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Affordable Help for Some Kinds of Hearing Loss

Remember last week when I wrote a blog post about how so much non-life-threatening health or medical stuff that can go wrong in old age is located above the neck?

Even so, in the United States, Medicare excludes coverage of almost everything above the neck.

We personally foot the bill for medical needs related to our eyes, ears and teeth except, in many cases, when they involve surgery. Correction for cataracts is one example as are cochlear implants.

But in general, we are on the hook for what is, usually, thousands of dollars and even tens of thousands of dollars as was the case with my teeth several years ago.

Another pricey, above-the-neck treatment is hearing aids. One-third of Americans age 65-75 have some degree of hearing loss. That goes up to nearly 50 percent in people older than 75.

In addition, only about 20 percent of people who could benefit use hearing aids. Some may reject them because of the social stigma attached but undoubtedly, for many, it is due to the price which can easily top $4,000 for both ears and experts estimate their life span is from only three to seven years.

Now, there is an affordable alternative ($10 to $500 or so) for some with certain kinds of hearing loss.

Last year, in a full-on, bipartisan voice vote in the Senate and 94-to-1 vote in the House, the U.S. Congress passed H.R. 2430: FDA Reauthorization Act of 2017. The president signed it into law on 18 August 2017.

The bill is an amalgam of several other stand-alone health care bills including the notable provision we are concerned with today. H.R. 2430, as govTrack reports, “Allows certain types of hearing aids to be sold over the counter.”

Leading up to the vote, there was strong opposition from organizations representing hearing aid professionals, and even gun rights groups which, according to GovTrack, “claimed the provision could allow the FDA to regulate sound amplification devices often used by hunters.” (Not true, says GovTrack.)

Let me be clear: whatever Govtrack says, the devices at issue are not hearing aids or, at least, are not called that. They are called Personal Sound Amplification Products, or PSAPs for short. They are what the name says, sound amplification devices that are one-size-fits-all, cannot be adjusted to individual hearing loss and should not be considered a replacement for hearing aids.

It saves me a lot of effort when I can piggyback on other people's work and in hunting around the web, I found that the most useful, basic information on PSAP devices came from Consumer Reports.

Earlier this year, they reported on a small study of PSAPs published the Journal of the American Medical Association in which:

”...researchers pitted five different PSAPs against a traditional hearing aid. They found that among 42 older adults with mild to moderate hearing loss, three of the five PSAPs performed nearly as well as the hearing aid.

“Some PSAPS may help with mild to moderate hearing challenges (such as difficulty hearing the TV or a conversation in a noisy bar), experts say, but won’t work for more severe hearing loss.”

As noted above, there are cheap PSAPs and more expensive ones. Consumer Reports breaks down what to expect from differently priced PSAPS they tested in their labs:

”The two cheaper models we tested, the Bell & Howell Silver Sonic XL, $20, and the MSA 30X, $30, offer basic functions, such as on/off switches and volume control.

“Pricier models, such as the SoundWorld Solutions CS50+, $350, allow you to customize settings to amplify sounds in the frequencies where you need the most help or stream music or take phone calls through your smartphone via Bluetooth.

“These pricier PSAPs might also have such features as a directional microphone, which can pick up sounds in front of you and not those behind or to the side of you. This makes it easier to hear conversations in a crowded restaurant or other noisy places.

In their report on PSAPs, Consumer Reports is careful to issue this warning:

"Additionally, our hearing expert says these low-end devices might overamplify loud noises, such as a fire engine wail, which could potentially damage hearing further.”

The magazine also says that PSAPs are generally simple and straightforward to use but as with Ikea, there is some work getting started:

”You have to learn how to insert and remove the device from the ear, adjust the settings to maximize its performance, change the battery, and clean and maintain it...

“Certain parts could also be small and hard to manipulate, and some higher-end PSAPs may require you to download an app for making adjustments.”

In the end, Consumer Reports suggests you consider what is most important to you in using a PSAP:

”If you simply want a little amplification while watching TV, for example, you may do well with a moderately priced device. But if you’re looking for help in a range of situations - dining out with friends, taking phone calls, listening to music - you might consider a pricier, full-featured version.

“For now, however, CR advises that you avoid very inexpensive models, such as those under $50.”

Unless one's hearing loss is complex enough to need an audiologist, I think this is a great idea. There was a time, not so long ago, when reading glasses required a prescription from an optometrist or ophthalmologist and were quite pricey. Now we can pick them up with the toothpaste and vitamins.

As several readers noted in last week's post, untreated hearing loss can be a serious health hazard. It can lead to social isolation, loneliness, reduced personal safety, impaired memory and more.

PSAPs are not an ideal solution (yet; they will undoubtedly get better over time) and they are not for every kind of hearing loss. But for many it can improve lives at an affordable price.

Be sure to do your homework before purchasing a PSAP and, perhaps, consult an audiologist, too.

Below are a few additional links for more information. Do keep in mind as you check into PSAPs that the professional hearing loss community quite understandably does not usually recommend them. I'm pretty sure the professional eyecare community wasn't too hot about drugstore readers either when they first appeared. But do consider the source when you read recommendations.

If you have used or are using a PSAP, please let us know in the comments how they are working for you.

Over-the_Counter Hearing Aids

Best PSAP Hearing Devices

Under new law, over-the-counter hearing aids could be cheaper and more widely used


Thank you for posting this. My hearing device has changed my life for the better. My family is grateful that I can engage fully with them. I can enjoy social gatherings without pretending I can hear what’s going on in conversations. I can hear the TV at a reasonable volume. All a plus!

So far I haven't noticed any hearing loss, but that could always change (that's my mantra these days) - but I wonder about needing a little amplification for the TV. If that's the case, I think I'd opt for a set of headphones, rather than an over-the-counter hearing device. I guess using headphones would preclude the chances of conversation if one is watching a program with another person, but that's not necessarily a bad thing, in my opinion.

It should be noted that in some states MEDICAID will pay for all or part of the cost of hearing aids.
In NY State, Medicaid will pay all costs for most hearing aids if (1) Your net worth is low enough to qualify and (2), You are more than 50% deaf in both ears. Unfortunately, for me although I am almost totally deaf in one ear, I do not qualify because my other ear hears just fine. I'll have to wait until I lose almost all of my hearing to qualify. Boy, i can hardly wait.

Free hearing tests given at Costco!!! My husband does the headphones at night watching tv. He had his ears checked and got hearing aids that he can adjust for noise in a restaurant, background, etc that are adjusted from his iPhone. No more repeating myself 5 times and getting supremely frustrated.
The big takeaway that I was shocked to learn was that the hearing aid does not bring you back to 100%. It will only bring you up a certain %. The rest is lost forever. We were told most people were not getting the ones that go in the ear.
Most people are getting a very small wire that goes over the ear and can barely be seen. My husband was shocked that he could hear the wheels moving on the cart!
So great that he is not left on the conversations and not a social outcast because he can't hear what people are saying to him. Love it!

Be aware that not all hearing loss is remediated by hearing aids or simply amplifying sounds which needs to be determined. A hearing assessment by a licensed qualified Audiologist is able to address possible medical problems, if present, which can be preferable to simply consulting aid sales dispensers.

Hearing screening free events are offered annually by many cities Senior Services programs.

ASHA.org website provides helpful information to consider. This is the American Speech-Language-Hearing Assoc. whose Audiologists (ASHA Aud with CCC) fulfill requirements for National Certificate of Clinical Competence and meet State licensing requirements.

In the interest of disclosure I am a retiring member of ASHA as a Speech-Language Pathologist and have provided therapy for some with hearing loss, adapting to aid use for both patients, family members and caregivers.

Accumulated ear wax can sometimes be a simple cause of hearing loss. A medical examination with an otoscope can reveal this for fairly simple resolution usually.

Vision and hearing sensory systems are vital to maintaining cognitive function. They are critical for functional daily living quality of life in the aging process.
I believe health care should include providing coverage for these health needs.

Really important information you are providing here.

I also believe that "health" care should include the basic function of hearing--but it doesn't, so I'll need to rely on what I still have; despite some loss I can still hear most of the time. I'm hoping that PSAPs will improve rapidly and remain affordable. A local hearing aid center wanted almost $6,000(!) to outfit me. Fuggedabout it!

Eyeglasses are a good example of affordability. Most people who need reading glasses can now afford them one way or another (although Rx lenses can still be pricey). Even the Dollar Store has them.

I'd probably get hearing aids if it weren't for the price although I'll be honest: I wouldn't relish wearing them. Hearing aids scream "old/possibly infirm person!", which I may be. However, I'd rather not advertise that fact to the general public since that can also be read as "target" for purse snatchers, muggers, etc..

Amplification in a hearing device, whether it's over-the-counter or a Cochlear Implant, rarely solves the problem. If you are in a noisy environment it will amplify all of the background noise as well as the voices of those who you are trying to hear. Hearing Aid manufacturers have tried to solve this problem, but for me it never works.

I have purchased expensive aids promising that I could hear in noisy environments and they have never helped. According to some, they have helped those with a mild loss. Even my CI has a setting for noisy environments and I still am unable to hear much in a restaurant. The speaker needs to be amplified and not the person wearing the aid so that background noise is not louder along with the voice. I recently purchased such a device. The speaker wears a microphone and I wear a receiver. The help was still minimal for me, but I am sure it would work for others.

The surgery to implant a CI is paid for by Medicare, but the regular adjustments of the processor by an audiologist are not. In my case it costs me $100 a visit at the U of A speech center. Also, the parts of the CI are rarely covered when they do wear out and a power cell is extremely expensive. Maintenance means a fight with my Insurance company and I was able to get them to pay 80% of my last power cell. It makes no sense at all to pay for the surgery and then not pay for the maintenance.

None of my hearing aids that I had prior to my implant were covered by Medicare, nor were the batteries. I have spent thousands to be able to hear and nothing has really been very satisfactory. I do have a profound hearing loss now, but that was not always the case. A second implant would probably solve the problem so I could hear bi latterly but at my age it isn't feasible.

I haven't seen an Ophthalmologist for several years and my vision is fading. The cost of seeing a specialist plus my advanced age keeps me from checking on my Macular Degeneration. I do take special vitamins for the problem, but they are over the counter meds and not covered by Medicare. They are not cheap!!!

When will this country wake up and follow the proven methods of every other industrialized country and have single payer health care that covers all of the"above the neck" problems? Because people are beginning to demand it there is talk of doing so, but Congress is more interested in pleasing their donors (the Insurance companies, the Pharmaceutical Industry, and the suppliers of medical devices ) than they are in taking the humane and less expensive option. Today I saw a headline stating that Medicare for all would cost trillions. That's very misleading and it shows they powers are frightened and starting to fight back with negative articles.

We the people need to start organizing and fighting for the humane things being illogically denied us.


There are free amplifier apps for smartphones. They use the phone's mic and earbuds and claim to amplify tv sound, conversations, etc. Search 'amplifier app' online. I have a little hearing loss, especially in group settings and British flicks. I plan to give an app a try.

We joined Costco in order to get my hearing aids at an affordable price. Very satisfied with the quality; they work better than my last set, which were much more expensive. Now, what do we do with our Costco membership? No way can the two of us consume the food in sizes that they offer. Having purchased plastic wrap there, we are now set for life. . .

Tarzana, thank you so much for mentioning apps for smartphones! Other health issues have been overshadowing my mild but worsening hearing loss, which is why I haven't been willing to spend several thousand dollars to do anything about it.

I still absolutely hate being so limited when the background is noisy. An app would be much better than nothing. I am running off to do a bunch of internet research, RIGHT NOW!

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