A new study shows that simply lowering the cost of hearing aids - even by as much as 40% - does not improve hearing aid purchase for patients with partial insurance coverage or those who need to cover the entire cost out of pocket.
Only patients with full insurance coverage for hearing aids get them at a younger age and with significantly less hearing loss than patients with partial or no coverage.
Still, those with full coverage were less likely to upgrade to more advanced devices, or purchase hearing aids for both ears than others in the study, if it meant going beyond what's covered by insurance and having to pay for additional costs.
"Many in health care assume that patients would more readily acquire hearing aids at a younger age or before their hearing loss becomes more severe if the devices were less expensive," says study lead author Virginia Ramachandran, Au.D., an audiologist at Henry Ford Hospital. "But it's clear from our study that patients are motivated by more than cost when deciding to purchase hearing aids."
The study appears in the May issue of The Hearing Journal.
Hearing loss is a common problem in older adults. For many it's more of an annoyance rather than something that impacts their ability to function. In fact, about 75% to 80% of adults with mild hearing loss do not get hearing aids, despite the potential benefits.
While even mild hearing loss can have a negative impact on quality of life, it is still unclear exactly why more people are not motivated to use hearing aids.
In many cases, patients have negative attitudes toward hearing aids, even though the devices have greatly improved in terms of comfort and visibility in the ear. Likewise, patients with mild hearing loss often feel they don't need hearing aids.
Study co-author Brad A. Stach, Ph.D., points out that a lot of people view buying a hearing aid along same line as buying a new refrigerator: It's an expensive item, so even if it's on sale, you won't spend the extra money unless you need it.
"On the other hand, if you need a new refrigerator, you'll shop around to get the best value for the best appliance. It's no different with hearing aids. Most patients will only get them if they feel they need them, regardless of cost, and will often spend a little extra to get the best device," says Dr. Stach, division head of Henry Ford Audiology.
Aside from the Veteran's Administration system, hearing aid care in the U.S. is generally not fully covered by insurance.
To determine how much of a factor cost is in hearing aid acquisition, the Henry Ford study looked at 1,200 patients who got hearing aids between 2007 and 2010. The patients had either full insurance coverage, partial insurance coverage or had to cover the entire cost out of pocket (private pay).
As part of the study, the cost for hearing aids in the partial insurance coverage group was reduced by 20% for two devices or 40% for one device.
The study shows that patients who had full coverage for hearing aids obtained them about seven years earlier and with better hearing than the other two groups. But there was no difference in age or hearing loss between people who paid for the full cost of hearing aids or purchased hearing aids at a substantially reduced cost.
The more patients had to pay out of pocket (partial and private pay groups) the more likely they were to upgrade to a more advanced device. Patients with full coverage were the least likely to upgrade, and only purchased what was fully covered by insurance.
According to the study, the only situation in which patients are motivated to get hearing aids earlier is when they are provided at no cost.
But "free" could come at a higher price to patients' hearing health, says Dr. Ramachandran. "If insurance only fully covers certain hearing aids, patients may miss out on reaping the benefits of more technologically advanced devices or devices better suited to their needs."
Hearing aids have also greatly advanced in appearance and comfort.
"What people may not realize is that hearing aids now aren't like the ones your grandparents used to wear. Most are small and very easy to wear," says Dr. Ramachandran. "The challenge is changing old perceptions about hearing aids, and showing patients that the benefits far outweigh concerns about appearance and even cost."
Dr. Ramachandran adds that hearing aids can have tremendous benefit for patients with milder degrees of hearing loss.
But the most important thing is that the hearing aids are appropriately fit by an experienced audiologist. Even the best hearing aid on the market won't help if it is not fit properly by an expert.