Cochlear Implant expenses: How much does it cost?

Posted by Bill Gebhardt @billgebhardt, May 30 12:40am

Interesting that in all the discussions on implant, no mention of costs. This was on of my questions in my bio: “What does an implant cost and how receptive is Medicare in helping with the cost?”. I have an appointment with UC Davis in Sacramento in August to consider an implant. My finance manager, (of 55 years) and I have no idea of the costs. Bill

Hi Bill. Good Question. Medicare does cover the costs of a cochlear implant, assuming a person is qualified medically to receive one. There are variables among the Medicare programs that may determine whether or not a co-pay is involved. I was still working when I had my implant. My insurer covered all but $1500 of the surgery and external equipment. On Medicare, I've had to pay about that amount to upgrade processors. (Worth it!) I know other people on Medicare who have been covered 100%. When I have consulted with my Medicare representative when changing Advantage Plans, I got the 'deer in the headlights look' as they don't know what a CI is. You have to go deeper. My CI is from Cochlear Corporation. They will help you figure this out once you qualify for the surgery. I believe the other CI manufacturers will do the same. While I cannot give you the complete answer you are looking for, if you qualify for a cochlear implant, Medicare will cover most of the expenses, but you may have to go the extra mile and fight for it. Medicare will also cover most of the costs of processor upgrades every five years. I hope others will share their experiences on this as they seem to vary.

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@julieo4

Hi Bill. Good Question. Medicare does cover the costs of a cochlear implant, assuming a person is qualified medically to receive one. There are variables among the Medicare programs that may determine whether or not a co-pay is involved. I was still working when I had my implant. My insurer covered all but $1500 of the surgery and external equipment. On Medicare, I've had to pay about that amount to upgrade processors. (Worth it!) I know other people on Medicare who have been covered 100%. When I have consulted with my Medicare representative when changing Advantage Plans, I got the 'deer in the headlights look' as they don't know what a CI is. You have to go deeper. My CI is from Cochlear Corporation. They will help you figure this out once you qualify for the surgery. I believe the other CI manufacturers will do the same. While I cannot give you the complete answer you are looking for, if you qualify for a cochlear implant, Medicare will cover most of the expenses, but you may have to go the extra mile and fight for it. Medicare will also cover most of the costs of processor upgrades every five years. I hope others will share their experiences on this as they seem to vary.

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If you have Medicare without any additional insurance, there will be some significant costs. If you have Medicare plus an Advantage plan, there will still be costs, probably significant ($1,000 or more I'm guessing). If you have Medicare plus a Part F plan, everything should be covered. We had no idea about the difference between Advantage and Part F plans (which are not generally advertised) until my husband was put on the list to receive a kidney just before he turned 65. He's younger, and we had group ins. for our two-person graphics company that cost $2,000/month–I hadn't been able to go on Medicare because that would have left him totally without ins. as the company group policy required a minimum of two people. The financial adviser at the transplant center told us that he needed to apply for Part F coverage (instead of an Advantage plan) as soon as he turned 65 and was eligible. At the time, he hadn't been on dialysis long enough (a year) to go on Medicare early: dialysis is $60,000/month, and our $2000 company plan only paid 80%, leaving $12,000/month for us to pay! The month he turned 65 he applied for a Part F plan through our regular broker, and we immediately owned absolutely nothing for dialysis. Two years later, he got a kidney, and the transplant cost not one penny!

That, in a nutshell, is the difference between Advantage plans and Part F (or even newer plans now available). Advantage plans tout that they cover vision and hearing, but they only pay a tiny amount toward glasses or aids. They pay part of the 20% that Medicare doesn't cover, but far from all, plus there are co-pays. Part F means that you pay nothing for anything medical: no co-pays, nothing. However, Part F does not pay for glasses or hearing aids, although they do cover all associated doc visits. Although I couldn't get Part F when my husband went on Medicare, I was able to elect Part F when we moved to another county by switching to an Advantage plan that didn't cover people in the county we moved to. I questioned whether it was worth it to pay so much more for Part F every month (at that time about $150 plus a $35 pharmacy plan (Part F doesn't cover pharmacy except "medical" pharmacy, like the horribly expensive anti-rejection drugs). Since I had experienced Stage 1 cancer (roughly a quarter million in expense, 20% of not covered by our company policy), I did elect Part F–and less than a year later learned that I'm now in the early stages of kidney failure, i.e., need to see a specialist every three months, with over a thousand in labs, all of it totally paid by Medicare and Part F.

Here's the short form: Anyone on Medicare has about $200 deducted from their SS before it arrives, their share of Medicare, exactly the same for everyone. Advantage plans cover some of most things, and some are totally free, while others cost modest amounts. However, you can be left with very large amounts to pay on your own. Again, the promised vision and hearing coverage is a token amount, far from the cost of glasses or aids. Part F coverage (you may need to find a broker to buy it and you can only elect to have it for either 60 or 90 days after you become eligible for Medicare) now costs close to $300 month for me (at 78), about $250 for my 73 YO spouse. You also need to have a separate pharmacy plan, which generally costs $35-40/month. When you see a doc or an audi, you pay nothing. I know that the surgery for a CI would cost nothing, but I haven't yet learned how much Part F pays toward the CI itself.

If you can predict that you'll have excellent health for the rest of your life when you become eligible for Medicare, it's fine to opt for an Advantage plan. However, if you later have cancer, need a transplant or some other horribly expensive surgery, you simply can't afford to opt for Advantage. My Part F plan monthly premium will increase next month when I turn 78, meaning that I'll pay the $200 deduction from SS, nearly $300 for Part F (up from just over $200), plus $35 for pharmacy coverage: Less than $550 to never pay for anything medical. I need to add that Advantage plans pay something toward dental while Part F pays nothing. Since I haven't had real teeth for years, that's not a problem for me, but it can be a significant cost for my spouse. We track the amounts we'd owe (the portion of our bills Medicare doesn't pay), and month after month it's more than we pay for Part F and pharmacy ins.

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Greetings bill, Medicare will indeed help pay for the majority of the cost. Good thing; my surgeon billed them over 100.000.00. Of course, they don’t pay that. Your copay varies from state to state. I live in Colorado and my copay was 1500. Well worth it. I wouldn’t be hearing without it. Situation is a little different from the jungle you stumble into when you deal hearing aid people. Good advice given to rely on medical people. If you qualify, they’ll figure out how to get paid. Good luck, john.

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Bill…… I'm interested in what you find out at UC Davis. I live in the Sacramento area and have Kaiser Senior Advantage insurance. They will not cover a CI for me. The quote that I got from a man who recently had an implant was $20,000 per ear for self pay clients. That is very expensive but I will have to consider it if I get to the point of qualifying for an implant. The man that I spoke with said that his hearing went from 25% to 65% and it was well worth the cost to him.

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Sadly it seems the part F plans are being phased out.

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@thedeafguy

Sadly it seems the part F plans are being phased out.

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There supposedly is some new letter plan that will replace them. For at least a little while, Part F will continue for those of us who already have it, just not be available for new people. Our broker mentioned the new "magic" letter, but, for the life of me, I can't remember what it is. We've used the same broker for well over 20 years, and he's always given us good current advice, so I'll leave it up to him. I do know that at least my Part F plan will continue, since I received a letter with a very large monthly increase (from just over $200 to $290).

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@judyca7

Bill…… I'm interested in what you find out at UC Davis. I live in the Sacramento area and have Kaiser Senior Advantage insurance. They will not cover a CI for me. The quote that I got from a man who recently had an implant was $20,000 per ear for self pay clients. That is very expensive but I will have to consider it if I get to the point of qualifying for an implant. The man that I spoke with said that his hearing went from 25% to 65% and it was well worth the cost to him.

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Judy, my appointment is on Aug 17 so hang in there.

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Thanks Bill…… I hope you will post what you find out at the appointment.

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The peple who do the implants have the costs. Some hearing offices will referr to one place in town. Call them. It is my understanding, Medicare will cover if the provider accepts assignment.

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I didn’t pay out of pocket for mine. Medicare and insurance paid all of it. If they hadn’t paid, I would have paid. To me, it would be worth it.

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Wonderful. Do you like yours? I have been contemplating the testing but wanted to finally get as deaf as I am. Your Comments to bill54321 Big time Thanks!

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@lizzy102

I didn’t pay out of pocket for mine. Medicare and insurance paid all of it. If they hadn’t paid, I would have paid. To me, it would be worth it.

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Wonderful for you but please give us an approximate money wise. That is if you were given the amount on your paperwork. Thank you. This way the people without insurance coverage will get an idea of the cost .

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