Low Levels of Insurance Reimbursement Impede Access to Cochlear Implants

Serving Clients With Hearing Loss: Best Practices in Mental Health Counseling

“…Individuals may not have the option of pursuing second opinions by qualified specialists because of insurance coverage restrictions and limitations of specialist availability and locality. Depending upon the quality and scope of individual medical insurance, coverage for various specialist services may be restricted (Garber, 2002). Reimbursement rates are particularly low for Medicare and Medicaid recipients and are often insufficient to cover the costs of audiologists' services (Garber, 2002).…”

“…Depending upon the quality and scope of individual medical insurance, coverage for various specialist services may be restricted (Garber, 2002). Reimbursement rates are particularly low for Medicare and Medicaid recipients and are often insufficient to cover the costs of audiologists' services (Garber, 2002). Sur-Serving Clients With Hearing Loss prisingly, hearing aids are not covered under Medicare, even though more than one third of the nation's older population has significant hearing impairment by age 65 (Garber, 2002; U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, 2007).…”

Lack of Financial Barriers to Pediatric Cochlear Implantation

“…7 It is well known that there is wide variability in Medicaid reimbursement for cochlear implantation throughout the United States, with some states compensating below cost and others covering costs. 6,11 Thus, depending on the state, some cochlear implant centers stand to incur tremendous losses by serving those with lower SES (ie, those insured by Medicaid). 6,11 However, these financial barriers are mitigated in states where Medicaid reimbursement adequately covers the hospital costs of implant purchase and implantation.…”

“…6,11 Thus, depending on the state, some cochlear implant centers stand to incur tremendous losses by serving those with lower SES (ie, those insured by Medicaid). 6,11 However, these financial barriers are mitigated in states where Medicaid reimbursement adequately covers the hospital costs of implant purchase and implantation. As a result, Medicaid-insured cochlear implant procedures in such venues do not necessarily create substantial financial losses compared with their privately insured counterparts.…”

Cochlear Implants: Growing Pains

“…Generally, private or public third‐party payers do not adequately reimburse hospitals for the cost of the cochlear implant system. 3 Changing Medicare and Medicaid policy on the reimbursement for the implant surgery, for aural rehabilitation after surgery, and for the purchase of the device has been a frustrating challenge. Regrettably, savings accrued by reducing the cost of deafness to the social welfare system are not applied to the medical care system's annual budget.…”