Did you know that a hearing aid can cost $6,000? Did you know that the average price for a hearing aid is $2,400? Did you know that your expensive health insurance probably doesn't cover it?
Hearing aids are not covered by Medicare. They are also not covered by most state Medicaid programs or by the Affordable Care Act or most private insurance. Essentially, you're on your own.
Thirty million Americans suffer age-related hearing loss. Only about 14 percent of them currently use hearing aids. The primary reason for this is the high cost. About one in five Americans in all age groups suffer hearing loss. They don't wear hearing aids either.
This could change. In December the US Food and Drug Administration announced that it is considering creating a new category of over-the-counter hearing aids. The aim, it said, would be to encourage "new, innovative, lower-cost products to millions of consumers."
An over the counter hearing aid would be a consumer-electronics product, and would be marketed like other consumer electronics. That is, there would be competition, and competition lowers prices. Right now all FDA-approved hearing aids are manufactured by a handful of companies, and they are not interested in underselling each other.
Why is the FDA considering this? Acting on the advice of several major medical recommendations this year, the agency is concerned with the personal and public-health costs of untreated hearing loss. Hearing loss is associated with depression and isolation, with a greater risk of falls, and with cognitive decline including dementia. It also leads to unemployment.
Barbara Kelley, the executive director of the nonprofit Hearing Loss Association of America, says her group receives requests every day for information about financial assistance for hearing aids. "Sadly, there are few financial aid resources," she wrote in a letter to the Senate sponsors of recent bill that would make OTC hearing aids legal. (It's good the FDA is acting independently, given the general stalemate in Congress.)
Why doesn't insurance cover hearing aids? The fact is that at $6,000 a pair, insurance companies can't afford to cover them. Permitting the sale of over the counter hearing aids would open up the market to competitive pricing. As prices come down, covering hearing aids would no longer be prohibitively expensive to insurance companies.
The FDA announcement was part of a ruling that, effective immediately, consumers are no longer required to have doctor's clearance before buying a hearing aid. Most people waive that requirement anyway. In waiving the physician requirement, the FDA was following another of the recommendations of the two advisory groups: the President's Council on Science and Technology and the National Academies of Sciences, Engineering and Medicine. Consumer groups like the Hearing Loss Association of America also endorsed these recommendations.
Some people worry that waiving the physician requirement and allowing OTC hearing aids means that serious medical conditions will be missed. All such hearing aids will include labeling that warns the consumer to see a doctor immediately if the hearing loss is accompanied by certain red flag conditions -- sudden hearing loss, single-sided or asymmetric hearing loss, drainage from the ear, pain, dizziness.
It's possible to get less expensive hearing aids now. You can go to Costco, which usually has audiologists on staff. You may get some reimbursement from your insurance company. You may be able to buy a brand sold by your insurance company. If you're a veteran you can get them through the V.A. If your hearing loss is affecting your ability to work, your State Vocational Bureau might help. But what's really needed is an easy affordable way to buy hearing aids.
None of this affects me personally. I have a profound loss and a cochlear implant in one ear and severe to profound loss in the other. I will never be buying an OTC hearing aid. But as an advocate for people with hearing loss, I know that untreated hearing loss is a major problem.
If all the people of all ages who could benefit from hearing aids used them, they would be as common as glasses. And that would eliminate a second deterrent: stigma. As use increases, stigma decreases. This is good for us as individuals, and it is good for our public-health dollars.
A version of this post first appeared on Hearing Health and Technology Matters: Why Advocates Like Me Welcome the New Hearing Aid Ruling.