Medicare Blog

when will medicare pay for cochlear implants

by Dr. Raleigh Hackett Published 3 years ago Updated 2 years ago
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Medicare currently has an NCD for cochlear implants in section 50.3 of the Medicare National Coverage Determinations Manual. Medicare currently covers these devices when the speech recognition scores are 30% or less correct.

Will Medicare cover cochlear implants?

Today, Medicare not only covers the cochlear implant, but also its accessories such as microphones and batteries. The surgery may include additional coverage from the use of operating microscope to intra-surgical monitoring.

What type of hearing loss qualifies for cochlear implant?

In July 2019, the U.S. Food and Drug Administration (FDA) approved cochlear implantation in people with single-sided deafness or asymmetrical hearing impairment. Before that, only people with bilateral hearing loss (meaning hearing loss in both ears) were eligible.

What is the criteria for a cochlear implant?

To be eligible for a cochlear implant, you must have: Hearing loss that interrupts spoken communication. Limited benefit from hearing aids as determined by specialized hearing tests. Motivation to participate in hearing rehabilitation and be part of the hearing world.

What is the total cost of a cochlear implant?

The average cost of cochlear implants is between $30,000 and $50,0002 depending upon the device, the individual's specific hearing needs, surgical fees and other factors.

Why you shouldn't get a cochlear implant?

The standard surgical risks of a cochlear implant are all quite rare. These include: bleeding, infection, device malfunction, facial nerve weakness, ringing in the ear, dizziness, and poor hearing result. One long-term risk of a cochlear implant is meningitis (infection of the fluid around the brain).

Who Cannot benefit from cochlear implants?

However, some people cannot benefit from cochlear implantation. In order for a cochlear implant to work, the auditory nerves must be intact. Cochlear implants cannot help when deafness is caused by the injury or absence of the auditory nerve fibers.

Who is a good candidate for cochlear implant?

A cochlear implant may be right for you, if you: Have inner ear hearing loss. Have trouble understanding speech even with properly fit hearing aids. Are motivated and have a support system that can help them or loved one understand sounds and speech.

What is the best age to get a cochlear implant?

Children can receive a cochlear implant beginning at 10-12 months of age. For a child hoping to receive a cochlear implant at this age, evaluations should start around 3-4 months of age. A congenitally deaf child should have cochlear implant surgery before 3 years old, earlier if possible.

What are the disadvantages of cochlear implants?

Other Risks Associated with the Use of Cochlear ImplantsMay hear sounds differently. ... May lose residual hearing. ... May have unknown and uncertain effects. ... May not hear as well as others who have had successful outcomes with their implants.May not be able to understand language well.More items...•

Which is better hearing aid or cochlear implant?

Hearing aids are more suitable for those with mild-to-severe hearing loss, whereas cochlear implants are more suited for those with profound hearing loss. While hearing aids amplify sounds, cochlear implants provide a sense of sound.

Does Medicare cover cochlear implants for single sided deafness?

Medicare currently has an NCD for cochlear implants in section 50.3 of the Medicare National Coverage Determinations Manual. Medicare currently covers these devices when the speech recognition scores are 30% or less correct.

How long do cochlear implants last?

How long does a cochlear implant last? Will there ever need to be a replacement? The surgically implanted device is meant to last a lifetime. However, there have been some cases in which there has been equipment failure and the device was surgically replaced.

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