Insurance companies are evil. Who knew?

February 20, 2009 3:56 PM

Has anyone successfully had a cochlear implant covered when the insurance company says that it's excluded?

My son needs a cochlear implant. Our insurance (United Healthcare), provided by my husband's employer, says that they won't cover it. There seems to be some evidence that the exclusion is illegal under Title V, but I'm having a hard time finding much support. Any thoughts?

Please don't debate cochlear implantation here. Thank you.

posted by LittleMissCranky to health & fitness (2 comments total)

I don't have personal experience with their work, but I know someone who works for the Let Them Hear Foundation, which offers help with insurance appeals.

Best of luck! I've had an implant myself for two years now, and grew up hard of hearing; if I can help at all in sharing my experiences, please don't hesistate to MefiMail me.
posted by spaceman_spiff at 4:07 PM on February 20, 2009

You might call UHC back and ask if there are any special circumstances under which they would cover it. If there are, your doctor's office will need to provide the medical records which support the special circumstances and obtain a preauthorization prior to your son getting the implant.

You would think that if there were special circumstances that UHC would have mentioned it by now, but a lot of times insurance companies will not offer up this bit of info unless you specifically ask. You might also contact your dr's office to see if they have successfully appealed a cochlear implant denial in the past.
posted by DrGirlfriend at 4:14 PM on February 20, 2009