My Adventures with CI and Aetna insurance

Cochlear Implants
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I’ve had hearing loss for at least 20 years but it got noticeably worse in 2013 when I had chemo to treat leukemia (AML). The AML was treated very successfully by a stem cell transplant at Mayo Clinic in Phoenix.

I got my first HA’s from Costco in Prescott, AZ (KS-5) in 2014. (Thanks to this forum for telling me about Costco.)

This July, I got my 4th set of HA’s (Phillips Hearlink 9040 RIC) but they sounded worse than my ~4 YO KS-10’s even after several adjustments at Costco. In addition, my secondary insurance (Aetna Direct) reimbursed only ~64% of the $1,781.69 price (inc. an Audio Clip), claiming Costco is not “in network”). Later I pointed out that they were not following their policy for my plan, which states they will cover up to $3000 every 3 years for members with Medicare primary and then they reimbursed the balance of my claim.

While I was appealing the insurance decision, I visited an in-network audiologist in Prescott who reported Word Rec. Scores: L 24%, R 48% (SPL not reported) and recommended implants. The audiologist wanted to sell me HA’s with out-of-pocket cost over $1500 after a discount and after Aetna’s $3000 reimbursement.

Then I scheduled appointments with Courtney Kolberg, AuD and surgeon Dr. N. Deep at Mayo Clinic in Scottsdale and Phoenix. My reported word recognition scores @ 90dB showed 50% on L, 55% on R plus other tests including 30% word recognition on the L @ 60dB with “Multi-talker babble”. She said I qualify for an implant under Medicare and she let me try a “high-power” Naida Link HA @ 65 dB SPL, which sounded rather good with my R ear but less so on the L.

Apparently I am to get an implant on the L plus a high-power HA with custom earmold on the R and possibly another HA for low-frequency on the L. I have another appointment with her on Tue, 24th and surgery is scheduled on Mar 7.

Dr. Kolberg reviewed the implants from the 3 manufacturers: Advanced Bionics (compatible with Phonak HA’s), Med EL and Cochlear (Resound HA). She seems to favor AB and Cochlear. I think she also said I will get a backup second controller (off the ear) besides the main one that looks like a fat HA.

Since the Phillips HA’s do not help, I returned them for a refund and I’ve asked Aetna about returning their reimbursement.

I changed my Forum posted audiogram to reflect Dr. Kolberg’s results which are similar to the Costco and local audiologist audiograms except for the word recognition score.

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@FredO its an amazing journey your about to begin. Trying to decipher what the speech is with all that white noise (babble) is a tough test for all of us.
@Dani has MedEl. He might be able to offer some advice.
A lot of this group have got Cochlear N7 or N8. @Raudrive
And @joanhawsey has AB.

What I like about my N8 is the direct streaming straight into my ears. Phone calls are now easy to understand. You don’t need any other assistive listening devices like MedEl does/used to. I’m not sure what MedEls new Sonnet 3 requires. I’m not even sure it’s been released yet.

You need to do an internet search on the companies and ring the companies and speak to a representative, ask all your questions. But ultimately be guided by your surgeon as to what device would suit you best.

Good luck on your new hearing journey.

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Is Dr. Kolberg your surgeon?
The reason I ask is the surgeon has more experience with the different brand implants and which brand has the best support for your area where you live. This is very important. As a CI person you will have times you need support and help. Not all CI brands support equally in different areas. Your surgeon usually has a good understanding of this.

Insurance can sure veca pain. Good luck getting past all that bureaucracy and hearing better.

Keep us posted.

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No. She is the audiologist. The surgeon is Nicholas Deep.

When I told the surgeon I was inclined towards Advanced Bionics and Phonak. he indicated that would be a good choice.
The audiologist urged me to choose the implant first, then accept the HA that pairs with it. I expect she will show me the three choices & go over their pros & cons.

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Haha, I read it the wrong way. Raudrive actually has Cochlear.

Concerning MedEL: Sonnet 3 is out since September/Octobe 2024 (depending on your location). It now is capable of integrated (not just by an additional adapter) direct streaming just like Cochlear does since years (via MFi or ASHA). On the other hand T-coil functionality is no longer integrated. For this you now need the separate device.

Btw I wish you Merry Christmas!

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Is your audiologist a CI audiologist? What brand does she support?

Contacting MedEl, AB and Cochlear and asking about surgeons and audiologist In your area might shed some light on a better decision. After the implant the audiologist will be very important. There are ok and better CI audiologist. This is where making contact with the company and asking who they recommend.

All three companies can help you hear better.

MedEl and Cochlear have off the ear and on the ear processors, AB does not. Technology wise the three companies go back and forth with advancement. At this time I believe Cochlear has the step ahead IMHO.

Good luck with this

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I met with Dr. Kolberg a couple hours ago. Dunno whether she is a CI audiologist but considering she is with Mayo Clinic, it is likely. When I asked about meningitis vaccine she told me she is a Dr. of audiology, not an MD.

I feel confident in her, she has an air of competence. Also, I am favorably inclined toward Mayo Clinic because of their treatment of my leukemia plus complications 11 years ago.

Today I found out why she doesn’t recommend Med EL for me: they don’t stream to iPhones.

I am to get two processors. In talking with her, I decided not to get an off the ear processor. The Advanced Bionics processor is rather fat – a negative. But I was favorably impressed with the Phonak Naida Link HA, which works with AB plus my current KS-10’s were made by Phonak so I chose the AB implant.

My next appointment is for the surgery on Mar 7. And then a couple weeks later to turn on the implant. UPDATE: surgery was moved up to Jan 17 (due to a cancellation) & the followup to Feb. 7.

Thanks for your thoughts.

Fred

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And review of AB last sound processor - Naida CI Marvel.

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Thanks for the links. Lots of great information.

The wireless information has a few errors concerning the Cochlear K2 processors. Maybe they are just not up to date. App controls do control bilateral processors independently or together.
Streaming is in stereo.

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FredO - good luck with the process. I am thrilled with my AB processor (in Carribean Blue!) and linked Phonak Marvel HA. Phone is no longer an issue. I am two years post implant and use streaming a LOT for books, podcasts, music, etc. There is an active Facebook group for AB users if you are on Facebook. If you have any questions - you will always find help on this forum!

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Two days ago, my Advanced Bionics Marvel CI processor was installed and programmed at Mayo Clinic. I was scheduled to receive a high-power Naida Link M HA but it hadn’t been delivered yet. Hopefully, it will be there for my first followup appt. next week.

As expected, it is not (yet!) helping my hearing. When someone speaks, I hear a sort of unintelligible metallic buzzing that matches the speech tempo. I rely on my old KS10 HA in my other ear for communication.

Streaming from my iPhone to the implant is unintelligible. Fortunately, streaming to the KS10 works well.

Per the audiologist’s suggestion, I am trying to watch/listen to videos with captions using only the implant. By reading the captions, I can (barely) recognize some of the words spoken. But if there is more than one speaker, I cannot recognize which is speaking except by watching the video, even if one is male and the other female, I cannot distinguish their voices.

Connecting the processor to my Zenbook laptop often fails, even if I disconnect or turn off the hearing aid. (The HA often connects spontaneously except when it is turned off.)

— Fred

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Your activation sounds similar to mine.
I ended up taking hearing aid off at a week and never put it back on. This forced the new CI to learn. For me this was the right decision.

The brain is lazy and will do what’s easy.

If you are getting words this quick that’s great.
Thanks for the update.

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I also took my old phonak hearing aid out for 8 weeks before I got a resound aid, even though I could understand some speech at activation, I didn’t have clarity. The effort of concentrating on what was being said was exhausting. For me clarity took several mappings even though comprehension of speech was improving rapidly.

If you enjoy reading, join your local library. They have an app for audiobooks you can stream, also borrow the hard copy of the book. Then read along with the audio version.
Good luck to you on your new hearing journey.

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Update: I finally told my Zenbook “Forget Device” and then “Connect a new device to ZEN” and that worked. But I hope I do not need to do this to get streaming working. My KS10 HA often connects automatically without me needing to tell the Zenbook to connect to it.

I also found a couple YouTube videos from people who speak clearly enough that I can understand their words with a bit of help from captions. FYI, these are (both for my hobby, astrophotography) Deep Space Astro and Nebula Photos.

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Question: Any suggestions for wearing a hat w/the implant other than cutting a hole in the side of the hat? I’ve had 7 skin cancers & should limit sun exposure. But a hat knocks off the headpiece.

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@FredO Could you wear a sports headband over your processor, then put a hat over that?
Cochlear make hats especially to fit with a processor. Have a look do any of these hats suit your need?
https://www.google.com/search?q=cochlear+dum+hats+australia&sca_esv=ff0c03999835dfdd&rlz=1CDGOYI_enAU695AU695&hl=en-

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I wear ball cap and sun hat with few issues with my AB CI. I had to loosen the ball cap just a tad and try to hold it in place a bit when putting on my hat. Other option is to get a had that has an elastic drawstring around the crown so you can loosen to put it on then tighten when hat is in place. When bike riding I bought a thin skull cap to put under my helmet to help secure the magnet. It will get easier as you get used to it.

It is 3 weeks after your activation - has anything changed for you in that time regarding quality of the sound, understanding? It takes time - but I found it improved quickly the first month or two. The phone was the last to become clear for me - even a year after. Streaming was better sooner. Cochlear brand has an 800 you can call daily for phone practice. I found that very helpful. 1-800-458-4999. It is free.

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Hi All,

Thanks for your suggestions and encouragement.

It’s been 23 days since activation of my implant. Per a suggestion of the audiologist, I’ve been listening/watching videos through only the implant to train my hearing. Understanding words has definitely gotten better, especially after adjustments 10 days ago.

Streamed NY Times articles, read by “an automated voice” are rather easy to understand. Actual speech is a bit harder and speech via the microphones is often difficult, especially with background noise or with other talking, even using a high-powered Naida Link M HA in the other ear.

I like to listen to music, such as my granddaughter’s piano videos and streamed concerts from the Cleveland Orchestra. Unfortunately, the sound is not especially pleasant even through the HA. My old KS10 HA sounded better with music. I may even take the KS10 to an upcoming local orchestra concert. I’ll remove the headpiece during the concert because a HA sounds better.

Hopefully, sound quality will improve after my next adjustments in 17 days.

As for a hat, I tried to find a wide-brimmed one with adjustable fit. Most I found online are caps that provide little sun-shading. Some bucket hats are advertised for use with a CI but these also offer little shading. I found I can use my existing hats by re-positioning the headpiece as Joan mentioned.

Finally, I’ve not used the Roger microphone much yet but plan to take it to a couple meetings this week. I can point it at speakers to capture their speech.

— Fred

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Hi All,

It has been about 3 months since activation of my CI and I am definitely understanding speech better. Most mornings, I turn on only the implant at first and listen to my wife and streamed NY Times articles through the implant. I can usually understand almost all of what is said, at least for streaming or when the person speaking is near and facing me.

The metallic, buzzing noise has largely faded.

I’ve found I do not need the Roger microphone. At meetings I rarely take it out of my pocket.

Last week at an AZ Philharmonic concert, the orchestra sounded fairly decent although not as good as I would have heard it a few years ago. My hearing problems mostly started from nerve damage during chemotherapy for leukemia about 12 years ago and have gotten worse the last ~3 years.

the past month I’ve had a problem with my implanted ear – a “noise” a bit like a toy train whistle or perhaps a harmonica playing only one note, especially when I’m not wearing the headpiece, such as when I’m in bed. Bending my outer ear or with that ear on the pillow triggers this apparent noise. Sometimes, it lasts several minutes before fading away. Right now, with the implant working, touching my ear does not produce the noise except, of course, if I touch the microphone.

Just now, I temporarily removed the headpiece and I didn’t hear the noise when bending or pressing on that ear. Apparently using the implant desensitizes this effect.

Has anyone else noticed this? I plan to ask my audiologist about it when I see her next week.

— Fred

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