Are you considering a hearing aid? If so, you should know a few things before making your purchase.
This guide will cover the different types of hearing aids, key features to look for, and how to choose the right care model.
We'll also touch on the subject of price so that you can make an informed decision about which hearing aid is right for you.
Let's start with hearing aid types.
There are several styles of hearing aids: behind-the-ear (BTE), receiver-in-the-canal (RIC), in-the-ear (ITE), and in-the-canal (ITC).
Styles That Sit Behind The Ear
BTE and RIC hearing aids are the most common. These styles sit behind the ear with a wire or tube reaching the ear canal.
Styles That Sit Inside The Ear
ITE hearing aids fit inside the bowl-shaped area of the outer ear. ITC hearing aids are smaller and fit inside the ear canal. Most ITC and ITE hearing aids are custom molded to match the exact shape of your ear. Some brands, like Eargo, offer in-the-ear devices that do not require a custom mold.
Read more about styles of hearing aids here.
Once you've familiarized yourself with the various hearing aid styles, you are ready to move on to hearing features.
Features to look for in a hearing aid.
When shopping for a hearing aid, there are several features you should consider.
- Bluetooth: Some hearing aids have Bluetooth streaming capabilities and can be paired with your Smartphone or other devices to listen to music and take phone calls.
- Batteries: Many hearing aids are rechargeable, while others use a disposable battery that needs to be changed every 5-7 days.
- Remote care: New prescription hearing aids allow remote adjustments from your doctor through Telehealth. Remote adjustments are beneficial for those who don't like making trips to the doctor.
- Sound quality: Hearing aids come with various levels of sound quality and intelligent features for managing background noise. As you move up the technology ladder, devices typically have better control over background noise.
- Buttons and app control: Most hearing aids have buttons or app controls that allow volume and program changes. Onboard buttons are convenient but sometimes less cosmetic.
- Fitting range: Importantly, you should look for a hearing aid that matches your hearing loss level (also called the fitting range).
If streaming music and podcasts are important to you, you'll want a hearing aid that has Bluetooth capabilities. The most popular style for Bluetooth streaming is a RIC, which offers the latest technology and works with iPhone, Android, and other Bluetooth devices.
Hearing aids come with disposable batteries that must be changed every 5-7 days or rechargeable batteries that go into a recharging case each night. Most people prefer rechargeable batteries, but they are more expensive and don't allow easy mid-day changes.
Modern hearing aids have built-in features allowing audiologists to update their program without an in-person visit. Remote programming is sometimes unavailable for budget hearing aids and invisible hearing aid styles.
Sound quality is difficult to quantify but ultimately comes down to the overall technical capabilities of your hearing aid. Premium products process sound faster and have more built-in algorithms to handle background noise and prioritize voices. If you lead an active lifestyle and often find yourself in background noise, it might be worth investing in a premium product like ReSound OMNIA or Oticon More.
Push Buttons or Toggle Switch
You may want a push button or toggle switch on your hearing aid. Controls allow you to change the volume and program on the go. Think about options that feature this function: RIC, BTE, or larger custom hearing aid (ITE, some ITC). Some of the smallest hearing aids on the market are adjustable through smartphone apps or remote control.
Appropriate Fitting Range
Mild to moderate hearing loss can be fitted with various hearing aids. In my experience, most people with mild hearing loss don't like the sound quality of a custom hearing aid due to the occlusion effect. However, some can adjust to this sound and still choose it due to cosmetic concerns. Those with more severe hearing loss will need to consider styles that can accommodate their hearing loss, such as a BTE or ITE.
Unsure about your hearing loss? Read more about hearing loss shapes and tests here.
Choose the Right Care Model
Once you've narrowed down your options based on type and features, you'll need to decide which care model is right for you. There are three main types of care models:
- Prescription: Sold and fit by a licensed hearing professional.
- Direct-to-consumer (D2C): Sold online or over the phone, then fit by a hearing professional remotely using Telehealth.
- Over-The-Counter (OTC): Self-fit using a phone app without the help of a licensed hearing professional.
Prescription Hearing Aids
The first group of hearing aids is prescribed by a local hearing professional. Usually at a local clinic or through a mobile clinic that comes to your home. This style of care is best for:
- Complex hearing loss (e.g. steeply sloping, unilateral hearing loss, etc.)
- Unusual ear canal anatomy
- More customized treatment and in-person support
Prescription hearing aids can only be sold by licensed professionals and require a comprehensive hearing evaluation. While this model will be the most costly, the audiologist has a broader range of options to provide the best, most customized treatment solutions. If you want custom earmolds, have unilateral hearing loss, have severe hearing loss, or need help cleaning or troubleshooting, prescription hearing aids are probably for you.
Some insurance providers cover hearing aids, but Medicare does not cover hearing aids.
Direct-to-Consumer Hearing Aids
The second group of hearing aids is sold online or over the phone and customized through Telehealth services. This care model is best for:
- Mild to severe hearing loss
- Normal ear canal geometry
- Comfortable with remote care support
- Good dexterity
Direct-to-consumer hearing aids are typically sold using an online hearing test and a remote hearing professional. A hearing professional programs your hearing aids to fit your hearing loss based on your hearing test.
Hearing aids are then shipped to your home. Additional adjustments can be made using a remote care model. This option can work well for those who are generally comfortable doing things independently but want assistance through remote care. Jabra and Audicus are the two leading companies in the D2C market.
If you have an unusual ear shape or hearing loss, prescription hearing aids will be a better option.
Over-The-Counter Hearing Aids
The third group of hearing aids can be purchased online or through retailers like Walmart and CVS. This care model is best for:
- Mild to moderate hearing loss
- Comfortable with self-fitting on a smartphone app
- Normal ear canal geometry
- Good dexterity
OTC hearing aids are available over the counter for those with mild to moderate perceived hearing difficulty. Most OTC devices are purchased at retailers like Walmart and CVS or online. OTC hearing aids allow you to customize your devices through a smartphone app.
OTC offers a great starting point for folks on a budget. Currently, the most premium hearing aids are unavailable over-the-counter and require an in-person or Telehealth prescription. If you are interested in OTC hearing aids we suggest you look at Lexie B2 - Powered by Bose.
Read more about OTC vs prescription hearing aids here.
What About the Price?
The price of a hearing aid will depend on the type, features, and care model you choose. Additionally, other options, such as financing, can make your choices more affordable. Prescription hearing aids tend to be the most expensive option, followed by direct-to-consumer options. OTC hearing aids are typically the most affordable option.
Prescription Hearing Aid Prices
Going the prescription hearing aid route will provide the most options but typically come with the highest price tag.
Many audiology clinics offer a bundled model, meaning that the price you pay includes all follow-up services for three years.
The average price range for prescription hearing aids ranges from $4,000 - $7,000, depending on the level of hearing aid technology.
Direct to Consumer Hearing Aid Prices
Direct-to-consumer options are less expensive than prescription hearing aids and fit between in-person and OTC options.
The middle ground of D2C offers some professional support through remote care and some self-guided elements in the process. The price range for D2C hearing care ranges from $1200 - $3,000 for a pair of hearing aids.
Over-the-Counter Hearing Aid Prices
OTC devices are the most affordable option but offer the least support and rely on the user to self-fit the devices.
The price range for OTC hearing devices ranges from $800 - $2,500 for a pair.
Questions to Keep in Mind
How much hearing loss do you have?
How independent and comfortable are you with technology?
Do you prefer to do things independently or have professional support or assistance?
What is your budget for hearing healthcare?
Do you have a complex ear history or unusual ear anatomy?
The answers to these questions will help guide you to the best option for your hearing loss, communication needs, and budget.
Our suggested decision framework.
First, decide which type of hearing aid is right for you. Next, consider which features are important to you.
Finally, choose a care model that fits your needs and budget.
With these things in mind, you'll be well on your way to finding the perfect hearing aid for you!