From Jamie Berke,
Your Guide to Deafness.
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One of the biggest complaints that both deaf and hard of hearing people share is the high cost of hearing aids. Hearing impaired people whose hearing losses are not severe enough for cochlear implants must use hearing aids. The problem is, hearing aids are not usually covered by health insurance plans while cochlear implants are.

A cochlear implant is considered a prosthesis by private insurance companies, but hearing aids are not. For example, the Cigna healthcare document Coverage Position Number 0190: Cochlear and Auditory Brainstem Implants (revised 5/15/2007) states, "The cochlear implant is an electronic prosthesis that stimulates cells of the auditory spiral ganglion to provide a sense of sound to persons with hearing impairment." At the same time, Cigna Coverage Position Number 0093: Hearing Aids (revised 5/15/2007) states, "Hearing aids are specifically excluded under most CIGNA HealthCare benefit plans."

Medicare also does not cover hearing aids (to view Medicare's full statement on non-coverage of routine hearing exams and hearing aids, go to Medicare.gov's Coverage Page).

Why Hearing Aids Are Not Covered

One reason hearing aids are not covered is because of sheer numbers. There are many more hard of hearing people than deaf people who can benefit from cochlear implants. People may lose their hearing as they age and need hearing aids. Things could change because of cochlear implant technology improvements allowing hard of hearing people to use implants.

Many Unable to Afford Hearing Aids

The problem is, hearing aids can be quite expensive. There are a dizzying array of hearing aids available today, and the better-performing ones are the most expensive. Every now and then, someone e-mails me asking for help getting hearing aids for themself or for a child. I have met parents of hard of hearing children who are bitter about the fact that cochlear implants are often covered by insurance while hearing aids are not.

Senior Citizens Without Hearing Aids

A May 1999 National Council on the Aging survey of seniors showed that 55% cited cost as a reason for not using hearing aids. This survey also found that untreated hearing loss has "serious emotional and social consequences."

Limited Help For Hearing Aids

Nonprofits and some service organizations (such as the Lions Clubs) help people, especially children, obtain hearing aids. There are also hearing aid banks for used hearing aids.

Basic analog hearing aids have also become more affordable as the technology wanes, but many people whose hearing losses require the advanced technology of more expensive hearing aids can not afford them. Some people have turned to the Internet to buy new and used hearing aids at their own risk.

My Personal Experience

Even I have struggled with the high cost of hearing aids. When my insurance did not cover hearing aids, I wondered if was worth it to spend thousands of dollars to upgrade. Due to a progressive loss, I had to keep buying more powerful aids. After the last hearing aid purchase, I told the audiologist, "That's it. I can't afford to keep doing this every five or six years. If I lose more hearing, I'm not buying another set of aids." After I lost more hearing, I did stop. This was my personal choice.

My View on Hearing Aid Costs

Deaf and hard of hearing people, as well as parents of deaf and hard of hearing children, should not have to turn to charitable organizations for a basic device that is so essential to functioning. If cochlear implants are covered by insurance, hearing aids should be, too. In my opinion, a cochlear implant is essentially a surgically implanted hearing aid. While a cochlear implant functions differently than a hearing aid, both cochlear implants and hearing aids serve a similar purpose -- helping their users to hear. Manufacturers have a right to recoup their research and development costs, but hearing aids need to be priced more reasonably.

Comments from About visitors:

Join the conversation in the About.com Deafness Forum.

Good instruments fit properly can cost. Patients should rethink priorities. I tell [patients] to put away each month what they would spend on cable TV to cover the costs. How about getting our priorities in line? Hearing aids restore people's lives. What kind of price can you put on that? **** I agree that the cost of hearing aids is high. It is high enough that the technology is simply not available to a portion of the population who need it. I do take issue, however, with the statement in the article that "a cochlear implant is essentially an implantable hearing aid.

A hearing aid takes in a signal, and the output is a signal which closely mimics the input. The cochlear implant requires computer circuitry much greater than that of a hearing aid. The output of a cochlear implant is a complex pattern of electrical pulses that stimulate the auditory nerve.

****

As a licensed hearing specialist...Miniaturization of hearing aids has long been the consumer's desire. Now they want to scream about the costs. Of the approximately 10% of this nation who suffer some form of loss, only 10% actually purchase hearing aids. If the industry could penetrate the market, then the costs of hearing aids would naturally decrease.

Many [customers] admit they did little [research]. The sale of hearing aids should be viewed as an investment, and the choice should be well thought out. Because hearing is [complex], each person needs to be fitted according to [his or her] needs. The purchase of hearing aids should be done with someone who you feel will be there when you have problems. Internet hearing aids will not be able to accomplish this. Nor will it be [possible] to physically examine the ear.

Digital aids generally are a better fit for most hearing losses as the technology allows for 'tweaking' the aids' response. An analog aid may be less expensive, but [may not give] the clarity needed to understand. Also, there are many ways to pay for your aids. All reputable hearing aid companies offer low or no-interest loans.

_{Source: The Consequences of Untreated Hearing Loss in Older Persons. Study by the National Council on the Aging, May 1999. Page 9. http://www.ncoa.org/attachments/UntreatedHearingLossReport%2Epdf (accessed January 13, 2008)}