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Cochlear implant program at UNC Health in North Carolina

A cochlear implant is uniquely different from a hearing aid. A hearing aid works by amplifying and making the everyday sounds in the environment louder. By increasing the level of the sound, this can often surpass the patient’s threshold for hearing as determined by his/her level of hearing loss and simultaneously improving the patient’s ability to hear and communicate. Traditionally, hearing aids are adequate for patients with mild to moderately-severe sensorineural hearing losses as well as patients with inoperable forms of conductive hearing loss.

A cochlear implant is an excellent method of treatment and intervention for patients who have levels of hearing loss in the severe to profound range or those who can no longer benefit from traditional amplification/hearing aids. The cochlear implant is classified by medical terminology as a “neural prosthetic device” similar to a pacemaker or heart defibrillator.

The cochlear implant consists of two distinct pieces. The first piece is an internal receiver/stimulator, which is surgically implanted, and the second is the external speech processor, which is worn on the outer ear (pinna) and looks similar in appearance to a behind-the-ear hearing aid. Both of these pieces must be present for the system to work for the patient as they are coupled across the skin and through the hair by magnetism. The internal receiver houses a magnet and the external portion magnetizes to the internal connection.

The function of the cochlear implant as well as the surgical process will be fully addressed with each patient at the initial clinical cochlear implant evaluation. Both the audiologist as well as the implant physician are knowledgeable in the process and would be happy to address additional questions you may have regarding this medical procedure.

Expectations

Patient expectations can be a sensitive and critical issue to address both pre-operatively and post-operatively with not only the patient undergoing the surgery but with the patient’s family and friends. Post-operative outcomes for cochlear implant recipients can take many recognizable forms, including sound awareness (known as detection) at the most basic level to open-set speech recognition in noise, which represents the pinnacle of achievement for cochlear implant users. The level of achievement that a patient achieves is largely dependent on his/her hearing history and exposure to amplification and spoken language. Patients who developed spoken speech prior to the onset of profound hearing loss are routinely identified as post-lingually deafened. A patient with this background in hearing is different from a patient whose primary means of communication is through sign language or other forms of manual and visual communication.

Patients who rely on sign language are often described as being pre-lingually deafened, meaning that the hearing loss preceded his/her development of spoken language.Research has shown auditory verbal therapy and speech rehabilitation to be viable means for improving speech perception outcomes for most cochlear implant recipients. Referral for these services is optional for each patient and can be discussed with your audiologist as we are supportive of this decision. Both post-lingual as a well as pre-lingual patients can be excellent candidates for cochlear implantation and we review each patient as a unique and separate case. Cochlear implantation is a life-changing experience and we believe in serving all of our patients to the best of our knowledge and expertise.

Cochlear Implantation Costs

Cochlear implantation and its benefit to individuals who qualify is a well-documented medical procedure. Medicare along with most major, private insurance companies recognize its significance and typically offer 80-100% coverage of the costs of the surgery and the implant system. Medicaid in contrast does not provide monetary coverage for the implant procedure for those patients who are 21 years of age or older. UNC Health Care does respect and support patients who elect to pay for medical services, such as cochlear implants, through out-of-pocket means.Each patient is requested to bring copies of their insurance card(s) to the initial cochlear implant evaluation, so that the information can be documented in our medical system.

Once candidacy for the process has been determined and a surgery date established, UNC Health Care will take the responsibility of evaluating your insurance and medical coverage for the cochlear implant procedure. Every patient’s medical coverage is unique, which can affect the overall cost of the surgery. Financial counselors are on-hand to discuss your individual insurance plan and your potential out-of-pocket expenses associated with the surgery.