Insurance Responds

I recieved word yesterday that my group insurance would only pay $35K for lifetime for a Cochlear Implant. That doesn't even cover the cost of half of one!

It's been a rough week.

I guess I'll back up a bit...

I applied to Medicare Part B to add in as a component as paying for the CI. Only then was I denied. I wasn't given any real explanation other than the standard form letter. So upon calling and finding more information nothing else was further provided. Eventually, I was given a letter from the Administrator at the local SSA office in which explained what happened. I had to go back to when i First qualified for Medicare to prove that I had coverage so that I can add Part B. at anyt ime. IN doing this, this means that I'd hav eto go back to my wife's previous employer to verify that I was covered by a policy at the time I first became eligible for services and Part B. This shouldn't be a problem but geez, why not tell me in the first place?

I am purusing this path. However, this would only pay for 1 CI. I would like 2. Many people with Usher Syndrome that I have talked to do extremely well and much better with 2 CIs. If I wasn't blind due to Retinitis Pigmentosa, then I wouldn't have much of a problem since I had perfect lipreading. Now, I see people that at times, look more like cartoons, that I really cannot see how their mouth is moving. Nor do I hear speech to really match mouth movement with sound. Speech sounds much like the teacher in "Peanuts" (waaa, waa, waa) you kow.

I'm grateful for the fact that my wife is doing much better with her TBI (traumatic brain injury) after the car accident. This is probably one of the big pushers for me to start moving forward with the CI. I mean, I was geared for it a few years ago, but the accident took place and our world turned upside down. Now it's time for me to forge forward, try to imporve life, at least my hearing, in which I could imrpove communication methods and "hear" speech. Seeing my children grow up or at least being able to hear them again is important. My son plays the trumpet. I have never heard him play before. I haven't even worn a hearing aid in over 2 years. They are 10 years old and have expired their life expectancy. The audiologist 2 years ago said they would not benefit me and could not recommend a hearing aid for my right ear as I couldn't benefit anything.

So now my frustration makes a complete circle: why doesn't insurance pay for a medically necessary procedure?