Hearing Aids
What Is a Hearing Aid?
A hearing aid is a small electronic device that helps compensate for (but not cure) mild to profound hearing loss. Hearing aids come in a wide variety of styles and sizes and can be worn by people of all ages struggling with hearing loss.
Hearing aids are medical devices regulated by the Food and Drug Administration (FDA). They are fit and sold by state-licensed hearing care professionals—audiologists typically have the most training with them. A handful of manufacturers dominate the market and produce hundreds of types of aids with various components and technology levels.
How Do Hearing Aids Work?
A hearing aid typically contains a microphone, amplifier and speaker. The microphone picks up acoustic sound waves and converts them into electrical signals, which are then processed and enhanced by the amplifier. Those signals are then sent to the speaker, which converts them back into sound waves, providing a louder and clearer sound for the wearer. This method of sound amplification can help improve a person’s hearing and make speech from others easier to understand.
How Much Do Hearing Aids Cost?
Hearing aid prices can vary dramatically depending on the manufacturer of the aid, the model you choose, the additional technology features you select and the audiologist from whom you purchase them. Most hearing aids are priced individually, so if you have hearing loss in both ears, remember to double the prices you see listed by hearing aid retailers. Taking top manufacturers and models into consideration, starting prices for a pair of hearing aids in 2022 ranged from about $1,400 to over $5,000.
Hearing Aid Types
There are many different types and styles of hearing aids available to best suit the wearer, their level of hearing loss, their fit preferences and their physical abilities (such as finger dexterity needed for replacing batteries). Some hearing aid devices sit outside the ear, others nestle completely in the ear, and several types have both inner and outer ear elements.
Four basic types of hearing aids include:
Behind-the-ear (BTE) hearing aids, which house all tech components behind the ear in a casing that connects to the inside of the outer ear via a thin tube to a dome or ear mold. A common style is a mini-behind-the-ear (mBTE) or a slimmer BTE.
Receiver-in-canal (RIC) hearing aids, which are also worn behind the ear but connect via a form-fitted wire to a small speaker that sits in the ear canal.
In-the-ear (ITE) hearing aids, which are nearly hidden inside the ear canal with no components behind the ear.
Completely-in-canal (CIC) hearing aids, which are custom-made to sit entirely inside the ear canal.
Read our in-depth guide to different types of hearing aids for more information.
Over-the-Counter (OTC) Hearing Aids
According to a new rule from the FDA, over-the-counter (OTC) hearing aids may also be available for adults with perceived mild to moderate hearing loss as soon as October 2022. These hearing aids are expected to be significantly more affordable than current prescription options and will be available at stores and online retailers (who aren’t required to be licensed sellers). Users will not require a medical exam, prescription or fitting adjustment by an audiologist or hearing health professional to purchase these hearing aids.
According to panelist Abram Bailey, an audiologist and Forbes Health Advisory Board member, Audicus, Bose, Eargo, Jabra, Lexie and Lively are all brands to keep an eye on as the OTC hearing aid market solidifies.
Benefits of Hearing Aids
Only one in five people who would benefit from a hearing aid uses one, according to the Hearing Loss Association of America[1]. Cost, confusion about and access to hearing care, and gradual hearing loss going unrecognized are all reasons for this underutilization. Vanity also plays a role, though hearing aids continue to become smaller and sleeker.
“Having hearing loss is like you’re backing out 10 feet from a conversation,” says John Coverstone, an audiologist in New Brighton, Minnesota, and host of the AudiologyTalk podcast. “People feel more isolated,” he says.
Studies link trouble hearing with serious health consequences. Untreated hearing loss increases your risk of anxiety, depression, social isolation, falls and cognitive decline, research shows.
Proper hearing aids can greatly improve hearing and, consequently, health, studies find. For example, wearing hearing aids appears to reduce the “excess risk” of dementia from hearing loss, according to a 2020 report in The Lancet[2].
How to Choose a Hearing Aid for You
The best hearing aid for you depends on your level of hearing loss, your lifestyle and your fit preferences. First, consult a hearing health professional, such as an audiologist, for a hearing examination to determine your level of hearing loss. From there, they can help you review specific hearing aid models most appropriate for your situation and pick the one you’d like to try.
Finding the Best Hearing Aid Fit
With hearing aids that house some or all components behind the ear, two kinds of parts go in the ear—an open-fit dome or a closed-fit mold. Many people like the feel of an open-fit dome as it lets some hearing pass in naturally. A closed fit, custom-made ear mold may result in the best hearing but users have to adjust to the “stopped up” feel.
The most important factors for hearing aid success are acoustic fit and physical fit, says audiologist Catherine Palmer, former president of the American Academy of Audiology and director of audiology and hearing aids at the University of Pittsburgh Medical Center.
Acoustic fit is how well an audiologist programs the aids to your specific hearing needs. Physical fit has to do with how well they fit in your ear, which affects both hearing and comfort.
A great hearing aid fit hinges on three things:
Your type of hearing loss. Many people lose hearing in the high frequencies first. Others have difficulty across all frequencies. Hearing tests measure sensitivity, or how loud a sound has to be to be heard, and clarity, or how well someone can understand speech. Often, you’ll also get a “speech in noise” test. These results create a sound prescription for the best hearing aid for you.
Your lifestyle. Do you work? Do you love dining in restaurants? Do you listen to podcasts? Your lifestyle suggests which features, such as Bluetooth connectivity, are important. Also, certain hearing aid styles, such as behind-the-ear or completely-in-the-canal are better or worse for certain situations.
Your dexterity. If you have trouble manipulating batteries, a rechargeable hearing aid is often recommended.
Based on these findings and your budget, your hearing professional will recommend style, technology level and features. “At the end of the day, the best hearing aid is the one the person will wear,” says Palmer.
Once your hearing aid is programmed and customized for you, real-ear measurements are typically performed. This is an important test to ensure our hearing aids are meeting your sound prescription. At this point or later checkups, an audiologist may also recommend accessories such as a clip-on “remote microphone,” which can dramatically help you hear one particular person.
Features to Consider
Hearing aids can also come with a variety of features, including (but not limited to):
- A directional microphone that makes conversing in noisy environments easier
- A telecoil (t-coil) that amplifies a speaker’s voice over background noise in public places
- Remote microphones
- Feedback suppression technology, which reduces acoustic feedback (often experienced with phones)
- Impulse noise and wind reduction technologies
- Rechargeable batteries
- Wireless connectivity with Bluetooth-compatible devices
- Remote controls for easy adjustments
- Preprogrammed settings for different listening needs and environments