If you lose a leg, insurance will likely cover the cost of your prosthesis. If you lose your arm, it's the same. Even if you lose your ability to perform sexually, more than likely your Viagra is covered.
But if you start to lose your hearing, far too often you are on your own.
If hearing loss were officially considered a disability, it would rank as the largest disability class in the country. Some 37 million people suffer from hearing loss, according to the Centers for Disease Control and Prevention, and that number will only grow as the population ages.
Yet most private medical insurance doesn't cover the cost of hearing aids. While the Department of Veterans Affairs often pays for them, in most cases Medicare, which covers many more people, does not.
The Affordable Care Act expanded coverage to include newborn hearing screenings when it passed in 2010, but that was the single preventive-care expansion related to hearing problems. It would take an actual act of Congress to change it further.
Only 19 states require that health benefits plans in their states pay for hearing aids; most cover children only, according to the American Speech-Language-Hearing Association. Only three states require coverage for both children and adults.
When private insurance does pay, it typically covers the cost of an exam to assess hearing loss, and that's about it.
The devices are expensive, sometimes costing in the $1,000 to $6,000 range -- and that's per ear. Perhaps this explains, at least in part, why 75% to 80% of adults with hearing loss do not get hearing aids, according to a recent study done by Virginia Ramachandran, a senior staff audiologist in the Division of Audiology of the Henry Ford Hospital in Detroit. Her study showed the only group that consistently got hearing aids had insurance that paid for them in full.
Hearing aids are considered elective, much like plastic surgery or liposuction. But unlike those cosmetic procedures, life without hearing can have devastating effects. It can leave people feeling isolated or depressed and may even lead to serious illnesses like dementia. It can put their safety at risk.
"It's really an invisible disability," said Laura Hansen, owner of Assist2Hear, a Littleton, Colorado-based hearing assistance company. She got involved in the profession after seeing her father struggle when he started losing his hearing. No one was there to really advocate for him, she said.