Accessible and Affordable Hearing Health Care

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Accessible and Affordable Hearing Health Care

80% of people who could benefit from hearing aids do not get them. There are many reasons why people do not seek help for their hearing loss but we should not underestimate the impact of the cost of hearing aids.   The number one inquiry that comes into the HLAA office is about affording hearing aids and the number one page visited on the HLAA website is the information fact sheet on financial aid for hearing technology.

To overcome the barrier that cost presents and to encourage more people to take action to treat their hearing loss HLAA has been focusing on ways to improve access to affordable hearing health care. There is no one silver bullet and so we are working on several fronts:

  • Educating about itemization of professional services & price transparency
  • Supporting Hearing Aid Tax Credit legislation: H.R. 1479 & S 905
  • Advocating for insurance coverage & tax relief in the states
  • Supporting lower cost options for consumers
  • Supporting Direct Access for Medicare Recipients
  • Insurance coverage under employer plans
  • HLAA member discounts for hearing aids
  • Essential Health Benefit in the Affordable Care Act
  • Supporting innovative approaches to entering the hearing health care system
    • Mobile apps
    • Telemedicine
    • Software to program hearing aids/implants

Support innovation in Hearing Health Care: Give Consumers More Options [Read more]

What follows is a chain of events in reaction to the hi HealthInnovations Inc.
program announcement.

We will keep this page updated with events as they happen.

August 2009: NIDCD convened a working group on Research on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss. View agenda, summary report, presentation.

United HealthCare hi HealthInnovations Inc. announced a hearing aid program that uses the Internet for hearing aid sales, an innovative on line hearing test and an itemization model for providing hearing health care services. Though untried HLAA believed that programs such as these that offer optional ways to encourage and enable people to get their hearing tested and buy hearing aids at affordable prices should be given a chance to prove their effectiveness. HLAA therefore did not join the opposition to the program that built up and was expressed by audiologists, hearing aid specialists and hearing aid manufacturers.

October 3, 2011: hi HealthInnovations Inc. (HI) a subsidiary of UnitedHealthCare, based in Minnetonka, Minnesota announces a new direct to consumer hearing aid benefit. Description of online test.

October 12, 2011: The Better Hearing Institute (BHI) released a press release warning consumers against “Do it Yourself Hearing Care.”

October 26, 2011: The Minnesota Department of Health released a statement stressing the importance of seeing a hearing health practitioner for hearing loss and advising that failure to do so “skirts state and federal legal protections and could result in harm.”

October 26, 2011: The International Hearing Society (IHS) sent a letter to HI requesting that the company cease and desist selling hearing aids through its website

January 18, 2012: Hearing Industries Association (HIA) sends letter to FDA requesting that they issue a warning to HI for illegal marketing and distribution of hearing aids

January 23, 2012: The Florida Academy of Audiology announces to members that the delivery of a hearing aid purchased through UHC is in violation of state licensure law

January 2012: HLAA declines the request to join audiology professional organizations and hearing aid manufacturers in opposition to the program

January 2012: Brenda Battat, executive director of HLAA and member of the NIDCD Advisory Group presents an update on the HI program and the reason for HLAA position to the NIDCD Advisory Board

February 9, 2012: The AAA and ADA, in collaboration with the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), the International Hearing Society (IHS), and the American Speech-Language-Hearing Association (ASHA) issued a joint position statement on Consumer-Administered Hearing Tests and Direct-to-Consumer Hearing Aid Sales.

February 2012: HLAA presents our position at the Hearing Industries Association (HIA) Annual Business meeting in Florida

February 2012: HLAA issues a statement of our position on the HI program which is posted to the HLAA website and published in the Jan/Feb issue of HLM. HLAA did not join the opposition. We took the position that although working with an audiologist or hearing aid specialist is the ideal approach we should give innovative programs a chance. It’s a way to get more people into the hearing healthcare channel which ultimately will benefit everyone – consumers, audiologists, hearing aid specialists and manufacturers. 

February 2012: HLAA receives emails and calls criticizing our position from audiologists, hearing aid specialists and hearing aid manufacturers who claim that the only way to fit hearing aids is with an audiogram and the services of an audiologist or hearing aid specialist. HLAA publishes some of the comments in the magazine and on the website.  [View sampling of comments]

February 2012: Co chairs of the HLAA Dayton/Cincinnati Walk4Hearing in Ohio pull out in solidarity with the ENT group where they work.  The group is against the HI program. HLAA staff together with local volunteers take over running the walk for 2012

February 2012: HLAA meets with the American Academy of Audiology (AAA) leadership to discuss issues including the hi HealthInnovations program.

March 2012: HLAA issues another statement in the March/April issue of the magazine reiterating our position

March 8, 2012: HLAA sends a letter to the FDA presenting the consumer perspective

March 2012: Hearing Review interview updates the latest on the hi HealthInnovations Hearing Network

March 2012: Some hearing aid companies pulled their support for the HLAA Walk4Hearing and the HLAA convention.

March 2012: FDA Requires HI to Obtain 510k Approval Before Continuing to Market Online Hearing Test

April 9, 2012: HI takes down their online test for revisions. HI is now asking consumers who visit their website to instead submit audiogram test results before purchasing or ordering a hearing aid.

April 2012: HLAA meets with ASHA leadership to discuss the HI program and other audiology issues including itemization of services

April 2012: Aetna announces a new hearing care discount option for Aetna Medicare Prescription Drug plan members

June 2012: (taken from - CALIFORNIA: Controller Review of Health Care Services Hearing Aids Program Finds Millions in Waste

DHCS / - Sacramento / – State Controller John Chiang has released his review questioning millions of dollars in reimbursements to Medi-Cal hearing aid providers. In a letter to the Department of Health Care Services (DHCS), the Controller recommended rate changes that could save the State up to $27.4 million over a three-year period. "At a time when health care services to California's neediest are being cut to the bone, I urge the department to reconsider policies that cause taxpayers to pay not only up to $3 for every $1 of goods provided, but also for services never rendered," said Chiang. "Spending less needs to be paired with spending smartly." The review stemmed from a March 2011 State Controller's Office (SCO) report in which auditors questioned more than $500,000 in reimbursements paid to one Medi-Cal audiologist. The review revealed a significant difference between what the audiologist paid for hearing aids, and the amount he was reimbursed by DHCS. In one case, the audiologist had purchased a pair of hearing aids for $120, but under the DHCS Medi-Cal reimbursement policy in effect at the time, he was reimbursed $1,465. SCO auditors expanded their scope to review 60 claims filed in 2009 by five other Medi-Cal audiologists and hearing aid providers. The review found that discounts and rebates were offered to the providers, resulting in a significant difference between the actual acquisition costs for the providers and the wholesales costs reported to DHCS that are used to determine the reimbursement rate. For example, one provider paid $436 for a hearing aid and was reimbursed for a wholesale cost of $1,218, almost three times the acquisition cost. The review also found that DHCS had failed to comply with a 2007 state statute requiring DHCS to enter into contracts with vendors of hearing aid appliances by June 30, 2008. Consequently, providers may purchase hearing aids from a variety of vendors and there are no guidelines related to approved vendors or products, making it difficult to determine the quality of vendors and the level of care provided to Medi-Cal clients. The review further noted that audiologists were being reimbursed for fitting the hearing aids and up to six follow-up visits per client. However, the audiologists reviewed had little or no documentation showing how many follow-up visits were actually made, nor are they required to submit it. SCO auditors made several attempts to meet with DHCS to discuss their findings. Before they were able to meet, DHCS issued new instructions that revised the way reimbursement would be calculated. The Controller believes the new reimbursement guidelines are a constructive first step, but believes additional savings could be achieved by further revising the original policy in one of the following ways:

  • Using the current Medi-Cal methodology, but substituting the actual acquisition costs instead of the one-unit wholesale cost to the formula, would save $25.5 million, or 41 percent;
  • Using the Durable Medical Equipment reimbursement methodology, which is the actual acquisition cost plus a 100 percent mark-up, would save $18.7 million, or 30 percent; or
  • Using the current reimbursement policy of the California Children’s Services, which is the actual acquisition cost plus a 60 percent mark-up, would save $27.4 million, or 44 percent.

In addition to developing a new reimbursement methodology, DHCS also should provide assurance that the State is obtaining the most favorable prices by implementing the 2007 statute requiring contracts with vendors, says Chiang. The Controller believes this would help ensure the quality of hearing aid products provided to Medi-Cal beneficiaries.

August 17, 2012: Unprecedented joint letter issued from the Academy of Doctors of Audiology (ADA), the American Academy of Audiology (the Academy) and the American Speech-Language-Hearing Association (ASHA) to educate their members on issues as wide ranging as Internet sales, rehabilitation needs of consumers, and engaging consumers to ethics for the profession. See the full letter.

HLAA applauds ADA, the Academy, and ASHA for joining HLAA in supporting consumer needs and setting a path for audiologists to evaluate how their practices will respond to and work in a new hearing health care delivery system.

HLAA continues to work with professionals to ensure accessible, affordable and available hearing health care to a wider number of consumers. We will be joining ASHA at their summit, Changing Health Care Landscape, in October 2012.

This is one more example of HLAA working toward and reaching goals that benefit consumers.