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What you need to know about new access to over-the-counter hearing aids

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Prescriptive, custom-fit devices offer more features, but Dr. Even says over-the-counter devices may help people with mild to moderate hearing loss. However, he recommends getting an exam first.

Recent FDA changes now make hearing aids available over the counter to people 18 and over without a medical exam or a prescription. KERA’s Sam Baker talks about the need for this, and concerns about it, with Dr. William Even, an audiologist and clinical assistant professor in the otolaryngology department at UT Southwestern Medical Center.

So what was the need for this option in the first place?

Probably the biggest need is that of those that really could benefit from hearing aids, only about 20% of those folks actually use them.

A little background information on that. You go back to the 1960s Medicare ad deemed that hearing aids were routine and low cost and therefore uncovered under Part B plans.

But as most people know, they're not so low cost for most people. And that same tracking data that shows only 20% of patients wear them also shows the greatest factor towards obtaining devices is if it's covered or partially covered by an insurance plan.

Now, given that that has not changed, I would say that over-the-counter hearing aids are a bit of a stop-gap measure to cover some of those folks that have a lesser degree of hearing loss until will say they graduate into something that's prescriptive and likely a little more expensive as well.

So, describe the difference between over-the-counter hearing aids versus prescription.

You could probably think of it a little bit like the reading glasses you can get in a drugstore that have a set prescription in them. These devices are set up for a perceived mild to moderate hearing loss.

So, it's kind of up to the patient to decide if they're in that range. And then it would just have some basic, you know, volume and tone control per patient preference.

A prescriptive device is going to be individually programmed by frequency. Some of these devices are going to have, eight, 12, 16, or 24 frequencies that we can program in a very specific way to match a prescriptive target. And we use some objective measurement tools to determine if that's the case.

It's not required for over-the-counter hearing aids, but should you get a hearing exam anyway if or when you have any perceived loss of hearing?

Absolutely. Getting the test sometimes could be helpful to determine if you're really a good candidate for it or not. And the test for hearing loss is generally covered by insurance issues, but the devices are often not.

I know you have concerns about the over-the-counter aids, but I wondered if you thought it still might be a good step towards getting some people to move along the lines of seeking some type of help rather than nothing.

Absolutely I do. With only 20% of folks pursuing devices currently if we could increase that from 20% to 30% or 40% with this mild to moderate group, I think that would be fantastic to get those folks in the fold and used to using devices so that when they are when they grow out of candidacy in that mild to moderate range, that they'll be a little more ready to pursue prescriptive devices.

Readiness and comfort with getting hearing aids is a big factor when people are not ready for it or kind of dismiss it out of hand due to the cost, they might let this go on much, much longer. So I think it's a nice intermediate step.

Why is it important that people seek help for hearing loss?

The obvious concern is just difficulty in communication. But beyond that, there's some association between hearing loss and cognitive decline, depression, isolation, and even a risk of falling.

So, getting it treated even at the early stages can help with some of those things. In fact, there have been some studies that show treating hearing loss could save Medicare, say, $2,500 per patient per year, which might help justify some coverage for that at some point in the future.

RESOURCES:

What Are Over-the-Counter (OTC) Hearing Aids?

Over-the-Counter Hearing Aids: https://www.nidcd.nih.gov/health/over-counter-hearing-aids

FDA Finalizes Historic Rule Enabling Access to Over-the-Counter Hearing Aids for Millions of Americans

Quick Statistics About Hearing

UTSW ear experts recommend exams before buying OTC hearing aids

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.