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Over-the-counter hearing aids are coming — and lots of people could benefit

Coverage of aging is supported in part by AARP Arizona

One in 3 Americans between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Hearing aids are available but not always accessible, costing thousands of dollars out of pocket. But big change is on the way. 

The news seemingly appeared to break on Twitter the morning of Aug. 16. A flurry of tweets, including one from  President Joe Biden, appeared on the social media site about how the  Food and Drug Administration finalized a rule making over-the-counter hearing aids available to the public starting in mid-October.

"It's exciting because the landscape is wide open, and there's going to be tremendous competition," explained  Dr. Justin Golub, an ear, nose and throat doctor and associate professor at Columbia University in New York City. He’s been anticipating this news for a while. 

"I think there's going to be a lot of innovation, because these consumer electronics companies are going to step into the game," he said. "And they're among the most innovative companies out there."

Companies like Apple, for example. And big box stores like  Best Buy also have plans to jump into this space later this fall. 

Hear Kathy Ritchie discuss hearing aids with host Lauren Gilger on The Show

otc-hearing-aids-show-lg-kr-20220823.mp3

Affordable health care

But what makes this announcement even more significant is that it’ll make hearing aids more affordable. That’s because unlike prescription hearing aids, which require a hearing test and an audiologist who fits these devices to meet a person’s unique needs, over-the-counter hearing aids will be a sort of one-size-fits-all product.

Michele Michaels is the hearing health care program manager at the Arizona Commission for the Deaf and Hard of Hearing.

"These devices, some of them will be even $1,000," she said. "I don't think we're gonna see anything less than a few hundred dollars, because it's just really difficult to make that high quality of the device for less than that."

While $1,000 is a lot, especially for older adults on a fixed income, Michaels said, "insurance companies, for the most part, have not covered hearing health care."

And it’s not just private insurance companies.

"There's actually an exemption that says Medicare will not cover hearing aids when when Medicare was started, way back when. Hearing wasn't seen as a health care issue," said Michaels.

Michaels says it's not just older adults who can’t access hearing aids. In Arizona, she says, AHCCCS (Arizona Health Care Cost Containment System), the state’s Medicaid program, covers hearing health care up to the age of 21.

"But after 21, there's just not a lot out there," Michaels said.

According to the  National Institute on Deafness and other Communication Disorders, close to 29 million adults could benefit from hearing aids. But prescription hearing aids can cost a fortune. 

"A regular pair of hearing aids is probably at least $3,000, on average, with high-end pairs approaching $5,000 or $6,000, or possibly even more, which is just incredibly expensive," Golub said.

Besides the potential cost savings, there’s something else this democratization of hearing aids could minimize: ageism.

"If children have hearing loss, there's a very good chance that they'll get diagnosed and treated and wear a hearing aid," said Golub. But older adults? That's a different story.

"The rate of hearing treatment is pretty low. It's frankly quite abysmal. Over 80% of people over 80 have hearing loss, but under 20%, actually, wear hearing aids," Golub said.

Mild hearing loss and the dementia connection

And this lack of awareness, or even interest, in providing hearing health care to older adults is cause for big concern.

Golub was an author of a recent paper that looked at those glaring discrepancies between children and older adults. He and his colleagues noted that even mild hearing loss could lead to cognitive decline and dementia. While more studies are needed, they wrote, “the evidence no longer supports the assumption that mild hearing loss is innocuous in adults.”

Over-the-counter hearing aids would target exactly that: mild to moderate hearing loss in people over the age of 18. 

"I think one of the biggest pros of this happening is that it will destigmatize wearing hearing aids. Already, wearing devices in your ears is becoming commonplace as we all walk around with things in our ears doing Zooms all day," said Golub.

And with companies like Apple possibly getting in on the action, it seems that the line between headphones and hearing aids is blurring.

That said, the FDA in its final rule, also issued guidance to clarify the differences between hearing aids, which are medical devices, and personal sound amplification devices, which help with those with normal hearing amplify sounds. 

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Senior field correspondent Kathy Ritchie has 20 years of experience reporting and writing stories for national and local media outlets — nearly a decade of it has been spent in public media.