AARP Eye Center
Background
Hearing loss is a substantial problem, affecting more than 30 million Americans.
More than 40 percent of Americans older than 60 (more than 60 percent of those older than 70) and nearly 80 percent of people older than 80 have some level of hearing loss. It can negatively affect older people’s quality of life by preventing them from engaging with others. This can lead to social isolation and limit the ability to work. Hearing loss is also associated with depression, dementia, cognitive decline, and poorer physical functioning. Studies have also shown that even mild hearing loss is associated with a threefold increase in falls. Despite the prevalence of hearing loss, hearing-aid use is relatively low (15 to 30 percent). This is primarily because of their high cost, which Medicare does not cover. Cost is a major barrier to getting assessment and treatment for hearing loss in the form of hearing aids. The average price for a hearing aid is $2,400, and most people need two. Most people would have to pay the total cost of hearing aids out of pocket due to lack of insurance coverage. Some state Medicaid programs cover hearing aids. However, Medicare expressly excludes coverage for hearing assessments and hearing aids.
In 2016, The President’s Council of Advisors on Science and Technology and the National Academy of Medicine (formerly known as The Institute of Medicine) recommended policy changes that would help lower the cost and promote greater use of hearing aids. For years, experts suggested that the Food and Drug Administration (FDA) establish a new classification for basic hearing aids. Starting in 2022, the FDA permitted these devices to be sold over the counter at drug stores for the treatment of mild to moderate hearing loss—similar to what is allowed for reading glasses. This change does not alter FDA regulation of more complex hearing aids.
The FDA has also reduced restrictions on the sale of personal sound amplification devices. These are a type of generic hearing aid. They can be helpful in situations in which amplification and noise cancellation are all that is needed. These devices are generally available over the counter for a few hundred dollars.
As basic hearing aids come on the market as over-the-counter devices, their cost is expected to decline to a few hundred dollars. Competition for more complex hearing aids is also likely to intensify. Prices will decrease as the FDA reduces regulatory restrictions on these devices.
Lower hearing-aid costs will be good news for consumers, especially seniors with hearing loss. Increased competition and declining costs should encourage state policymakers to expand hearing-aid coverage and may also give federal policymakers greater leeway to consider adopting Medicare coverage for these devices. This would be of great benefit to current and future beneficiaries.
HEARING AIDS: Policy
HEARING AIDS: Policy
Hearing assessments and hearing aids
Policymakers and regulators should make necessary changes to help lower the cost and promote greater adoption of hearing aids.
Audiologists should offer more standardized prescriptions that patients can use to compare products.
Safety and efficacy
The Food and Drug Administration should carefully review the safety and efficacy of new hearing aids before allowing them on the market.
Compatibility
The Federal Communications Commission should ensure full and prompt implementation of its hearing-aid compatibility rules to increase the number of wireless phones that can be used effectively with hearing aids and cochlear implants (see also Telecommunications).
Sales tactics
The Federal Trade Commission and state consumer protection agencies should investigate complaints of high-pressure sales tactics that inhibit older people from getting professional counseling before purchasing a hearing aid.
States should regulate hearing-aid dealers and sales practices, including direct response and mail-order solicitations. They should require that advertising mention bonding of sellers and require adequate consumer protections.