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17 Million U.S. Seniors With Hearing Loss Do Not Use Hearing Aids

More than 1 in 4 seniors forego hearing aids because of cost, but more over-the-counter options may be available soon

· Updated: August 16, 2021

Millions of American adults could benefit from using hearing aids. Yet, fewer than 1 in 3 adults over 60 with hearing loss use them. To help us understand why this gap exists, we analyzed a study of Americans aged 55 or older as well as data from the National Health Interview Survey (NHIS) to get a sense of current attitudes about and usage of hearing aids.

Our study revealed a number of barriers that stop people with hearing loss from purchasing hearing aids, including cost, comfort, and appearance. Luckily, technological advances and shifts in political ideologies are paving the way towards more accessible hearing aids.

Read below for the full report on why people forego hearing aids, who's planning to upgrade their devices, and what advances hearing aid users are likely to benefit from in the near future.

Key Findings

  • 13 percent of the entire U.S. adult population experiences at least some hearing difficulty.
  • Currently, 6.9 million people aged 60 or older use hearing aids, but an additional 17 million seniors with hearing difficulties do not use them.
  • Seniors who have hearing loss but don't use hearing aids are twice as likely to report frequent symptoms of depression than those who use the devices.
  • 26 percent of people with hearing difficulties say they don't use hearing aids because they're too expensive.
  • More than half of hearing aid wearers plan to upgrade one or both of their hearing devices in the next year.

Current State of Hearing Loss

According to our analysis of NHIS data, about 34 percent of all seniors over 60 in the U.S. have some trouble hearing. People ages 60-69 were most likely to report hearing loss.

We previously reported that men and women experience hearing loss at different rates, and the pattern has continued. According to NHIS data, 41 percent of men and 27 percent of women over 60 experience hearing loss. It's not entirely clear why men experience higher rates of hearing loss than women, but some experts believe it's because men are more likely to work in loud environments or smoke, which can impact hearing.

It can be hard to wrap your head around the numbers, but more people experience hearing loss than is commonly believed. Out of the entire U.S. adult population, 13 percent have hearing difficulties. The number of people experiencing hearing loss is likely much higher, as hearing loss is underrecognized and undertreated.

Hearing Aid Usage

Overall, 7.5 million people aged 60 or older use hearing aids according to the NHIS. As Americans age, the rate of hearing aid usage increases. NHIS data from 2018 revealed that around five percent of all people in their 50s use hearing aids, but that percentage rises to around 24 percent among all people in their 80s.

Source: National Health Interview Survey

Hearing aid usage among people with hearing difficulties is relatively low: According to the 2018 NHIS, only 28 percent of people aged 60 or older with poor hearing use hearing aids. Nationwide, this is more than 17 million people. 

Hearing aid usage among people with at least some hearing loss, by age group

Age Uses hearing aid No hearing aid
19-29 7% 93%
30-39 3% 97%
40-49 5% 95%
50-59 10% 90%
60-69 18% 82%
70-79 30% 70%
80 or older 42% 58%

Source: National Health Interview Survey

It's possible that some people with hearing difficulties are turning to other options to improve their hearing. Many of the people we surveyed with some hearing difficulties are employing other devices and technologies to listen to the world around them.

Do you use any of the following devices to aid in hearing?
Closed captions or subtitles 29%
Wireless headphones 19%
Bluetooth adapter 9%
Amplified telephone 5%
Remote microphone 5%
Captioned telephone 3%
Visual or tactile alert system 2%
Pocket Talker 2%
Other 2%
None 55%

Source: SeniorLiving survey of people 55+

More than half of people with minor hearing loss don't use any devices to support their hearing, though. This is perhaps due to lack of awareness about their hearing loss, the cost of devices, or feeling that they can function well enough without a hearing device. Stigma surrounding hearing loss or aids may also be a factor.

Hearing Aid Effectiveness and Technology

Hearing aid technology has come a long way since its inception. Even the most basic hearing aid models today perform better than the highest quality hearing aids of previous years. Nearly three out of four people in our study using hearing aids felt satisfied with their performance.

How effective are your hearing aids?
Highly effective 73%
Somewhat effective 25%
Not so effective 2%

Source: SeniorLiving survey of people 55+

Although most people in our study found their current hearing aids effective, 55 percent of users plan to upgrade their aids within the next year. 

Hearing aid technology is continuing to evolve to benefit users. Modern-day hearing aids are becoming increasingly automated, helping users navigate conversations and hear better in difficult listening situations. While many hearing aids in the past were large and bulky, many of today's models are smaller and sleeker than ever. Some of the latest features include Bluetooth compatibility, remote support, and remote microphone technology

While advances in hearing aid technology are great news for hearing aid wearers, new technology typically comes with a higher price tag. For some, the benefits of new technology may offset the increased cost.

Why do people forego hearing aids?

When we surveyed people with hearing loss to determine why they were not using hearing aids, cost remained a barrier for many. In this year's study, we found that one in four people with hearing difficulties do not use a hearing aid because of cost.

This is an improvement over last year, when 38 percent of people told SeniorLiving that hearing aids were too expensive. As businesses reopened, the economy began to rebound, and relief checks were mailed out, more people might have been able to afford hearing devices in 2021.

Why don't you use hearing aids?
I can manage without one 70%
I have not been prescribed one by a doctor/audiologist 42%
Too expensive 26%
I just don't want one 18%
My doctor deemed it unnecessary 10%
I have other technology to assist me 3%
I find them uncomfortable 3%

Source: SeniorLiving survey of people 55+

Hearing Aid Costs

As mentioned above, cost was a key player in many people's decisions to wear hearing aids. Of the people we surveyed, 85 percent said cost was a factor in their decision to purchase hearing aids.

Hearing aid costs vary widely, ranging from $1,000 to upwards of $5,000. Typically, a set of hearing aids falls somewhere in the middle. However, there are often additional costs when purchasing hearing aids, including the price of hearing tests and hearing aid fittings.

One of the biggest reasons people with hearing difficulties choose to go without hearing aids is inaccessibility. Not only can hearing aids themselves be costly, but the sheer task of hearing tests and fittings may be enough to deter some people.

Additionally, hearing aid dispensers often work with a small number of manufacturers, meaning hearing aid wearers may be limited in their options and may have no choice but to buy a more expensive hearing aid model.

Another factor that drives up the cost of hearing aids is bundling or bundled pricing. When hearing aid users can choose unbundled services, they can lower their expenses by selecting only the necessary items.

Insurance for hearing aids

Despite millions of Americans experiencing hearing loss, most insurance policies do not cover the cost of hearing aids or examinations and fittings.

If healthcare plans include hearing benefits, they are often limited, covering only a portion of hearing aid costs. In some cases, insurance plans may offer discounted hearing aids from specified healthcare providers, but this is far from enough coverage for some.

While the standard Medicare plan has some hearing benefits, it does not cover hearing aids or hearing tests. However, the Medicare Advantage Plans offer optional coverage for hearing aids at an additional cost. The plan typically covers the hearing aids themselves, as well as the cost of examinations and fittings.

Hearing aid accessibility has been heavily criticized in recent years, leading to a push towards making over-the-counter hearing aids more widely available. This goal is looking more attainable, as President Biden has committed to signing an executive order that would allow pharmacies to sell over-the-counter hearing aids.

Impact of Hearing Aids on Quality of Life

Due to the stigma surrounding hearing loss and the high cost of hearing aids, hearing difficulty is underdiagnosed and undertreated. Although many may feel they can function well enough without hearing aids, hearing loss may be affecting their quality of life.

According to our analysis of NHIS data, people over 60 who have significant difficulty hearing but do not use hearing aids are two times more likely to report feeling depressed daily or weekly than those with poor hearing who use hearing aids.

Depression frequency among people 60+ with at least some hearing loss

Depression frequency Uses hearing aids Doesn't use hearing aids
Daily or weekly 13% 26%
Monthly or a few times a year 33% 27%
Never 54% 47%

Source: National Health Interview Survey

Hearing loss makes it difficult for people to participate in conversations, which can lead to feelings of loneliness or isolation. If hearing aid accessibility improves, thousands of American citizens may be able to improve their quality of life and even their relationships.

As the population of people over 65 grows in the next 10 years, so will the number of people shopping for hearing aids. Luckily, some of the barriers to acquiring hearing aids appear to be coming down.

Our Data

SeniorLiving surveyed 598 U.S. residents aged 55 or older. Among all respondents, 18 percent had been diagnosed with hearing loss, 51 percent had undiagnosed hearing loss, and 31 percent had no hearing loss. They were asked about what devices they used, if any, to improve their hearing, their satisfaction with their hearing aids, and their plans to upgrade their aids in the next 12 months.

Additional data came from the U.S. Centers for Disease Control National Health Interview Surveys from 2018.