Hearing loss affects approximately 1 in 5 Americans aged 12 years or older. Prevalence is highest among older adults; two-thirds of Americans aged 70 years and older have hearing loss. Hearing loss is associated with numerous negative health and quality-of-life outcomes, including cognitive decline, dementia, falls, depression, social isolation, hospitalizations, readmissions, and higher health care costs. Studies have shown the impact of hearing loss on patient-clinician communication, indicating it likely impedes effective care provision. Although there are many reasons for Medicaid programs to cover hearing aids and related services, the up-front cost of including this benefit can create barriers. 

Amber Willink, Mary Ann Hernando, Sarah Steege

The high cost of hearing aids and related services is borne largely by individuals, as insurance coverage that includes hearing care is limited in the United States. This is particularly true for older individuals and low-income adults, as the Medicare program currently statutorily excludes hearing aids and related services from coverage, and, as noted, many state Medicaid programs do not yet provide coverage of hearing aids for adults. As a result, many people go without needed services. Indeed, despite the prevalence of hearing loss among older adults, only approximately 11% of older Medicare beneficiaries use hearing aids. Furthermore, among Medicare beneficiaries, those who are also enrolled in Medicaid have the lowest rates of hearing aid use, the lowest rates of accessing hearing care services, and the highest rates of reported difficulty hearing even with their device.

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