As more and more of us move into our 60’s, 70’s and 80’s, the likelihood that we will experience some form of hearing loss increases.  My own hearing loss started in my 40’s.  I attributed it to listening to too much rock and roll as a teenager at too loud a volume, thereby fulfilling a prediction my mother made that I would end up deaf.

In my instance, however, it wasn’t until I experienced a severe case of vertigo and was put through an MRI to see what was going on in my brain that the true underlying cause of my hearing loss was found.  Turns out I had an acoustic neuroma.

Now this is a very rare benign tumor that was growing on my acoustic nerve and literally squeezing it to death like some gnarly anaconda so I couldn’t hear.  I ended up having to undergo surgery to have it corrected, and now I wear hearing aids in both my ears.

In my case, insurance covered the cost of the MRI, the surgery, and partially, my hearing aids.  I point this out, because the sad fact is, hearing aids, which are essential to me being able to do the work I do, are not covered by most insurance and NOT COVERED AT ALL BY MEDICARE!

Why is this a problem?  Most people don’t even realize their hearing is getting worse and will go for many years without getting their hearing tested.  The longer hearing loss is left uncorrected both the quality of life and overall brain health are negatively impacted.

Over two-thirds of our brain is dedicated to experiencing the world we live in through visual and auditory perception.  When either of these is negatively impacted, our brain attempts to compensate.  When it can no longer do that, it loses the neuronal pathways and synapses essential to transmitting the neurochemical code that makes us see colors and hear music.  This, in turn, results in functional changes such as withdrawal, self-doubt, fatigue, and irritability.


180-area multimodal human cortical parcellation on the left and right hemisphere surfaces. Colors indicate the extent to which the areas are associated in the resting state with auditory (red), sensation (green), visual (blue).

More and more of us may be needlessly experiencing subtle cognitive decline that we wrongly attribute to dreaded Alzheimer’s, when it is really hearing loss. I mention this because the issue is quite easily addressed with hearing aids.

Sadly, for reasons I have yet to fully understand, when Medicare was first introduced in 1965, the drafters of the legislation left hearing aids and glasses off the list of “durable medical equipment” that Medicare would pay for.

Today it isn’t any better.  According to Lisa Packer, a writer for “Healthy Hearing

“Medicaid coverage for hearing aids varies from state to state, with some states excluding coverage entirely. And most hearing aid providers don’t accept Medicaid or Medicare due to the complex paperwork involved as well as a low, and slow, reimbursement rate.

While some Medicare Advantage plans include coverage for hearing aids, traditional Medicare, … doesn’t include any coverage whatsoever. A lot of private insurers follow Medicare’s lead, so if Medicare doesn’t cover it, they don’t either.”

Many of us find the cost of hearing aids prohibitive.  Even with insurance, my first pair cost me close to $8,000.  Today, as technology has improved, the bells and whistles that come with hearing aids are quite impressive.  Unfortunately, prices have not come down and range anywhere from $400 to $10,000.

Unless and until there is sufficient demand, it is unlikely that insurance companies or Medicare will cough up the money to pay for hearing aids.  This leaves those of us with hearing impairment not just caught in the middle, but at risk for overall functional and cognitive decline because we cannot afford the “cure”.

Several strategies exist for addressing this.  Given the probability of needing hearing aids, for those of you who have access to a Health Savings Account (HSA), I suggest you start putting money toward purchase as soon as possible.  If you are already on Medicare, do take advantage of the audiology screening that is a covered benefit, and at least determine how much hearing loss (if any) you have.  Then shop around.

Another strategy is to get hearing aids (and yes, glasses), added to the approved list of durable medical equipment.  This requires that you contact your elected representatives and ask them to support legislation that would change the Medicare Act.

It so happens that such legislation was introduced by Pennsylvania Congressman Matt Cartwright back in 2014.  It was re-introduced in 2015 (H.R.2748).  The bill amends Title XVIII of the Social Security Act (Medicare) to cover aural rehabilitation services, hearing aids as durable medical equipment, audiology rehabilitation services, and related hearing services.

Right now the bill is languishing in the Health subcommittee of the House Ways and Means Committee.  In order for it to be resuscitated, it needs lots of people writing, calling, texting, and posting on whatever social media you post on to bring this to the attention of your elected officials (many of whom have hearing loss, by the way!)

In the work I do with aging adults, there is nothing more energetically draining than to have to shout back and forth in order for each of us to be understood.  I see people who have been labeled as having “dementia”, make a miraculous recovery when their hearing is improved or restored.

I would not be so emphatic about this except for the fact that I have this hidden disability.  I cannot tell you how my life has changed because I now wear hearing aids.  While they are not perfect, they allow me to stay present in a conversation, participate in social activities, and keep my brain attuned to what is going on around me.  I can hear the birds sing.  I don’t have to have my TV volume set on “high”.

I would be lost without them, and like so many others, would probably withdraw into my own world and lose out on so many things.

Thanks for reading.

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