Aim <p>This study aimed to explore the potential association between universal newborn hearing screening, reimbursement policy for unilateral cochlear implants, and trends in educational placements and cost implication in Taiwan.</p> <p>Subject and Methods.</p> <p>Government data from the 2009, 2015, and 2021 school years were analyzed to assess changes in educational placements and costs. Individuals with moderate-to-profound hearing impairment were selected from a cochlear implant institute to assess their actual utilization of hearing devices across the three periods.</p> Results <p>The proportion of students with hearing impairment attending centralized special classes decreased significantly from 25.2% in 2009 to 10.5% in 2021, associated with reduced special educational budget allocation. Over a 12-year compulsory education period, the transition from centralized special classes to decentralized resource rooms was estimated to save approximately US $100,000 per child with hearing impairment. Between 2009 and 2021, a notable increase in cochlear implant use was observed, particularly after the 2017 policy change that reimbursed cochlear implant expenses.</p> Conclusion <p>The data indicate that a recent increase in cochlear implantation, facilitated by changes in reimbursement policies since 2017, might be associated with shifts from specialized to mainstream schooling, offering educational benefits and cost savings.</p>