What Hearing Aid to get?

Most people probably associate three things with hearing aids: an elderly demographic, beige plastic construction and high-pitched feedback in public places. As it turns out, all those notions are now obsolete—or will be soon.

Basic Medicare and most other insurance providers have never paid for adult hearing aids. At an average cost of $4,700 a pair, that makes hearing aids the third-largest purchase in most people’s lives after a house and a car.

The most popular hearing-aid style is still the one that rests over your ear – a design that debuted in the 1950s. You know what else is decades old? Our country’s system for getting and paying for hearing aids.

The channel for buying hearing aids hasn’t changed in 60 years, either: You must buy them from an audiologist or doctor. They’re not available over the counter or by mail order.

Only six companies make most of the world’s hearing aids, and they sell them directly through hearing specialists. (You can buy “personal sound amplification products” in stores, but they can’t be marketed as hearing aids. In any case, most are fairly crude and ineffective for severe hearing loss.)

That’s one reason the price of hearing aids hasn’t dropped over time, the way most electronics do: the medical professionals you have to go through account for a significant fraction of the cost. Bottom line: many people who need them don’t get them.

“This is the sad part,” says Frank Lin, director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. “About 20 percent of adults who have a hearing loss actually use a hearing aid. I mean, 20 percent. And this figure hasn’t changed in decades.”

The other 80 percent may wind up missing out on a lot more than conversation in a noisy restaurant. Lin’s studies, which followed older adults for many years, revealed that hearing loss is “incredibly strongly” linked to serious outcomes, including impaired thinking, greater risk of hospitalization, even dementia.