August 6, 2024

UnitedHealthcare to Expand Cochlear Implant Coverage for Children 

UnitedHealthcare announced an important expansion in their coverage of cochlear implants in children. Effective September 1, 2024, UnitedHealthcare will cover cochlear implants for children 6 months old or older with bilateral sensorineural hearing loss (SNHL) as well as children 9 months old and older with single-sided deafness (SSD). 

Read the full media alert here.

HEALTH INSURANCE DOES COVER COCHLEAR IMPLANTS

This free, one-hour online course is an introduction to health insurance and cochlear implants. It explains the typical coverage process in public and private health insurance plans as well as the likely financial responsibility of the individual or family.

United Healthcare Issues New Cochlear Implant SSD Coverage Policy

The new policy, effective January 1, 2023, covers SSD in adults over 18 for the first time but continues exclusion of children under age 5. Also noted: it does not apply to 8 states (IN, KY, LA, MS, NJ, NC, PA and TN). ACI Alliance will release a formal public statement about the policy issued by the largest US insurance company, soon. Read more here.

Yes, You can change medicaid

By Nichole Westin MA / Governmental Affairs Manager, ACI Alliance

All children whose families are covered by Medicaid and meet specific state candidacy criteria are eligible for cochlear implantation. CI is not currently covered for adults in all states but it can be changed. Read more here.

COCHLEAR IMPLANTATION: HEALTH INSURANCE AND OTHER POSSIBLE WAYS OF GAINING COVERAGE

Cochlear implantation includes a number of necessary medical services and procedures that are provided over time by a team of clinicians. All of these services, as well as the cochlear implant device and related peripherals, are considered part of the medical intervention and are typically covered by health insurance in the United States. These medical services and procedures include candidacy evaluation, hospitals costs inclusive of supplies and medications used during surgery, physician and surgeon’s fees, the cochlear implant device and system kit, and programming and (re)habilitation following the surgery.  To read more please click HERE.

Processor Upgrades and Parts Replacements for Cochlear Implants: Pursuing the In-Network Option from Your Insurer

Cochlear implant parts such as coils, cables, microphones, and external magnets may need to be replaced periodically. Additionally, a processor might need to be upgraded with the passage of time and as newer technology becomes available. Barbara T. Mellert MPH, Academic Technology Consulting, Dartmouth College and parent of two children with cochlear implants, provides insights on how to work with your insurance company to obtain in-network coverage.  To read her article click HERE.

AN ADDITIONAL FUNDING SOURCE FOR COCHLEAR IMPLANTATION: DISABILITY BENEFITS UNDER SOCIAL SECURITY

Adults and children who do not have insurance coverage for a cochlear implant may wish to explore their ability to participate in a Disability Evaluation under Social Security. The Social Security Administration (SSA) website contains information regarding such evaluations. If someone qualifies for benefits based upon disability, he or she may be eligible to receive health insurance coverage and payment assistance for a cochlear implant through Medicare or Medicaid even if they are under age 65.  To read more please click HERE.