do specific ear testing on just my right ear and the scores were horrifying!

Speech in quiet: 15% of sentences correct

Speech in noise: 8% of sentences correct

So essentially my right ear was giving me nothing. Maybe a little bit of localization, but my left ear was doing most of the work, and that is what audiologists want to try and avoid. Both ears should be working together as a system. Just like your eyes.

So we submitted the appeal to the insurance with the new scores. At the end of June, we got another denial letter, but said that my surgeon could talk to them and they would reconsider it. Dr. B got involved and sent a letter of medical necessity that was submitted at the end of June. It was denied again in mid-July.

At this point, I was done. I was really concerned about timing for school. My one wish in this whole process is that I wanted the internal in before school started. School starts August 24th and it is now mid-July. I just didn’t see how this was going to happen. I didn’t care if I was activated during the semester. I could deal with that. It would suck and it would make my semester rough. I just didn’t want to be dealing with a recovery while trying to student teach and do classes. I was at my breaking point. I felt like maybe this wasn’t meant to be anymore. I didn’t care if I could hear. I had this feeling that maybe I am not meant to finish grad school. Maybe I am not meant to be a teacher of the deaf. I was doubting myself.

I had spent weeks calling the insurance company checking in. I had this routine that I called them on my way home from work on Monday’s. I am pretty sure that they got tired of hearing from me.

Thankfully, my mom encouraged me to keep pushing on. I think she was concerned because she has been listening to me for weeks about how I couldn’t hear. How hard it was and still is to hear kids at my summer job. How much I hated it. How I wished that it didn’t happen. And that life wasn’t fair.

Last weekend, I saw her at a family reunion in San Diego and she saw just how much I was struggling. It was this past weekend that we agreed that we pretty much needed to keep pressing on despites all of the “no’s”. In order to improve my quality of life, I needed to do this because it was slowly eating away at my confidence and everyday functioning. I think she was concerned just how much I was struggling emotionally. Since things were standing still, we decided to go ahead and purchase the Roger Pen DM system for student teaching in the fall. My other DM system is not meant for student teaching situations, so at least the pen would help me get through that part of the day.

After numerous conversations with my mom, we decided to do was going to do one more attempt at insurance. The last denial letter stated they wanted to see an MRI. We sent an MRI in mid-July and all I could do was wait.

To be continued……

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