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The Impact of Financial Coverage on Hearing Aid Utilization Rates Within the Military Health System
James J Pierre1, Alex W Yang1, Charles A Riley1,2
1Department of Otolaryngology, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Objectives:
To investigate hearing aid utilization rates among populations with varying hearing aid insurance benefits.
Methods:
A retrospective cohort study was performed. A total of 377 patients were included in the study after being identified through consecutive, hearing loss-related otology clinic visits. With respect to hearing aid benefits, patients were separated into full, partial, and no coverage populations. Chart reviews identified if a patient underwent hearing aid evaluation and fitting. Audiometric data were collected. Chi-square tests of independence and two-sided Z-tests were used for statistical analysis. ANOVA single-factor analysis testing was used to analyze pure tone averages (PTA) and word recognition scores (WRS) data.
Results:
The 377 patients who met criteria included: full insurance coverage (n = 210, mean age = 45 years), partial coverage (n = 82, mean age = 65 years), and no coverage (n = 85, mean age = 54 years). The full- and partial-coverage populations each had significantly higher hearing aid utilization rates (78% and 79%, respectively) than the no-coverage population (49%, p < 0.001). No statistical difference in mean PTA or WRS was noted among the three coverage categories.
Conclusion:
Patients with at least partial financial coverage are more likely to acquire hearing aids than those without despite similar degrees of hearing loss. This implies that the out-of-pocket cost of hearing aids is a primary impediment to hearing aid adoption and provides a useful road map for public and private insurers considering hearing aid coverage.
Level Of Evidence:
3 (retrospective cohort study) Laryngoscope, 135:2134-2138, 2025.
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