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(CNN) – 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.

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