In France, millions of people — primarily affected by presbycusis, age-related hearing loss — need hearing aids—but don't receive them when they need them most. This isn't necessarily because they haven't been diagnosed or fitted with hearing aids, but for much more practical reasons: some are no longer able to use their devices on a daily basis, others have forgotten to change the batteries, and still others have put their hearing aids away in a drawer because they've become too cumbersome to wear. And for those who suffer from loss of autonomy or cognitive impairment, the question of traditional hearing aids is sometimes no longer even relevant—they are simply not eligible.
The result: at the precise moment when communication is needed—a medical appointment, a family visit, care in a nursing home—the hearing-impaired person finds themselves without a solution. This article is not intended to pit two products against each other. It aims to show that there is a solution to these situations that hearing aids, even with 100% reimbursement, cannot always cover.
What the 100% Health plan will actually cover in 2026
Since 2021, the 100% Health reform has allowed anyone diagnosed with hearing loss to access a Class I medical hearing aid with no out-of-pocket expenses, provided they have a responsible supplemental health insurance plan. This is a major step forward, and it would be dishonest not to acknowledge it.
The process is as follows: consultation with an ENT specialist, medical prescription, appointment with a certified hearing aid specialist, assessment, personalized fitting, and then follow-up throughout the device's lifespan. The hearing aid is individually adjusted to precisely compensate for the wearer's hearing loss. It is a reliable, regulated, and effective medical device for hearing loss diagnosed in independent individuals.
But this path has its blind spots:
- The time between diagnosis and actual fitting of the device can extend over several weeks, or even several months.
- The renewal cycle is set at 4 years: in case of loss or breakage between two renewals, coverage is not guaranteed.
- Hearing aids are only dispensed by a hearing aid specialist in their office — no home sales or dispensing in nursing homes is legally possible.
- It assumes that its wearer is able to handle it, load it, and place it correctly — every day.
This last point is the one that is least discussed. And yet, this is where a large part of the real problem lies.
Situations where a hearing aid is insufficient — or no longer suitable
Cognitive disorders: when assistive devices become impossible
A study published by Lisan et al. in 2022 estimates that up to 30% of older adults with hearing loss and significant cognitive impairment cannot fully benefit from hearing aids. The reason is simple: handling a small in-ear device daily, changing its batteries, putting it away at night, finding it in the morning—all of this requires cognitive and motor skills that Alzheimer's disease or other forms of dementia eventually impair.
The prosthesis exists. It might even be in the bedside table drawer. But it's no longer being worn—because its wearer can no longer manage it alone. And no one around him has the means to take over with that device.
Waiting, breakage, being forgotten: the real daily reality of equipment
Beyond cognitive difficulties, there's a much more common reality: many people with hearing aids simply don't wear them when they need them. The batteries are dead. The device was left somewhere and no one remembers where. It's been hurting their ear for a few days and they're waiting for their next appointment. They're at the hospital for a consultation and they forgot their device at home.
These situations are not extreme cases — they constitute the daily reality for millions of families and caregivers. And in these moments, communication breaks down.
Specific situations that the prosthesis was not designed to cover
Hearing aids are designed for the wearer's everyday life, under stable conditions. They are not intended for: conversations behind a surgical mask, noisy environments such as a nursing home dining room, phone calls with poor reception, or medical consultations with a doctor who speaks softly. Even people with well-fitted hearing aids experience difficulties in these situations.
Turning the problem around: what if it wasn't up to the hearing-impaired person to act?
Hearing loss is always approached from the perspective of the person who cannot hear. They are prescribed a hearing aid. They are asked to wear it, manage it, and adapt. The problem is presented as theirs alone.
But what happens when the person can no longer — or cannot yet — assume this responsibility? Who takes over?
This is precisely the question Spokeo chose to address differently. Rather than designing yet another hearing aid for the hearing impaired, Spokeo designed a communication tool that the speaker takes control of. The caregiver clips the Smart Mic to their collar before entering the room. The child places the headset on their parent's head. The doctor ensures their patient understands correctly, without having to raise their voice through a mask.
This shift in perspective changes everything — especially for people who have lost the autonomy needed to manage their equipment on their own.
Comparison: Reimbursed hearing aid vs. over-the-counter hearing aid
| Hearing aid 100% covered by health insurance | Spokeo — hearing aid without a prescription | |
|---|---|---|
| Refund | Yes (Class I, no out-of-pocket expenses) | No — fundable via EHPAD care budget or ARS CNR |
| Order required | Yes | No |
| Access delay | Several weeks | Immediate |
| Suitable for cognitive disorders | Difficult | Yes |
| Controlled by the interlocutor | No | Yes |
| Occasional use | Not recommended | Yes |
| Works with surgical masks | Partially | Yes |
| Price | €0 (Class I with responsible health insurance) | €598 incl. VAT — individual box |
Not one or the other — but which one for which situation
Hearing aids covered under the 100% Health program remain the standard option for anyone diagnosed with hearing loss, who is independent enough to manage their device, and who wants a permanent, personalized solution. If this applies to you or a loved one, consult an ENT specialist and a hearing aid specialist—it's the right approach.
Spokeo addresses a different need: it is there for times when the prosthesis is not worn, for people who can no longer manage it, for caregivers and helpers who want to regain control over communication, and for all those who are still waiting for their device but cannot wait.
These are not two competing products. They are two responses to two different — and often complementary — realities.
→ Discover Spokeo, the over-the-counter hearing aid designed for seniors and those they speak with.
→ Do you manage a healthcare facility? Check out our offer dedicated to nursing homes and medico-social structures .
FAQ — Hearing aids: your frequently asked questions
What is the difference between a hearing aid that is covered by insurance and a hearing aid that is available without a prescription?
A hearing aid covered by health insurance (Class I or II hearing aid) is a medical device prescribed by an ENT specialist, individually fitted by a certified hearing aid specialist, and covered by the French national health insurance system (Assurance Maladie) under the 100% Santé program. An over-the-counter hearing aid like Spokeo is a pre-programmed listening assistant, immediately accessible without a prescription or medical consultation. It is not a substitute for a hearing aid for severe hearing loss, but it addresses specific situations that a hearing aid does not cover.
Is an over-the-counter hearing aid effective for the elderly?
Yes, in cases of mild to moderate hearing loss. Spokeo is particularly well-suited for seniors who can no longer manage their hearing aids independently due to loss of autonomy or cognitive impairment. Its ease of use—and the fact that the person speaking with you can take control—makes it a practical solution where traditional hearing aids become difficult to use.
Can Spokeo be used in conjunction with a hearing aid?
Yes. Even people with hearing aids who are properly fitted can encounter difficulties in certain situations: noisy environments, surgical masks, phone calls, medical appointments. Spokeo can be used in conjunction with an existing hearing aid for these specific situations.
How to finance a hearing aid without a prescription in a nursing home?
Healthcare facilities can finance the acquisition of Spokeo through their healthcare budget (a global package funded by the national health insurance), the Regional Health Agency's (ARS) non-renewable grants, or the Territorial Accessibility Fund. The Spokeo Facility Pack (5 units) is available for €2,392 including VAT with free delivery.
