Two-thirds of Americans aged 70 and older “have clinically relevant hearing loss,” according to the Johns Hopkins Cochlear Center for Hearing and Public Health. Unaddressed hearing loss can increase the risk of cognitive decline, dementia falls, cardiovascular disease, social isolation, depression, and anxiety, but less than 20 percent of the adults who could benefit from a hearing aid currently wear one.
Although the need is generally greatest for those 65 and older, the Medicare legislation of 1965 excluded the coverage for hearing aids (as well as for visual aids and dental care) and never updated it.
Medicare does cover the cost of a hearing exam performed by an audiologist, who can diagnose and prescribe treatment for hearing loss.
But if the result is a prescription for hearing aids, which can range in cost from about $2,000 to $12,000 a pair, they will not be covered by Medicare and only rarely by private insurance.
As things now stand, given the high and often prohibitive out-of-pocket cost of hearing aids, many have waited far too long to get needed technological help. But the wait may end soon.
On July 9, President Biden signed an executive order giving the drug agency 120 days to issue guidelines so that those with mild to moderate hearing loss could purchase high-quality hearing assists directly from retailers like Apple, Bose, or Samsung that cost several hundred dollars a pair, not several thousand.
Such companies have already proven themselves by creating superior sound quality and are expected to not take long to market top-of-the-line hearing aids that cost no more than a basic cellphone. (I already hear much better when using the speaker-phone feature on my cellphone rather than my landline. FaceTime or Skype also provide greater clarity.)
Affordable access to a device is just the first step toward improved hearing for the millions of people who now struggle to understand conversations, lectures, movies, or broadcasts on radio and television.
Additional legislation now before Congress would expand Medicare coverage not only for medically prescribed hearing aids, but also for critically important audiology services that could benefit those who purchase over-the-counter hearing devices and need adjustments, as well as those who might benefit from seeing an audiologist, but who don’t necessarily need a hearing aid.
Dr. Frank Lin, an otolaryngologist, and director of the Johns Hopkins center explained that audiologists can provide their patients with better communication tips, even if they don’t require a hearing aid. “For example, by speaking face-to-face with people, shutting out background noise, adjusting the volume on the phone or using a cellphone on speaker or FaceTime instead of a landline,” he said. “Right now, audiologists are not paid to do this unless you purchase a hearing aid.”
Yet a similar concern doesn’t keep people with poor vision from wearing glasses. And modern digital hearing aids border on invisibility.
They come in three main styles: behind-the-ear, in-the-ear, and in-the-ear-canal. Sound is conveyed through a tiny speaker that fits inside the ear, attached by a barely visible wire to a very small flesh-colored “computer” containing a microphone, amplifier, and battery that sits behind the ear.
When the new generation of over-the-counter hearing aids become available, they may look very much like the already popular AirPods that so many people of all ages now walk around with while listening to music and podcasts, and while making calls on their cellphones. Perhaps people might not even notice them.
Brody is a journalist with NYT©2021
The New York Times