‘It’s not optional’: Advocates say Quebec’s one-hearing-aid policy discriminates against seniors

Advocates say Quebec’s one-hearing-aid policy for seniors is unfair and are calling on the government to restore full coverage.

Mitzi Melnick Richmond says Quebec’s hearing aid coverage policy for seniors is unfair — and wants the government to reconsider a rule that only pays for one device.

The 93-year-old Montrealer wears a hearing aid in each ear. For her, they’re not a luxury — they’re essential.

“For the government to cut anything medical is very shocking,” she said in an interview with CTV News.

Under the Régie de l’assurance maladie du Québec (RAMQ), seniors who qualify for the program are typically covered for only one hearing aid — even if they have hearing loss in both ears. Meanwhile, children, workers, students, and people with visual impairments can still qualify for two devices under the same program.

“We call that being unfair. It’s ageism,” said David Gélinas, president of Quebec’s Order of Audioprosthetists. “There is no good reason for the RAMQ not to cover both hearing aids when there’s hearing loss in both ears.”

Until a few years ago, the RAMQ did cover two hearing aids for seniors. That changed, Gélinas said, in what he believes was a cost-saving move.

“Historically, the only argument that has been given is the economic argument,” he said, adding that the reasoning doesn’t hold up. He said that new research shows better hearing coverage would save the government money in the long run.

“We’ve done an economic study showing that if the government were to invest $135 million over five years — or about $25 million a year — [the province] would get back over $1 billion in benefits over the course of five years,” Gélinas said. “That’s $8.90 in return for every dollar invested.”

The figure isn’t just for covering second hearing aids; it also accounts for increasing the overall adoption rate of hearing aids in the province. Currently, Gélinas said only about one in three Quebecers with hearing loss actually uses a hearing aid.

He highlighted that in at least 25 per cent of cases, people who aren’t covered under the RAMQ for both devices simply can’t pay for the second one out of pocket.

Hearing aids can cost thousands of dollars — a steep price for many seniors living on fixed incomes. “I think that would be a terrible strain,” said Melnick Richmond.

She’s witnessed the impact of hearing loss firsthand. “If I’m not hearing a conversation that is going on, I’ll just back up because you don’t always want to tell others you can’t hear them.”

Melnick Richmond said she’s seen people withdraw many times: “And then they go into a bit of a depression.” Because, she said, people won’t ask others to repeat themselves — often to avoid feeling like a burden.

“One of my husbands didn’t always wear his hearing aids — and you could see how he just backed away,” she said.

Gélinas also said the consequences of untreated hearing loss go far beyond social isolation. “It’s also closely tied to cognitive decline, falls, and even income loss,” he said.

He pointed to strong evidence linking untreated hearing loss to a higher risk of dementia, something that’s particularly relevant for an ageing population.

“Hearing loss is the number one controllable risk factor for dementia,” he said. “If we correct hearing loss properly, we can influence other aspects of life that are costly for the government.”

The average cost of caring for one person with dementia in Quebec is about $52,000 a year, according to Gélinas.

In a statement to CTV News, the Ministry of Social Services said it is reviewing the hearing aid file. A spokesperson added the ministry and RAMQ “are currently working on changes to the hearing aid program.”

But for advocates like Melnick Richmond, the fix is simple.

“If someone has hearing loss in one ear, cover one hearing aid,” said Gélinas. “If they have hearing loss in both ears, cover two — for everyone.”