Accepting And Affording Hearing Loss: An Uphill Battle
Treatment may be costly, but ignoring a hearing problem could be worse.
Life can be difficult for the hearing impaired, and is often accompanied by isolation and increased social anxiety. Even though hearing loss is a common problem with many available treatment options, most people let it go for more than 10 years before seeking a hearing aid, according to a Health Technology Assessment out of the United Kingdom in 2007.
“Hearing loss is invisible and insidious. I don’t think people really think about that,” says audiologist Deborah Berndtson, spokeswoman for the American Speech-Language-Hearing Association.
According to ASHA, about 17 percent of Americans report partial hearing loss, but only 1 in 5 seeks help for it.
A hearing problem, whether you know about it or not, can often lead to unintended consequences, Berndtson says. Professionals in the workforce who don’t treat hearing loss “will often suffer financially. They won’t get that raise or promotion because they’re not hearing well,” she says. Whether the perception is that they don’t understand what’s going on or that they don’t address their communication strategies, “people will see that. They miss out.”
Your career isn’t the only thing that could suffer due to untreated hearing problems. “There is just overwhelming evidence now about the health effects of hearing loss,” says Dr. M. Jennifer Derebery, an otolaryngologist and director of House Clinic in Los Angeles.
She says hearing loss patients are more likely to have depression and high blood pressure. “We’re very social animals. If you get a more mature person, they can become more and more isolated, they can’t join in conversation, and that’s been shown to affect cognition,” Derebery says. Hearing loss alone doesn’t definitively cause Alzheimer’s or dementia, she notes, “but it does have an effect on cognition. They can’t hear; they can’t participate.”
Denial and Delay
“Most people who get hearing aids aren’t thrilled to get them,” Derebery says. Unlike those with vision problems, the hearing impaired face a social stigma.Working in a call center more than 15 years ago, Stacey Oliver-Knappe of Orlando, Florida, noticed her hearing problem but “faked it for about a year.” After a co-worker called her out, she couldn’t fake it anymore but still avoided the problem. When her best friend started teasing her and vowed not to quit until she went to the doctor, Oliver-Knappe decided it was time to get checked out.She found out she’d need surgery in her left ear, the result of a calcified bone. After that, she’d need to wear a hearing aid, but it was the surgery that scared her. “I ran out of the building to call my best friend. I was freaking out,” recalls Oliver-Knappe, now 44 and the owner of her own training business, The Customer Service Gurus.
Although many put off treatment because they’re in denial about their hearing loss, others don’t get treatment because of financial barriers. Health insurance covers the diagnosis, but once that’s made, it rarely covers hearing loss treatment. Oliver-Knappe faced this situation. “My first hearing aid cost $2,500 … I was making slightly over minimum wage at the time,” she says. That was in 2000; her second hearing aid cost $2,000 in 2006.
A decent hearing aid will run you $800 to $1,200, with the “Rolls Royce” of hearing aids topping out at around $4,000, Derebery says. “But most hearing aid candidates don’t need that,” she adds, saying those expensive devices are intended for patients with 90 percent hearing loss or more.
Normally, audiologists bundle their services, including fittings and programming, so they’re included with that price. Though not usually covered by insurance, you can use health savings account or flexible spending account funds to pay for hearing devices.
Oliver-Knappe had health insurance during both periods, but like most hearing loss sufferers, her hearing devices weren’t covered. She had to pay for her hearing aids out of pocket after petitioning her insurer for coverage and being rejected. Most insurers consider hearing aids and other devices “not medically necessary,” taking their lead from Medicare, which also does not cover hearing devices.
“Typically, insurance companies will tend to follow suit with what Medicare pays,” Derebery says. More than 49 million Americans relied on Medicare in 2012, the most recent year for which data are available. Most of them are seniors, and about half of all adults over 75 have partial hearing loss, according to the National Institute on Deafness and Other Communication Disorders.
Congress decides what Medicare does and does not pay for, and in order to get coverage for hearing loss treatments, legislation must be passed. That’s exactly what some groups have been trying to do for years.
One bill, introduced in the House in February, would provide audiology diagnostics and treatment to all Medicare beneficiaries. Another, introduced in the House in April, would provide a $500 tax credit every 5 years to individuals who need hearing aids. Both bills are supported by the American Academy of Otolaryngology and ASHA, and both are still under review by lawmakers.
“You have to start somewhere,” Berndtson says.
If you think you are having trouble hearing, scheduling a doctor’s appointment should be your next step. If your health insurance plan is a preferred provider organization, you can make an appointment with an audiologist directly, but if you have an HMO, you’ll need to see your primary care doctor for a referral first. If you’re worried about paying for treatment down the road, ASHA has some funding resources for those who qualify.
And if it’s wearing the hearing aid you’re worried about, don’t fret just yet. “The vast majority of hearing aid wearers are happy with their hearing aid despite what you’d think,” Derebery says. Some hearing aid models are barely visible, with just a small transparent tube showing, she adds.
You might not even need a hearing aid, though. Some people have a mild enough impairment that phone or television amplifiers will do. There are also microphone devices for significant others or caretakers to wear, as well as communication strategies to try.
Those include always having all conversation participants in the same room and looking at who’s speaking to catch visual cues. Another tactic is dining at quieter restaurants to reduce background noise and sitting near walls rather than in the center of noisy rooms.
Hearing loss “is nothing to be scared of,” Oliver-Knappe says. “If I tell someone I am partially deaf, I usually get this look of pity. I try to reassure them it’s not a big deal, and if this is the worst thing that happens to me health wise, it’s been a great ride.”
About 20 percent of Americans (48 million) report some degree of hearing loss
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