In December of 2020, Advanced Bionics announced that they had received FDA approval for the new Marvel line of processors. These processors consist of the new Naida CI M for adults and the new Sky for children. Internally, the new Marvel Sky is the world’s first FDA-approved cochlear implant designed specifically for children. It is a bit different from the internal magnet that I have since the child will still be able to receive MRIs without having their magnet removed in advance. With the internal magnet that I have, I cannot receive MRIs for the rest of my life unless I have my implant removed ahead of time (and who wants to go through all of that?).
With the exception of the internal pieces (which don’t affect me since once you have the internal piece implanted, it’s good for life, unless, of course, you have a device failure or some kind of accident or something), both the Naida CI M and the Sky are virtually identical. An East Coast Advanced Bionics representative, Doug Lynch, told me that the only difference between the two processors is that the Sky has more settings available for the environments children are most likely to be in (such as a classroom or playground) and the Sky comes in more fun colors. As a college professor, the new settings available on the Sky sounded like they would be more beneficial to me. As you know, I also love making my cochlear implants stand out and have always wanted a red processor, so the colors alone made the choice between whether to get the Sky or the Naida CI M an easy one for me. Based on the posts I have read on the Advanced Bionics Cochlear Implant Users Group Facebook page, it sounds like most adults are also choosing the Sky for themselves so they can get more fun colors. The only downside is that the colors take longer to ship, especially the most popular ones like purple, which I HAD to order. But considering how often I’ll be wearing my cochlear implant processors, I think it is worth waiting on the colors I truly want rather than settling for other colors I may not want as much.
Fortunately, Advanced Bionics did confirm a few weeks ago that my order was processing and would be shipping soon. They said it could be anywhere from this week to the end of the month, so needless to say, I have been anxiously waiting for an e-mail stating they’ve shipped! When they do ship, you guys will be the first to know!
In the meantime, I’ve had A LOT of questions to ask the various AB reps, including Doug. They are all so nice and never grow tired of helping to answer my questions, fortunately. Here are the five initial questions I asked Doug, along with his answers for each.
1. How do the points work? How many points do I get for each ear?
When I first heard about the FDA approval of the new Marvel processors for Advanced Bionics, I immediately wanted to know how to go about upgrading. I reached out to Dough right away for more information. After a few weeks went by and I didn’t hear anything new, I reached out again, and Doug sent me the order form.
Receiving the order form was very exciting but also very overwhelming. I had an order form back in 2014 and 2015 when I received my Naida Q70s and upgraded to the Q90s, but I had my audiologist walk me through the forms and help me to make the best choices given my specific needs and my lifestyle. With COVID-19, I was on my own more for this upgrade process and had to navigate the forms independently, which was challenging at times.
The main thing with the order forms is understanding how points work and how to spend them. For each ear, you are given three points to spend on accessories. The accessories include the Phonak TV connector, the Phonak Roger Select iN, the Active Lifestyle Kit with the M Waterproof Battery, and a few other options. Some accessories cost more than others. For example, I wanted the Active Lifestyle kit for each ear which cost two points. This left me with one point for each ear. Normally, the only accessories you can get for one point are the Phonak Remote Control or the M Zn-Air Battery Pack (disposable batteries). I don’t use any of the Phonak accessories, so it didn’t make sense for me to order the remote.
I also really don’t like disposable batteries since they die so quickly. Instead of getting either of these options, I combined my single leftover point from each ear to order an extra large rechargeable battery which was two points.
2. If I choose my own colors, does that take up points?
One of the most confusing parts about the order form was that it said, “Spend 3 points to personalize your cochlear implant system” at the top. It gives the option for all of the colors right underneath this heading, so I wasn’t sure if this meant that choosing my own color would cost all three points. This was important to me since, at this point, I already had my heart set on getting at least one purple Marvel Sky and was debating whether I wanted the second one to be red or pink. The colors are important to me since I see them as a way of expressing myself and showing my pride and that I am not afraid to let the world know that I am deaf, that I wear cochlear implants, and that they have been the best thing for me. I’m not sure if I would have used all three points to choose my own color if I had to, though. I may have just gambled and let them pick because some of the accessories that require points are also crucial. The Active Lifestyle Kit is essentially the new model of the old AquaCase that I currently use with my Naida Q90s. The AquaCase is not exactly the best-designed tool in that it is bulky and not always 100% water-proof (it has annoying rings to inset to seal out water, but they are tough to replace). However, it is still highly beneficial to me to wear in the rain when I go swimming in the summer or simply at the gym. I was excited about the new Active Lifestyle Kit since it looks much better made than the AquaCase. It is much smaller, and it has a built-in water-proof battery, so I don’t have to worry about bringing a smaller battery.
Fortunately, I didn’t have to choose between having cool colors that I wanted or the accessories. As Doug informed me, the colors do not cost anything. So, wear your processors proudly and boldly! Get creative with the colors! Do you want all of the colors? Some members of the Advanced Bionics Cochlear Implant Users Facebook group realized that there is a way to get them all. Here’s how:
- Choose color 1 for the headpiece.
- Choose a different color for the wire.
- Choose a different color for the processor.
- If bilateral, choose another different color for your second headpiece.
- Choose another different color for the wire.
- Choose another different color for the processor.
- Use your points to get the Active Lifestyle Kit.
- Choose another different color for the headpiece on the Active Lifestyle Kit.
- Choose another different color for the wire on the Active Lifestyle Kit.
- Repeat steps 8-9 with all different colors.
I didn’t go quite that far to have everything a different color, but my initial processors will have matching headpieces and processors and be purple on the left with white cords and red on the right with white cords. My Active Lifestyle Kit will have pink headpieces on one side and navy blue on the other side. I forget what color cords I got for the Active Lifestyle Kits.
3. Will the new Active Lifestyle Kit require smaller batteries still? And if so, are those batteries included in the kit, or would they need to be purchased as a separate accessory/separate points?
As mentioned in my previous response, one of the most significant benefits of the new Active Lifestyle Kit is that it has a built-in water-proof battery and therefore does not require the smaller batteries (or any batteries, for that matter). You will still need to bring the little tool to change the T-mic to the new water-proof mic, but that’s not a big deal.
“Instead of an actual case, we have a battery that is also a case. So, you would take your battery off, take your T-Mic off, and place the processor on the M Waterproof battery, then close the lid on the battery, and booooom, you are water-proof (it does require a water-proof microphone (AquaMic) and associated cable.”– Doug Lynch, Advanced Bionics Rep
4. What exactly are the Roger/Phonak accessories?
I never used the Roger or Phonak accessories, but I still wanted to know more about what they were and what they did, just in case, I changed my mind about them. I wanted to make sure I wasn’t missing out on something that could benefit me and my hearing. This was Doug’s response:
“If you use a Roger Transmitter (Roger Pen, or Roger Select), you need a receiver to accept those signals. With Marvel, the receivers are built into the processor instead of the current state of affairs, where one needs a physical receiver connected to a battery. So the receivers on the order form are actually software licenses that enable the use of the built-in receiver.”– Doug Lynch, Advanced Bionics Rep
I’m still unsure if I fully understand Doug’s response, but I kind of just accepted it since I never needed the Roger or Phonak accessories in the past. I assumed I still wouldn’t need them now, and I knew I wanted to use my points for the Active Lifestyle Kits anyway.
5. How does the Bluetooth technology work?
The Bluetooth technology is the feature I am most excited about with the new Marvel cochlear implant processors. In the past, Advanced Bionics had a tool called the Naida CI Connect that allowed patients to connect their cochlear implants to Bluetooth streaming. However, the tool was very expensive. I think I found out before that it costs over $1,000 and was not covered by insurance. I considered purchasing it a few times but wasn’t sure how much I would use it or like it, and $1,000 is a lot of money to spend on a product you’re unsure about.
I am so glad that I waited and didn’t buy the Naida CI Connect since now, with these new processors, I will no longer need it. Doug confirmed that:
Marvel can connect to virtually any Bluetooth-enabled device (Android, Apple, TV, computer, tablet, etc.). Separately, Roger transmitters (Roger Pen or Roger Select) can connect to virtually any Bluetooth-enabled device, as well. So, if you have a Roger Transmitter, you can choose to connect via Bluetooth with your Roger transmitter, or to simply connect with your Marvel Processor.Doug Lynch, Advanced Bionics Rep
So I can stream any form of Bluetooth I want directly into my ears without an outside tool.
Some members of the Advanced Bionics Cochlear Implant Users Group on Facebook that already received their upgrade stated that this is one of their favorite features and that it is essentially like having top-of-the-line Bluetooth earbuds in all day long. They also noted that even if you stream all day long, it doesn’t really drain the battery or negatively affect it.
Despite asking Doug 5 in-depth questions and receiving some great answers, there are still five questions that I wish I would have asked the first time around. They are:
1. How much will this cost me?
I know that this will probably sound incredibly naïve and dumb of me, but I didn’t think this upgrade would cost me anything. My initial cochlear implants – everything from the external processors to the internal magnets, surgery, etc. did not cost me anything at all. I had Aetna back then, but my insurance has been Independence BlueCross Blue Shield (IBX) for a few years now, which usually covers more than Aetna did, and I never have to pay more than a couple of dollars for appointments. My replacement wires, batteries, etc., have been an out-of-pocket expense, but I was initially told that it just because they aren’t covered by insurance and my processors are not out-of-warranty (the warranty is usually only good for three years).
My jaw nearly hit the floor when I received a bill from Advanced Bionics for $21,000. Imagine thinking that a medical expense will be free and then receiving a bill for $21,000. I thought that it was a mistake and that my insurance just hasn’t been processed yet. I also initially read it wrong and thought it said $2,100, which is still a lot of money, but much better than $21,000.
After several calls to both Advanced Bionics and IBX, I learned that my insurance is out of network, and I have a $7,000 deductible, which is why accessories like batteries were never covered in the past. It wasn’t that it wasn’t covered by insurance, it was simply that batteries only cost about $100, and my deductible was $7,000.
I still don’t understand how this will work, but as of now (and this could change in a heartbeat), IBX is still out-of-network but will cover about 60% of my $21,000 total expense. Since they are out-of-network, they will pay me directly, and then I will pay Advanced Bionics. I have a down payment with Advanced Bionics of about $2,000 and then monthly payments of about $800. I have to start paying it soon, even though my processors haven’t even shipped out yet. I am not happy about that. With the challenges COVID-19 has brought to our postal service, the thought of spending a few thousand dollars on a product before even receiving it makes me nervous, but there’s not much I can do about that. It is beyond my control.
Oh, and the $21,000 total is for both ears. I nearly had a heart attack over this expense. If the $21,000 were for each separate ear, I probably would have just died.
2. What happens if I don’t upgrade?
I was extremely gung-ho about upgrading as soon as possible when I thought it was free. However, when I found out they would cost me around $8,000 after insurance (from the total $21,000 expense), I wanted to wait on upgrading for a while. While I thought the upgrade would be amazing, I am doing very well with my current Naida Q90s and didn’t feel I needed new processors. It would be something nice to have, but not a necessity. It’s like how I have an iPhone 11 now and before I had an iPhone 7. My iPhone 7 worked great, and I essentially didn’t need to upgrade to the 11, but the 11 had more features and options and was a little nicer, so when I had the money, and it was convenient for me, I upgraded.
Unfortunately, though, an iPhone is not the same thing as a cochlear implant processor. Whereas there are dozens of phone brands that you can choose from and switch between, you can’t for a cochlear implant. Cochlear implants only have three brands: Cochlear, Advanced Bionics, and MED-EL. Once you choose a brand, which in my case is Advanced Bionics, you can’t change your mind and switch to another one. The downside of this is that it gives the brands a lot of power and influence, which can become unethical.
Don’t get me wrong, I am beyond excited about Advanced Bionics’ new Marvel processors, and I think they will be amazing. But when I received an e-mail from them on March 4th explaining that they would be discontinuing the sale and support of my current processors – the Naida Q90 (except for those that were still under warranty, which mine aren’t), I couldn’t help but feel that they were using their power and influence in an unethical manner. With the discontinuation of support for all out-of-warranty Q90s, I felt stuck and forced to upgrade. Sure, it technically was still my choice, but if I didn’t upgrade and my current processors broke, I feared I wouldn’t be able to get the help or support from AB that I received in the past. Therefore, I decided to upgrade immediately rather than wait and see how other people liked theirs. This hardly seems fair, but I guess it is what it is.
3. Can I keep my old processor, even if I upgrade?
I never had a backup cochlear implant processor. Not having a backup leaves me with a lot of anxiety. Sometimes my cochlear implant processors fall off or get knocked off. I’ve had them fall off in the street a few times while adjusting my mask or cleaning or doing other things around the house. Fortunately, I always find them, and they haven’t broken, but I’m always full of “what-ifs.” If my cochlear implant processors were to get lost or break, I would be screwed since I don’t have a backup. The cost of purchasing another processor would be thousands of dollars (I believe the last estimate I’ve seen was nearly $10,000).
I like the idea of having an extra processor just in case mine breaks, gets lost, or is involved in some kind of accident. I know that there are times that Advanced Bionics will buy back old processors or allow you to trade them in for a new one. However, I didn’t want to trade mine in, so I asked Advanced Bionics if I could keep it and if it would still work. They said that if I traded them in, I could get a credit towards my new processors, which I believe they said would be about $2,000. I could keep my old ones, and so long as they were still programmed, they would continue to work if I ever needed them as a backup.
4. Can I program my new processor on my own?
One of the best new features with Advanced Bionics’ new Marvel cochlear implant processors is that they allow for wireless programming. Advanced Bionics also developed an app that goes along with the processors and allows you to change the settings or customize the sound to meet your preferences and needs. This gives the user more control and allows them to make adjustments without needing to schedule a visit with their audiologist, or at least that’s what I assumed.
I am still a little unsure of the answer to this question, to be honest. However, based on what I’ve read about the new Marvel processors from those who already upgraded, it sounds like you can change the settings and make adjustments in the app without the help of your audiologist. However, I would probably still feel more comfortable having my audiologist program my new processors for me to be on the safe side. As I get more comfortable with them and better attuned to the new features and how things work, I may choose to program them or adjust them myself in the future.
5. Where should I have my new processors shipped to?
COVID-19 changes everything, including the cochlear implant upgrade process. With my initial Naida Q90s, everything was always shipped directly to my audiologist’s office at Jefferson. However, now people see their audiologists and doctors less and less, and the new technology gives the user more control. It essentially will allow them to program their own cochlear implant processors (I think). It may make more sense to have them shipped directly to your home rather than to your audiologist.
Still, I wasn’t sure what the “right” answer was here. I didn’t want my audiologist to feel that I was betraying her, and honestly, I’m not sure I trust myself, my knowledge, and my skills to take on such a big task as programming my new processors myself. I decided to call Paula and ask what her preference or opinion was. She recommended that I ship everything to my home because she was afraid it might get lost at Jefferson or her office if I had them shipped there. Once I receive them, I will schedule an appointment to see Paula at Jefferson and have her program them for me.
Honestly, I’m super excited to be having these shipped directly to me because it means I can take my time to look at everything in advance. I can do my own unboxing or review video and blog post (stay tuned for that!) and spend some time thinking of any questions I may want to ask Paula at my appointment. I think this will make it a much less overwhelming appointment.
Is anyone else upgrading to the new Advanced Bionics Marvel processors? What questions do you have about the new processors or upgrade process? What questions do you wish you would have asked initially? Feel free to leave a comment and let me know!