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Agency for Care Effectiveness
Ear, nose, and throat

Active middle ear implants for patients with hearing loss

17 February 2023

Published on 02 May 2022
Last Updated on 17 Feb 2023

Guidance Recommendations

The Ministry of Health’s MTAC has recommended subsidy for active middle ear implants (AMEI) for:

  • Patients with moderate-to-severe conductive hearing loss (CHL) or mixed hearing loss (MHL) who fulfil the following criteria and cannot achieve success or adequate benefit from traditional therapy and external hearing aids:

    • Bilateral stable hearing loss in each ear of ≥40dB HL;

    • Normal (free of infection or tympanic retraction) middle ear;

    • Normal tympanometry;

    • No inner ear disorders;

    • An air-bone gap of ≥30 dB HL across all frequencies OR at least involving the frequencies of 500, 1000 & 2000 Hz in cases of preceding reconstructive middle ear surgery with elimination of pathology; and

    • Having contraindications or medically valid reasons for not using bone conduction hearing implants (BCHI).

  • Patients with moderate-to-severe sensorineural hearing loss (SNHL) who fulfil the following criteria and cannot achieve success or adequate benefit from traditional therapy and external hearing aids:

    • A pure tone average (PTA4) <80 dB HL;

    • Bilateral symmetrical SNHL with PTA thresholds in both ears within 20 dB HL of each other;

    • Speech perception discrimination ≥65%;

    • Normal (free of infection or tympanic retraction) middle ear;

    • Normal tympanometry;

    • No inner ear disorders; and

    • An air-bone gap of <10 dB HL across all frequencies.

Subsidy status

AMEI are recommended for subsidy for inclusion on the MOH Medical Subsidy List (MTSL). Listed models are recommended for subsidy when used in line with the abovementioned recommendations.

Only unilateral AMEI will be subsidised. No subsidy will be accorded for the contralateral ear in cases of bilateral implantation or to devices and accessories that are not included in the standard packages of AMEI devices.

Subsidies will not apply to devices and accessories that are not included in the standard packages of AMEI devices, including replacement of, or upgrades to, internal implants.

Active middle ear implants for patients with hearing loss [PDF, 276 KB]

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