Medicare and most private insurers do not cover hearing aids, even for people like Evans, who has struggled with total hearing loss since age 10 after contracting measles, mumps, chicken pox and suffering through a series of ear infections.
"It's hard to believe that a hearing aid - something that changes the quality of your life so much - isn't covered by insurance," she said.

It it an especially difficult issue given the fact that hearing aids, most of which cost an average of $1,000 to $3,500 each, have to be replaced periodically, said John Pater, an audiologist at Granger Medical Clinic in West Valley City.

The cost can overwhelm many low-income families and people on fixed
incomes and prompt some people to forgo hearing aids altogether. Evans' mother, who died in 1992, had worried so much about her daughter's financial burden that she left her a special savings account to pay for hearing aids.

The cost of cochlear implants, an electronic device surgically implanted in the inner ear that restores some hearing for deaf people, is covered by more insurance plans. But hearing aids remain the logical choice for most people with mild to severe hearing loss.

The state's largest health insurance companies - Regence BlueCross BlueShield and Intermountain Health Care - say hearing aids are generally not a covered benefit under any of the employer-sponsored plans they administer. But they say that is because employers are not willing to pay for the coverage.

"We get virtually no requests to have hearing aids covered," said Daron Cowley of IHC.

And with the rising cost of health care, hearing aids aren't likely to be added to many health insurance plans, either.

Questar Corp. spokesman Curtis Burnett said in an effort to keep health care costs for employees reasonable, the company has had to make some hard decisions about what types of things to cover - and not cover.

"Our No. 1 priority is catastrophic coverage, to make sure our employees' savings are not wiped out in the event they get really sick," he said.

Still, relief may be on the way.

Congress is considering a hearing aid assistance tax credit that would provide a $500 tax credit for each hearing aid purchased by people 55 and older and guardians of children 18 and younger. The credit would be worth up to $1,000 and available once every five years.

In the meantime, however, low-income families and retirees who struggle to pay for hearing aids have few community resources they can turn to for help.

Utah does have a Hearing Aid Recycling Program run by the Utah Department of Health's Hearing, Speech and Vision Services agency in Salt Lake City.

The program collects donated hearing aids and sends them to a manufacturer that either refurbishes them or gives the state credit toward a new hearing aid. But that program distributes hearing aids only to low-income children, said Rich Harward, program manager for the agency. And it receives a limited number of donations.

"I don't really know of anybody who helps adults who need hearing aids but don't have the money to buy them," Harward said. "Which is sad, because hearing aids aren't getting any cheaper."

Evans said people who buy their first hearing aids are often shocked at the cost - and the fact that their insurance company doesn't provide much, if any, coverage for hearing loss. She said people also are surprised to find out that they must be replaced at some point.

"It's not hard to see why depression is so common among people with hearing loss," she said. "When you're not able to hear people, you feel left out. When you find out your hearing aids aren't covered by insurance, you feel frustrated."

A handful of organizations help people who need hearing aids but cannot afford them. They include:

The Starkey Hearing Foundation, in Eden Prairie, Minn., provides hearing aids to low-income people of all ages who meet certain criteria. Information: 866-354-3254.

Miracle-Ear Children's Foundation provides free hearing aids to low-income children and teenagers 16 and younger who qualify. Information: 800-234-5422.

The Hearing Aid Recycling Program, run by the Utah Department of Health's Hearing, Speech and Vision Services agency in Salt Lake City, distributes hearing aids to low-income children. Information: 801-584-8215.

By Lesley Mitchell, The Salt Lake Tribune