Hearing aids: How to choose the right one

Maybe you've thought about getting a hearing aid, but you have questions. How will a hearing aid look? Will using a hearing aid really help? You may find answers when you know more about the following:

• Hearing aid choices.
• What to look for when buying a hearing aid.
• Whether you need one or two hearing aids.
• How to get used to a hearing aid.

Hearing aids don't restore full hearing. They can improve hearing by making sounds louder. This is called amplification.

All hearing aids use the same basic parts. Hearing aids carry sounds from outside your ear into your ear to make sounds louder.

Most hearing aids are digital. All run on batteries. Some use batteries that you can recharge.

Small microphones collect sounds around you. A computer chip changes the sounds into digital code. Hearing aids adjust the sound based on your hearing loss, what you need to hear, and how loud the sounds around you are.

Hearing aids turn up the signals and change them back into sound waves. The sound waves go into your ears through speakers, also called receivers.

Hearing aid parts

Hearing aids have several parts. The microphone picks up the sound. The speaker sends the sound into the ear. The battery gives power to the electronic parts. Some hearing aids have a volume control to make the sound louder or softer.

Hearing aids vary a lot in price, size, special features, and the way they're placed in the ears. Using two hearing aids may help you hear better, especially if you have hearing loss in both ears.

Most people get hearing aids programmed with a prescription for their hearing loss. Adults in the U.S. age 18 and older with mild to moderate hearing loss can get hearing aids without a prescription.

Hearing aids you get without a prescription come in fewer styles and offer fewer features than prescription hearing aids do. Talk to your healthcare professional about the pros and cons of both.

You can get hearing aids that don't need a prescription without a hearing exam. But it's good to get a hearing exam before getting any hearing aids.

The following are common hearing aid styles. Some are small and harder for others to see in the ear. Hearing aid makers keep making smaller hearing aids because people want hearing aids that are hard to see. Other hearing aid styles need to be bigger to have the power to improve hearing enough and to give more features.

Hearing aid styles

There are many styles of hearing aids. Examples include behind the ear, in the canal and completely in the canal. There are several types of behind the ear hearing aids.

A hearing healthcare professional molds this type of hearing aid to fit inside the user's ear canal. Also called CIC, it helps mild to moderate hearing loss in adults.

A completely-in-the-canal hearing aid:

• Is the smallest type and hardest for others to see.
• Is more likely to block wind noise.
• Uses very small batteries. These batteries have a shorter life and can be hard to handle.
• Often doesn't include extra features, such as volume control or a directional microphone. Directional microphones let the user focus on sound coming from one direction in a noisy place.
• May get earwax clogging the speaker.

A hearing healthcare professional molds an in-the-canal hearing aid, also called an ITC hearing aid, to fit partly in the ear canal. This style can help mild to moderate hearing loss in adults.

An in-the-canal hearing aid:

• Is harder for others to see when worn than are larger styles.
• Has features that don't fit on completely-in-the-canal aids. But these features may be hard to adjust due to the small size of the hearing aid.
• May get earwax clogging the speaker.

This type of hearing aid, also called an ITE hearing aid, comes in two styles. One style fills most of the bowl-shaped area of the outer ear, called a full shell. And one fills only the lower part of the bowl-shaped area of the outer ear, called a half shell.

Both styles help people with mild to more serious hearing loss. Both styles come with directional microphones to help the user hear better in noisy places.

An in-the-ear hearing aid:

• Has features, such as volume control, that don't fit on smaller hearing aids.
• May be easier to handle than smaller hearing aids.
• Uses a larger battery for longer battery life. It has options for batteries that the user can recharge.
• May get earwax clogging the speaker.
• May pick up more wind noise than do smaller hearing aids.
• Is easier for others to see when worn than are smaller hearing aids.

A behind-the-ear hearing aid, also called a BTE hearing aid, hooks over the top of the ear and rests behind the ear. BTE hearing aids can connect to different earpiece styles. Many BTE hearing aids use a tube to connect the hearing aid to a custom earpiece called an ear mold that fits in the ear canal.

This type helps people of all ages with almost any type of hearing loss. But people with a lot of hearing loss may need to choose this style because it can hold the largest receiver and give the most volume.

A behind-the-ear hearing aid:

• Has been the largest type of hearing aid. But some newer models are smaller and hard to see when worn.
• Has directional microphones, which let the user focus on sound coming from one direction in a noisy place.
• Can make sound louder than do other styles.
• May pick up more wind noise than do other styles.
• May come with a battery that the user can recharge.

The receiver-in-canal, also called RIC, and receiver-in-the-ear, also called RITE, styles are like behind-the-ear hearing aids. But the receiver sits in the ear canal. A tiny wire connects the piece behind the ear to the receiver.

A receiver-in-canal hearing aid:

• Most often is harder for others to see than are behind-the-ear models.
• Has directional microphones, which let the user focus on sound coming from one direction in a noisy place.
• Has manual control options.
• May come with a battery that recharges.
• May get earwax clogging the speaker.

This type of behind-the-ear hearing aid keeps the ear canal open. A narrow tube goes into the ear canal. This lets low-frequency sounds, such as barking dogs and lawn mowers, enter the ear on their own.

The hearing aid makes high-frequency sounds, such as children's voices, louder as they come through the hearing aid. An open-fit hearing aid may be a good choice for people with better low-frequency hearing and mild to moderate high-frequency hearing loss.

An open-fit hearing aid:

• Most often is harder for others to see than are behind-the-ear models.
• Doesn't fill the ear like the in-the-ear hearing aid styles do. This may make your voice sound better to you.
• May be harder to put into the ear because it's not custom fitted.

Some features that come with some hearing aids make it easier to hear in certain settings. Features include the following:

• Noise reduction. All hearing aids cut noise some. How much they cut it varies. Some also cut wind noise.
• Directional microphones. This feature involves two or more microphones. They can pick up sound from all around or from just one direction, such as in front of you. Directional microphones can improve hearing in places with a lot of background noise, such as a crowded restaurant.
• Rechargeable batteries. Some hearing aids have batteries the user can recharge. Rechargeable batteries can make hearing aids easier to use because there's no need to change the battery.

• Telecoils. This feature makes it easier to hear when talking on a telephone that works with telecoils. The telecoil picks up the sounds instead of the microphone.

  Telecoils also pick up signals in public places that have special sound systems, called induction loop systems. These systems may be in places such as churches, theaters and airports.

• Wireless connectivity. Many hearing aids work with devices that use Bluetooth. Devices include cellphones, music players, computers and televisions.
• Remote controls. Some hearing aids come with a remote control. This lets you adjust features without touching the hearing aid. Some hearing aids connect wirelessly to a cellphone and have an app that allows use of the cellphone as a remote control.
• Variable programming. Some hearing aids can store settings you program ahead of time for certain listening needs.
• Synchronization. If you wear two hearing aids, this feature makes them work together. So if you change the volume or the program for one hearing aid, you also change the other hearing aid. This makes the hearing aids easier to manage.

When looking for a hearing aid, learn about your choices to know what type of hearing aid will work best for you. Also:

• Get a health checkup. See your healthcare professional to make sure that what's causing your hearing loss can't be treated. Causes that can be treated include having an earwax buildup or an infection.
• Get a referral to a good audiologist. An audiologist is a healthcare professional who works with hearing issues. If you don't know a good audiologist, ask your main healthcare professional to suggest one. An audiologist checks your hearing, helps you choose the best hearing aid for you, fits the hearing aid to you and programs it to meet your needs.

• Ask about a trial period. You often get a trial period when you buy a hearing aid. It may take you a while to get used to the device and know whether it's right for you.

  When you get the hearing aid, get some things in writing. These include what the trial costs, whether this amount goes toward the final cost of the hearing aid and how much you can get back if you return the hearing aid during the trial period.

• Think about future needs. Ask whether you can raise the power of the hearing aid you get. Then you can still use it if your hearing loss gets worse. Hearing aids don't work forever. But they should last about five years.
• Check for a warranty. Make sure the warranty covers parts and labor for a certain period in case something goes wrong with your hearing aid. Some audiologists may include office visits or professional services in the warranty. Ask if you can add time to the warranty period.
• Beware of claims that sound too good to be true. Hearing aids can't restore all your hearing or erase all background noise. Beware of ads or sellers who claim hearing aids can do more than they can. The National Council on Aging rates hearing aids every year.

• Plan for the cost. A hearing aid can cost from about $1,000 to several thousand dollars. Hearing aids you get without a prescription tend to cost less.

  Professional fees, remote controls and other hearing aid features may cost extra. Talk to your audiologist about your needs and what to expect.

  Some private insurance policies cover part or all the cost of hearing aids. Check your policy to be sure. Medicare doesn't cover the cost of hearing aids for adults. In many states, private insurers must pay for hearing aids for children.

  Some civic organizations and hearing associations give financial help for hearing aids or can help you find financial help. If you're a veteran, you may be able to get hearing aids at no cost through the U.S. Department of Veterans Affairs.

You need time to get used to wearing a hearing aid. You may find that your listening skills improve little by little as you get used to sounds being louder. Even your own voice may sound different when you wear a hearing aid.

When first using a hearing aid, keep these points in mind:

• Hearing aids won't restore all your hearing. They can help you hear by making soft sounds louder.
• Give yourself the time you need to get used to the hearing aid. The more you use it, the more quickly you'll adjust to amplified sounds.
• Practice using the hearing aid in different places. Your amplified hearing will sound different in different places. Learn to adjust the volume in different settings.
• Go back for a follow-up. Audiologists may include the cost of one or more follow-up visits in their fees. It's a good idea to use these visits. You can get your hearing aid adjusted and make sure that your new hearing aid is working for you as well as it can.

To do well with hearing aids, wear them often and take good care of them. An audiologist can tell you about new hearing aids and devices that come on the market.

An audiologist also can help you make changes to meet your needs. The goal is that, in time, you find a hearing aid that works best for you to hear and talk with others better.