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The Economic Complications of Cochlear Implant Candidacy

Millions of Americans have now been diagnosed with hearing loss, and millions more live with hearing loss without a diagnosis. It can be mild, moderate, or severe and present in many different ways. However it shows up, it can prove frustrating when not treated most effectively. While many people with hearing loss can manage well with hearing aids, individuals with severe hearing loss are often a good candidate for cochlear implants. Unfortunately, even those who may be good candidates are now finding the devices are not an option thanks to Medicare requirements.

What is a cochlear implant?

When hearing aids aren’t enough, cochlear implants may be a more robust and effective choice for managing hearing loss. Cochlear implants pick up the sounds around the user with a microphone similar to a hearing aid, but then sends signals directly to the auditory nerve instead of an amplifier in the ear. While it isn’t the exact sound, it gives the person wearing the cochlear implant a sense of the sound.

A cochlear implant is made up of an external piece that is attached behind the ear and a surgically placed inner piece.

Not only does opting for a cochlear implant require careful consideration from a personal point of view, but it also requires that the candidate meet certain criteria. This is especially true for older adults under the Medicare umbrella, and experts are now pointing out a concerning disparity that may be affecting more than just hearing ability.

Older adults bear the burden

It’s no secret that untreated hearing loss has more profound effects on people than trouble hearing in a noisy environment. It has been linked to social isolation, depression, Alzheimer’s disease, and similar health concerns. Unfortunately, experts are finding that even those older adults who could benefit from cochlear implants and reduce their risk of these health concerns aren’t getting the approval they need to move forward. These are often individuals who have done everything right, managing their hearing loss for years with hearing aids and using other assistive listening devices, but find them no longer as useful. They seek out options for their more severe hearing loss. In many cases, while they may be a good candidate for a cochlear implant, they do not meet the stringent requirements of their Medicare benefits. This leaves them back at square one frustrated and increasingly isolated due to severe hearing loss.

According to a recent discussion and review on the topic of disparity in cochlear implant candidacy:

“In a recent review of our large academic medical center’s CI program (excluding patients with SSD), we found that although a majority of those who underwent a CI evaluation over a limited time frame were Medicare beneficiaries, this group demonstrated the lowest “hit rate” for CI candidacy. In other words, although Medicare beneficiaries in this sample were the largest group perceiving enough difficulty to be evaluated for a CI, they were the least likely to have access to one, mostly due to Medicare’s restrictive criteria.”

Hearing healthcare providers and hearing health experts are now advocating for expanded benefits for this group bearing the burden of worsening hearing loss with no real solution in sight.

Changing deafness and severe hearing loss

Hundreds of thousands of cochlear implants had been surgically implanted in both adults and children in the United States since they were introduced. That number is expected to continue growing.

The process may be long, but it can be a logical next step for many, especially those with severely worsening hearing loss.

If you or someone you know is affected by severe hearing loss, contact your hearing healthcare provider to discuss hearing aid options and cochlear implants to treat it.

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