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 2914. (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.

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!