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Even today, most of your clients and prospects probably have solid major medical insurance. A majority of prospects in the middle market or affluent market will have dental insurance, or the means to pay for dental care. Plenty have vision benefits, or have at least considered buying a vision care plan.

When the benefits menu includes major medical, dental and vision, it’s easy for the brokers to feel that they’ve put together a comprehensive package.

However, even a medical-vision-dental combination leaves out a significant area of care, one that is vastly overlooked by the insurance community but affects millions of working Americans: Hearing care.

Hearing problems affect people of all ages: 52 percent of those with hearing loss are between the ages of 18 and 64.

Considering the wide-ranging impact of hearing loss on quality of life, it’s somewhat surprising that many people wind up suffering in silence.

In the United States, 19 states require hearing care benefits through medical coverage mandates.

That figures means that, in 31 states, consumers are not guaranteed access to hearing care coverage.

Who does that affect?

Consider the following facts:

• 37 million Americans suffer from hearing loss.
• Of those 37 million, 27 million would benefit from using a hearing aid.
• Of those 27 million, about 20 million do not purchase a hearing aid.
• Most insurance plans do not cover these types of devices because the devices are deemed to be an elective treatment.

The very fact that 75 percent of people willingly forego the purchase of a hearing aid — something that can immediately improve their quality of life — says quite a bit about the cost of hearing care and the current hearing care finance options.

On average, digital hearing aids cost between $500 and several thousand dollars. Even when insurance plans offer some form of coverage, it’s usually only up to a certain amount.

The idea that hearing aids are elective treatments contrasts sharply with how society treats eyeglasses.

Glasses — for eyes that are nearsighted, farsighted, or need bifocals — come with a baseline prescription, and many insurance plans (including all-encompassing such as Kaiser Permanente or a subset of coverage through a group like VSP) provide coverage for annual checkups.

Plans may even cover annual or bi-annual access to new frames up to a certain amount. Things like scratch-resistant lenses, high-index lenses, and fashionable frames are where the bulk of the cost for premium glasses lies.

Now, let’s be clear: Many of the features in high-end hearing aids are comparable to the little extras that make fashionable eyeglasses fashionable. Having Bluetooth connectivity in your hearing aid, for example, is not a requirement for basic hearing needs.

However, the further that technology has refined hearing care, the more audiologists and hearing-aid engineers can define just why the intricacies of hearing care go far beyond the notion of “turn the sound up.”

When patients visit the optometrist, they’re checked for their far/near prescription as well as for conditions such as astigmatism and presbyopia (a need for reading glasses).

Hearing tests are similar in that they cover a range of issues beyond just volume. Frequency, tone, and intensity combine for a moving target, and a person’s hearing aid prescription is just as customized as their prescription for glasses or contact lenses — except that hearing aid customization in modern models comes in the form of programming the device’s digital processor to meet these specific needs.

There’s no one-size-fits-all solution for hearing aids. In a poll from the Deaf and Hard of Hearing Alliance, hearing aids featuring programmable technology and other modern features received satisfaction ratings of 81%. Lower-end non-programmable hearing aids only rated at 58%.

This customization is a big part of why hearing aids cost what they do, and this cost is the leading reason why so many people decide not to purchase a hearing aid.

Quality of life
In recent years, there has been a subtle but noticeable shift to move towards some measure of coverage.

Knowles Electronics, a hearing aid manufacturer, released a survey in 2008 noting that nearly 40 percent of purchasers received some assistance from their insurance provider. That increased access to assistance is a small but necessary step toward the goal of having hearing care recognized as a true quality-of-life need.

A common stereotype is that the bulk of hearing-care patients are senior citizens. There’s no doubt that seniors generally do require some form of hearing aids, just like they usually need at least reading glasses, if not more. However, hearing problems don’t discriminate by age, gender, or ethnicity. The following statistics provide a closer look at those who are affected by some form of hearing loss:

• One out of every 12 people under 30.
• One out of every eight people under 50.
• 1.4 million children are born with it or develop it at a young age.
• 10 million adults between 45 to 64.

With statistics like that, it becomes quite clear that hearing care would impact the quality of life for many people. Those are the numbers, but how do hearing issues affect day-to-day life for people?

In 1999, the National Council on the Aging (NCOA) and the Hearing Industries Association released findings from an immense study of 2,069 hearing-impaired people, along with 1,710 related relatives and friends. The studies found that:

• Many people overcompensated for hearing loss by acting defensive, pretending they heard things, and other negative actions.
• Respondents noted how the lack of proper hearing impacted their safety.
• Related friends and family expressed frustration and difficulty with social interactions during these moments.

Conversely, the same study group demonstrated marked emotional improvements upon using a hearing device, including significantly lower depressive symptoms, tension, insecurity, and angry outbursts.

In short, the impact of hearing devices (more importantly, the restoration of the sense of hearing) created an abundance of positive emotions, ones that can impact everything from communication to productivity to family and work life. It’s clear that providing proper hearing care is a critical part of the greater health care package.

The question, then, is: How can brokers add hearing health care coverage to their portfolio?

Without a coverage plan, general hearing care options remain limited for most people. In many cases, it’s as simple as an out-of-pocket payment, which can be extremely difficult to financially absorb. Some coverage options are usually available, but they all come with various limitations, particularly for adults.

Medicaid: Evaluation and device coverage is available for children under 21. For adults over 21, Medicaid coverage depends on individual state regulation.

Medicare: For seniors on Medicare, only a hearing exam is covered if you have Plan B and the exam is ordered by a doctor. Similarly, diagnostic hearing exams are covered if prescribed by a doctor. In most cases, hearing aids and other devices are not covered by Medicare.

The Patient Protection and Affordable Care Act (PPACA): When implemented, PPACA (colloquially known as “Obamacare”) will guarantee annual hearing tests for children under 21. However, it won’t provide additional coverage for hearing aids.

Flexible spending accounts (FSAs): FSAs vary by provider, but one PPACA-related caveat is the new maximum contribution limit of $2,500 per contributor, down from the old limit of $5,000. Moreover, the list of items that is FSA-approved varies greatly from provider to provider, and there’s no guarantee that hearing devices will be covered.

Given the alternatives, hearing care options are sensible to explore. A number of private coverage options exist, including various plans from my company, HearPO.

When you are considering hearing health care carriers, one question to ask is: Who’s behind the plan?

A plan founded by audiologists might have a different approach than a plan founded by an insurance company that added hearing benefits as an afterthought, only after it also began to offer a wide variety of other products.

Another question to ask is what percentage of your clients a carrier will be able to serve. If, for example, you handle businesses of all sizes, you will want to work with hearing care carriers that can meet the needs of employers of all sizes.