Simply put, an FM system improves access to sound. It pairs with hearing aids to compensate for distance and background noise. The speaker wears a transmitter and the listener wears a receiver. But FM systems can cost thousands of dollars and most insurance companies do not consider them to be medically necessary.
My two-year-old daughter Raina is hard of hearing and speech delayed. A few months ago, her early intervention team suggested an FM system might help to improve her speech. Since then, we’ve been trying to get her one.
Have you heard the myth of Sisyphus? It’s about a man condemned to roll a boulder uphill for eternity. As soon as he reaches the top, the boulder rolls back down again. Over and over. Trying to get an FM system for our hard-of-hearing toddler has felt a lot like that.
In the U.S., a child with hearing loss typically will not receive an FM system until they reach school age. Even then, s/he often cannot take the system home with him/her because it is owned by the school district. Some health systems don’t issue insurance referrals for a toddler to get an FM system since they’re typically unsuccessful anyway.
“There’s a difference between medical necessity and educational necessity,” we were told.
“In the U.S., a child with hearing loss typically will not receive an FM system until they reach school age.”
Insert angry-face emoji here.
Not to be deterred, I asked another audiologist at a different health system. That audiologist told us that an FM system might possibly be covered by insurance if we enrolled Raina in daycare a few hours per week. Even then, the odds of getting one were fairly slim and it would probably have to remain at daycare. So, what to do? We didn’t want to add the expense of daycare for an FM system that might not be covered and probably couldn’t come home with her anyway.
Frustrated but determined, I looked to our Health Reimbursement Account (HRA) instead. An HRA reimburses us for certain out-of-pocket medical expenses that insurance doesn’t cover. Our HRA plan maintains a list of qualified expenses. Qualified expenses include hearing aid batteries and hearing impaired telephones, but it makes it made no mention of FM systems. I called our HRA and asked directly. No one there knew what an FM system was or whether or not it would be covered.
“You can have her provider submit a form of medical necessity and we can determine coverage then,” a representative told me.
To demonstrate medical necessity, I gave our daughter’s audiologist her scores from the most recent Battelle Developmental Inventory. In Pennsylvania, a Battelle evaluation is done annually through early intervention. Raina’s Battelle scores showed her as being speech delayed. With Battelle scores in hand, her local audiologist had enough information to complete the paperwork stating medical necessity. She even ordered Raina an FM system on a trial basis so that we could try the different transmitters before we buy one.
Not all FM systems are compatible with all hearing aids. It’s important to run the specs past your audiologist first before buying an FM system. Many used systems, such as those found on eBay, are not eligible for returns. It’s important to verify compatibility before spending the money.
Receivers and transmitters can be mixed and matched to create a unique system. Our daughter wears Phonak Sky V-P hearing aids. Her audiologist told us that this system would be compatible:
Roger Transmitter (Roger Pen, Roger Touchscreen, Roger Easy Pen, or Roger clip on mic)
Integrated receivers Roger 18
Roger X and Audio Shoe AS18
Integrated receivers are slightly more expensive than the Roger X + audio shoe configuration but enable the hearing aid to remain waterproof and dust-proof. We will go with the integrated receivers to help protect the hearing aid from the kind of wear-and-tear exposure typical of a toddler’s use.
As for the transmitter, I’m not sure which we will prefer until we have a chance to try out both of them. I like how the Roger Pen is sleek and discreet but worry that a pen-sized object will be easily misplaced in our home.
The Roger Touchscreen has a very user-friendly interface. It is also larger than a Roger Pen, which means it should be easier to keep track of. Hopefully, it is as durable as the Roger Pen would be.