Hearing aids can be pricey, but here are a few tips to possibly help lower the costs.
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An over-the-counter hearing-aid option would give consumers the freedom to treat mild to moderate hearing loss themselves. But is that a good thing?

Certain hearing aids could soon be as easy to buy as reading glasses, a shift consumer and interest groups say would dramatically boost access to hearing help for the estimated 1 million Arizonans who need it.

The state’s most prominent hearing-care advocacy group, however, believes the change could hurt people with hearing loss more than it would help them.

The Arizona Commission for the Deaf and Hard of Hearing for months has fought the federal Over-the-Counter Hearing Aid Act of 2017, which would create a new class of over-the-counter hearing devices for adults. Republicans and Democrats alike have backed the advancing legislation.

“Most of the stakeholders in this debate, our goal is the same: We want to increase access to hearing health care, and we want to increase the affordability of it,” said Michele Michaels, hard-of-hearing specialist with the commission. “But this is not the way to go.”

‘You get what you pay for’

Nearly 50 million Americans have a noticeable hearing loss in at least one ear, a particularly common problem among people over 60.

On average, people wait seven years to get help, and only a fraction purchase hearing aids. Researchers observe even lower rates of hearing-aid use among minorities.

Cost isn’t the only barrier, but it’s a big one. The average hearing aid costs more than $2,000 and needs to be replaced after three to seven years. Most people need one for each ear.

“The number one call or email we get here is, ‘I can’t afford hearing aids. They’re too expensive,’” said Barbara Kelley, executive director of the Hearing Loss Association of America. “Medicare doesn’t cover them, and insurance covers very little.”

Lake Havasu City resident Terry McCormack noticed his hearing slipping roughly three years ago, when he couldn’t follow the dialogue in TV shows and movies.

He didn’t get hearing aids until earlier this year, largely because of the price.

“The audiologist said I had a significant hearing loss in my left ear and a moderate one in my right, and then, the sales pitch came out,” the 58-year-old said. “She had hearing aids ranging from $5,000 to $7,000 for both.”

Neither McCormack’s insurance nor his wife’s covered the devices. After months of research, he purchased a programmable pair with four settings for about $700 on Amazon.

“They’ve worked out well, but you get what you pay for,” he said. “The $7,000 ones had 24 different channels that you could really fine-tune.”

Worth the risks?

Over-the-counter hearing aids would be designed for adults with mild to moderate hearing loss, according to the legislation awaiting U.S. Senate approval.

But the commission, as well as audiologists and hearing-aid dispensers throughout the state, question the diagnostic abilities of untrained consumers.

“Based on what has been seen so far, only 25 percent of consumers can accurately assess their degree of loss, and they don’t know if they have the loss in one or both ears,” said Bob Baber, an Arizona hearing-aid dispenser with Miracle Ear.

“If they’re not getting professional hearing tests and physical exams, you could have a situation where someone thinks they need a hearing aid when they just have their ears totally impacted with wax,” he said.

Audiologists also uncover serious nerve problems, infections and tumors during exams, according to Tucson-based audiologist Judy Huch.

“People might say, ‘OK, you’ve found three tumors in 20 years,’” she said. “But for me, missing one tumor out of thousands of people would be too many.”

Huch rejected the parallel often drawn between over-the-counter hearing aids and reading glasses. She described using hearing aids as a “journey” because the devices require fittings and adjustments, and buying reading glasses as an “event.”

She and other professionals worry that if first-time users don’t know how to achieve the correct fit, then hearing aids might not work as intended, causing people to give up on them. 

And although over-the-counter aids would technically be restricted to adults, officials say there’s no real way to ensure people wouldn’t buy them for children if no prescription is required.

“There’s no such thing as ‘mild to moderate’ hearing loss for children because even minor hearing loss in a child is serious and significant,” said Michaels, the hard-of-hearing specialist. “That’s a big concern.”

‘A closed option for years’

Supporters of the legislation argue the potential benefits of over-the-counter treatment dwarf the risks.

Untreated hearing loss can lead to isolation, depression, reduced physical activity and injuries. Researchers believe a link between hearing loss and dementia could exist.

“Is an OTC option a perfect solution? There are still a lot of unknowns,” said Kelley, with Hearing Loss Association of America. “I’m not saying nothing bad could ever happen, but clearly, the status quo isn’t working. (Hearing aids) have been such a closed option for years.”

Kelley believes hearing-care professionals should give consumers more credit, saying she “would think that if you wake up with something draining out of your ear, you’re not going to run to CVS and buy a hearing aid.”

Over-the-counter hearing aids also aren’t an either/or situation. The association has long supported seeking the services of a hearing-care professional first.

“Getting something OTC doesn’t mean you can’t then take that to the audiologist or hearing-instrument specialist,” Kelley said. “In fact, we’d hope that audiologists would begin to carry more of these devices as a more open market leads to innovation and drives more people toward hearing care.”

‘Controlled access’

Advocacy groups on both sides of the debate say they will work to build in consumer safeguards if the legislation passes.

Hearing Loss Association of America said they’ve started drafting language for Food and Drug Administration labels, for instance.

The Arizona commission is weighing a “controlled access” mechanism similar to the current practice of requiring ID to buy medicine containing pseudoephedrine, Michaels said.

“Maybe there’s a new form of licensure or certification we could create for people who could dispense these devices and do the initial (physical) screenings,” she said. “There’s going to have to be more things we do on a policy and procedure level. It’s definitely going to require state agencies like ours to put funding into consumer education.”

In the meantime, the commission fights for several industry changes it believes would make hearing aids more accessible, including increased insurance coverage, tax credits, greater transparency in pricing, easier comparison of features across brands and the removal of proprietary locks on hearing-aid programming and adjustment.

“The bottom line for us is always consumer protection and consumer safety,” Michaels said. “Whether hearing-aids go over the counter or not, we want to make sure users don’t buy products that aren’t worthy of their dollars.”


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