Why doesn’t insurance cover hearing aids?

Melissa Nann Burke, The Detroit News 11:02 p.m. EDT July 18, 2015

Washington — The news can be tough for some to hear, but most private and government insurance plans don’t cover the cost of hearing aid devices.

It would take an act of Congress to change this, and that’s exactly what U.S. Rep. Debbie Dingell, D-Dearborn, is pushing for. Her first piece of legislation in Congress would allow Medicare to cover hearing aids.

“No one should feel isolated, confused or shut out from the world around them because they cannot afford the treatment they need,” Dingell said at the U.S. Capitol last week.

An estimated 70 percent of Americans with hearing loss between ages 65 and 84 are not using hearing aids, and cost is a factor for 46 percent of them, according to a 2009 study. Dingell notes that the average cost of a pair of the devices – $4,400 to $4,500 – is one few seniors on fixed incomes can afford.

The National Committee to Preserve Social Security, a grassroots group, last week endorsed her legislation, saying it would greatly improve the quality of life for many seniors.

“The beauty of this bill is not only that millions of seniors could finally get the help that they need to pay for assessments, of hearing aids, but this could delay the onset of dementia – Alzheimer’s could be slowed,” Max Richtman, the committee’s president, said at the U.S. Capitol last week.

“Think about the savings that could mean. We need to think about the long term.”

Richtman was referring to preliminary research that has linked unmanaged hearing loss to cognitive decline and the progression of dementia.

“Hearing loss is a normal process of aging, but there’s increasing understanding that hearing loss carries consequences for dementia, risk of fall and hospitalization,” said Dr. Frank Lin, an ear and throat specialist at Johns Hopkins University.

Hearing loss has also been linked to increased rates of depression and social isolation, Lin said.

While cost is a significant factor for some people who could benefit from hearing aids, others choose not to use hearing aids, often because of negative attitudes and stigma against wearing them, or because they don’t believe their hearing is that poor, experts say.

“It’s a difference between having hearing loss, and being so effected by it that you want to do something about it,” said Virginia Ramachandran, senior staff audiologist at Henry Ford Hospital in Detroit.

A 2011 study by Ramachandran and colleagues found that patients with full insurance coverage for hearing aids got the devices on average seven years earlier than those without coverage.

But the research also found that patients with partial coverage didn’t seek out hearing aids at a higher rate, “which is interesting because you would think if they were cheaper more people would use them,” Ramachandran said.

Dingell’s bill would also require a study by the Government Accountability Office of insurance and federal programs providing assistance for hearing aids and related examinations, and the effectiveness of the programs in meeting their need.

“It’s that second part of the bill is really important, I think, because otherwise you’re putting the cart before the horse,” Ramachandran said.

Some people who pay for hearing aids come back to her clinic three or four year later having never used them.

“Which is concerning because if you look at expanding coverage to a huge population like Medicare, you risk the potential of spending a lot of money on devices that people are getting and not using, ” Ramachandran said.

“The question becomes, how do you identify the people who absolutely need them and would use them, and then what’s the best model in order to deliver that. We need better data on that in order to inform the policy decision.”

Only three states, Arkansas, New Hampshire and Rhode Island, require that health benefits plans in their state cover hearing aids both children and adults.