Coverage for deaf and hard of hearing children among top concerns at Idaho Dept. of Insurance

Posted at 6:54 PM, Jul 29, 2018
and last updated 2018-07-29 22:11:15-04

Like any 10-year-old in the Treasure Valley, Stella enjoys gymnastics, playing on her iPad, and spending time with friends at Camel's Back Park. But unlike those friends, Stella faces a unique challenge: she was born deaf in one ear.

"We've got empirical data that it-- in fact-- is a major loss for a kid, particularly when they're trying to learn," said her mother Jennifer Thornfeldt.

And she is still deaf in that ear due to constant infections in her bone anchored hearing aid -- also referred to as a "BAHA". She was fitted with the wrong type and has no viable way of fixing it.

"I can't tell you the ire and the frustration and the general disbelief, that if any other part of your body breaks, it's covered no problem. But if your child's ear doesn't work than you're on your own?" Thornfeldt said.

Stella's mother's insurance, which is a division of Blue Shield, did not cover the implant itself...leaving her scrambling.

"The hospitals won't let you pay out of pocket. The insurance won't cover it. We don't-- most likely wouldn't be able to get Medicaid. And so the option was to let her be deaf in one year."

After researching and petitioning several times, Thornfeldt found a different option through the Affordable Care Act. But now that her daughter needs a new BAHA, she is back at square one-- since that same insurance won't cover replacements.

"I started to reach out globally, through a concierge service," Thornfeldt said. "And as it turns out, a very viable option is to go international and get it done in a different country, where it's less expensive than what we'd pay out of pocket here."

The family is now strongly leaning towards planning a trip to India to get the new BAHA replacement.
But the Thornfeldts aren't alone in their struggle. A large crowd of advocates voiced their desire for change at a public hearing at the Idaho Department of Insurance.

"Insurance companies don't have to cover them and so none of them do," said Democratic Idaho House Representative Ilana Rubel. "Insurance companies are not usually in the business of going above and beyond what they're required to, and we're looking to change that rule and say 'yes, they do need to cover hearing aids-- at least for children.'"

While no swift changes were made to legislation -- it is a multi-step process to see verifiable change-- many questions were raised.

"Medical policy only covers things that are medically proven necessary for treatment of some condition or disease," said a member of the Idaho Department of Insurance. "And so, what is that threshold if it is? I think we may have the same question."

Based on the turnout, Patrick McDonald of the Idaho Department of Insurance says he's optimistic we'll eventually see a rule developed requiring big company providers to cover hearing aids for children.

"And I think, between everybody concerned-- I think there's a genuine interest to fix this thing," McDonald said.