Otolaryngology

Many Insured Patients Still Can’t Afford Hearing Aids, Study Finds

Originally published January 30, 2025

Last updated January 30, 2025

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Man gets fitted for a hearing aid.

Keck Medicine of USC research reveals which types of health insurance are better at helping patients afford hearing aids — and which aren’t.


The rate of hearing loss is high among U.S. older adults. Despite this, many who need to use hearing aids aren’t. Are insurance policies precluding their access? Keck Medicine of USC physicians recently analyzed how different types of insurance policies correspond with hearing aid use. Their analysis is the largest of its kind to date.

“We were very excited to be able to do this research leveraging a really large sample size of older U.S. adults, which hasn’t been done before,” says the study’s lead author Janet Choi, MD, MPH, an otolaryngologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of Keck Medicine of USC.

How hearing aid coverage varies by insurer

For their cross-sectional analysis, Choi and her team gathered data from the CDC’s annual National Health Interview Survey (NHIS) for the years 2007-2018. Their study cohort comprised 82,466 U.S. adults aged 65 and up. These individuals had self-reported whether they had hearing limitations, whether they used hearing aids and what type of insurance coverage they had.

Janet Choi, MD, MPH

Using multivariable regression models, the team looked for trends in types of insurance coverage and hearing aid use. They considered both single-policy insurance coverage as well as combinations of different insurance types.

In total, they analyzed 16 insurance-coverage models, ranging from private health insurance and employer-provided private insurance to military health insurance, Medicare, Medicaid and combinations of these. Their models included “Private & Military,” “Private & Medicaid,” “Private & Medicare,” “Private & Other Government,” “Military & Medicaid,” “Military & Medicare,” “Military & Other Government,” “Medicaid & Medicare,” “Medicaid & Other Government,” “Medicare & Other Government,” and “Three or More Insurance.” The Medicare-only group served as the reference group because the majority of older adults in the U.S. have Medicare coverage, which typically does not include hearing aids.

This analysis realistically depicts how many Americans are covered by insurance today, meaning under multiple types of insurance policies. The researchers noted that previous studies on hearing aid use focused only on single insurance types, a narrower selection of insurance groups and much smaller study cohorts.

Unsurprisingly, the researchers found that better coverage for hearing aids resulted in a higher rate of hearing aid use.

The following insured groups had higher rates of hearing aid use: “Military,” “Military & Medicare,” “Private & Medicare” and “Three or More Insurance.” The researchers also found hearing aid users likelier to be older, male and White and have a higher level of education and income.

What does this study teach us?

This study demonstrates that patients with better hearing aid coverage are more likely to use hearing aids.

The researchers noted: “The high usage of hearing aids with military-related insurance may be attributable to the [Veterans Health Administration’s] purchase of over a quarter of hearing aid sales in the U.S. and acquiring a negotiation of hearing aid costs as low as $360 per device, allowing complete coverage. The VA also provides consultations, hearing evaluations, fittings, repairs and follow-up care for eligible veterans.”

Elsewhere, they found that Medicare Part A and B do not cover hearing aids or fitting exams. (Medicare Part C coverage sometimes does, but only in certain cases.) Under Medicaid, meanwhile, coverage for hearing aids differs by state. Finally, the researchers noted the biggest variation in hearing aid coverage among private insurers, especially those tied to large employers.

Need for better hearing aid insurance coverage

Overall, Choi’s group found that there is a large percentage of older U.S. adults who need hearing aids but who aren’t using them. They suggest that improvements in insurance coverage could increase hearing aid use by those who need them.

In their analysis, they found that among older U.S. adults who are aware of their hearing limitations — often an underestimate of those who actually have hearing loss based on hearing tests — only 51.3% reported currently using hearing aids. As Choi points out, since many people often don’t realize they are beginning to lose their hearing, the number of people who need hearing aids is likelier higher than current statistics show.

“This is actually one of the few studies providing evidence that when insurance policies change, there is a chance that hearing aid use may increase,” she continues. The group presented their research last fall at the American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting and OTO Expo in Miami. It has been submitted for journal publication.

“Future research should examine the impact of different insurance policies on hearing aid use and its downstream health benefits,” the researchers stated in their study.

And even as telehealth, remote audiology services and over-the-counter hearing aids may one day expand access to hearing aids, the fact remains that insurers need to make hearing aids more affordable today. According to the National Institute on Aging, hearing loss heightens the risk of dementia, depression and falls. Conversely, recently published Keck Medicine research led by Choi showed that using hearing aids could help people live longer.

Enhancing hearing care for older adults not only improves individuals’ health status but also reduces costs for the whole health system.

“There have been a lot of studies showing the negative health impact of hearing loss and increased health care costs as a result,” Choi says. “This is a good time for policymakers to really think about how to provide hearing aid coverage for older adults who sorely need them.”

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Jennifer Grebow
Jennifer Grebow is manager of editorial services at Keck Medicine of USC.

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