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November 5, 2014

Hearing and Vision Care for Older Adults: Sensing a Need to Update Medicare Policy

Author Affiliations
  • 1Departments of Medicine (Geriatrics) & Ophthalmology, Duke University School of Medicine, Durham, North Carolina
  • 2Duke Center for the Study of Aging and Human Development, Durham, North Carolina
  • 3Durham VA Geriatrics Research Education and Clinical Center (GRECC), Durham, North Carolina
  • 4Departments of Otolaryngology—Head & Neck Surgery & Medicine (Geriatrics), Johns Hopkins School of Medicine, Baltimore, Maryland
  • 5Departments of Mental Health and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 6Johns Hopkins Center on Health and Aging, Baltimore, Maryland
JAMA. 2014;312(17):1739-1740. doi:10.1001/jama.2014.13535

When Medicare became law in 1965, Congress made a justifiable decision to exclude items that were “routinely needed and low in cost,” reasoning that the cost of such items could be borne by the consumer. On that basis, hearing aids and lens-containing visual aids were excluded from coverage, with narrow exceptions, such as intraocular lenses for cataract surgery. Advocacy groups for people living with sensory impairment have long called for broader coverage of sensory aids. During the past year, the issue has gained new traction from legislative and scientific communities. In December 2013, Representatives Carolyn Maloney (D-NY) and Gus Bilirakis (R-FL) introduced a bill (HR 3749) to initiate a 5-year demonstration project to provide “usable and medically necessary” low-vision devices to Medicare beneficiaries.1 Earlier this year, the Institute of Medicine and National Research Council convened a workshop on the effect of hearing loss in healthy aging. The summary emphasized the public health implications of age-related hearing loss and pointed to Medicare’s noncoverage policy as a significant reason that hearing aids are used by fewer than 1 in 5 older adults who could benefit.2