I knew the road to cochlear implant wouldn't be smooth. Yesterday, the office manager at my otologist's office called to let me know that my insurance carrier had denied the request for candidacy evaluation testing for a cochlear implant. Their reason was that my doctor stated that I was satisfied with my hearing aid results. Apparently, because I chose to try hearing aids first, I am satisfied with them. They ruled that my hearing aid results were "acceptable." I wonder if I had chosen cochlear implant from the beginning, if I would be facing this issue at all.
The term 'acceptable' is a multi-faceted word. According to my dictionary, acceptable may mean capable or worthy of being accepted; pleasing to the receiver; satisfactory; agreeable; welcome; meeting only minimum requirements; barely adequate; or capable of being endured
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I wonder which term my insurance carrier wishes to convey. Is it 'acceptable' that I am profoundly deaf in one ear and must rely on the other ear to hear everything the world throws at me? Is it 'capable' that I miss a third of conversation and must ask friends and family to repeat themselves over and over? Is it 'pleasing' that I cannot hear bikers and other runners approach me from behind when I am on the trail? Is it 'adequate' that I cannot use the drive-in feature of restaurants or pharmacies because my deaf ear faces out? Is it 'agreeble' that I must use closed captioning to understand television and movies? Is it 'satisfactory' that I avoid social events and venues that are noisy and confusing for me? Is it 'adequate' that I can no longer hear the students I teach without great effort and external amplification? Is it 'welcome' that I worry constantly that another SSHL will take the hearing of my better ear as suddenly and profoundly as my left? Is it 'worthy' to endure because my insurance company has made an impersonal decision about what I
should be willing to accept and endure as a result of my hearing loss when a cochlear implant could significantly improve my quality of life?
I think not. If they mean that my hearing aids are 'barely adequate' when they say they are 'acceptable', then I suppose they are right. They are minimally adequate, and they are better than nothing. But that's not good enough for me.
I will not be held hostage by a company whose main objective is to protect their pockets and determine what is "acceptable" for me. They don't know me. We have appealed.
Fight them tooth and nail Bonbon.
ReplyDeleteGood for appealing. You are exactly right, if your audi and surgeon think the CI will be a better option for you and will give you the better quality of life it's worth fighting for.
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