Friday, April 06, 2007

Thoughts on insurance...

We have learned much about insurance companies through having a deaf child. We all know that insurance companies don't like to pay for things. But deafness seems to bring out a special aversion on the part of insurance companies.

We fought the insurance company to cover hearing aids going through all 3 appeals and lost at all levels. We fought for 18 months to get the first implant covered going through 3 levels of appeals that time too. Now, we just found out that insurance is refusing to pay for the mapping of the implants. We have been told that the cost is anywhere from $150.00 to $200.00 per ear. We are currently in the process of getting Chance mapped again and will have had at least 3 appointments by the time we finish for this session. I don't know if we are billed for each individual appointment, or if it will all be lumped together. There is no set number of appointments that one needs to get an implant programmed. It is very individualized.

It is interesting to note that we have had 4 different insurance companies since finding out about Chance's hearing loss and each of them have balked at covering services related to his deafness. We have shelled out thousands of dollars out of pocket because the insurance companies do not deem deaf services as needed. Or they can some how justify to themselves not covering the services. (Some of the reasons we’ve heard from insurance companies are “deafness is cosmetic,” and “deafness is a purely educational issue.”) And since you have insurance, there is no aid to help you pay for services. You are ranked into ‘have insurance’ and ‘don't have insurance’ groups regardless of whether your insurance actually covers the services you need or not.

The really tragic thing is, helping these kids get services now, makes a huge difference in their quality of life now and later. And time if of the essence. Getting language into kids is so imperative to their success with implants, that delays due to fighting insurance companies robs deaf children of precious time. Time that quite frankly, they don't have to spare.

The battles with insurance companies will go on sadly enough. How it can be justified that technology that helps deaf children to hear and integrate into society at large, is not necessary to cover, is beyond my understanding. I cannot fathom what the justification is for not providing coverage of something that makes such a difference in children’s lives. And just when you think you have it under control, you are told of yet another service that your child needs that the insurance company will not cover.

And that is why the battle will go on. We will not quit fighting and there are others like us. Someday, when parents of a child who is deaf get that diagnosis, fighting their insurance company will not be a battle they have to take on. They will be able to put their energy into getting the best services that their child needs instead of just getting the services.

1 comment:

Avery Gerner said...

We all deserve to get an insurance. It's just kinda sad to know that there are still people who are not aware of its uses and benefits. I'm just glad that you fought for your child's right to be insured.