What to Look for in a Hearing Aid

When the doctor says you have hearing loss, you may be eager to get hearing aids to regain the sounds you’re missing. But try not to rush it. Hearing aids come in varying shapes and sizes and have a number of available bells and whistles. With prices that range from about $2,000 to more than $8,000 per pair, and no reimbursement from Medicare, you’ll want to consider the options carefully before making an investment.

Types of Hearing Aids

Hearing aids come in several styles.

Behind-the-ear. This is a two-piece gadget. It’s worn behind the ear and has a little tube that goes into the ear canal to deliver sound. While small compared to hearing aids from decades ago, BTEs are the largest style of hearing aid today and big enough to contain circuitry for lots of special features, including directional microphones that allow you to focus on sounds in front of you.

In-the-ear. This one-piece hearing aid fits in the open part or outer shell of your ear and resembles a flat earbud. It can do the same job as a BTE, but with limited directional capabilities and fewer special features.

In-the-canal. This one-piece hearing aid is the smallest available and is popular for cosmetic purposes. Some of these devices fit partially in the ear canal, and some fit completely in the ear canal so they are hidden from view. In-the-canal hearing aids have the fewest capabilities and features.

The style that’s right for you depends on your hearing impairment. “For people who only need things to be louder — they understand speech but need the dial turned up — if cosmetics are the most important feature to them, I’d say either in-the-ear or in-the-canal would be OK. But some people need things to be louder and also have a deficit in understanding speech. In that case, you’d want to reduce background noise and direct your focus in front of you. Tiny hearing aids won’t do that as well,” says Linda Ronis-Kass, an audiologist at Penn Medicine at Washington Square in Philadelphia.

[See: Causes of Hearing Loss Beyond Loud Noise.]

Special Features

Just like smartphones with advanced yet miniaturized technology, many hearing aids now have the following high-tech features that make a big difference for the wearer.

Wireless connectivity. Bluetooth technology, found only in larger hearing aids, allows you to pair a hearing aid with all of your tech, including wireless TV streamers. “People are able to connect to their TV, smartphone, a computer tablet or laptop. You can use it for Zoom meetings. And the smartphone functions as a remote control,” says Melissa Schnitzspahn, an audiologist at Ohio State University Wexner Medical Center.

Rechargeable batteries. Many BTEs are rechargeable and have an embedded battery that does not have to be thrown away or changed by the user. Most in-the-canal hearing aids are not rechargeable.

Customizable programs. Hearing aids with directional microphones and smartphone apps may allow you to change the scope of sound being collected in a particular environment, such as a meeting room or restaurant. “You can change the microphone to have a narrow beam in front of you or a wider beam that allows in more sound,” Schnitzspahn says. “You can adjust for the acoustics of the space, whether it has a reverberant environment or a lot of background noise.”

Remote microphones. Some hearing aids can be paired with microphones worn by your friends and family. “Imagine if you’re driving with someone in a car, you’re both facing forward, you can’t see the person’s lips and car noise is making it hard to understand what they’re saying; you may want that person to wear a microphone to cut down on background noise and put the sound of their voice into the hearing aid. You can also use remote microphones for meetings or family gatherings,” Ronis-Kass explains.

[READ: Who’s Got Your Health Data?]

Other Considerations

Beyond special features, you should also consider the following factors when you’re in the market for hearing aids.

Comfort over cosmetics. “People often say they want the tiny hearing aid that no one can see. They don’t consider how the hearing aid will feel in the ear,” Ronis-Kass says. “But the smaller the piece in your ear, the more stuffed up your ear feels. When I show them the difference, they often decide to give the larger one a try.”

Ease of use. “If you have dexterity or vision issues, something that’s one piece might be easier to put into your ear,” Schnitzspahn says. “Also, something with a rechargeable battery might be a good option because you just sit the hearing aid into a charger rather than having to fit a tiny battery into a tiny battery door.”

Who’s selling it? You can go to an audiologist for a hearing aid, or you can go to a hearing aid seller at a brick-and-mortar store or an online outlet. What’s the difference? “Hearing aids are fit by a computer at first,” Ronis-Kass says, “but the art of hearing aid fitting has to do with much more than that. What if you say it’s not comfortable? I may have 12 different generic pieces of plastic I can choose to make you more comfortable, and I’ll know which ones to use based on your complaints.”

The Savvy Shopper

It’s not enough to look for certain features in a hearing aid; you should also look for red flags during the buying process. These can include:

Poor return policies. “Be mindful of the laws and regulations in your area. In Ohio we have a 30-day return policy. A provider may keep the deposit, but in that 30 days you have to be able to return the hearing aid if you’re not happy with it,” Schnitzspahn says. “Watch out for providers who don’t convey that message or make you feel like once you have a hearing aid there are no other options.”

Hot deals. “It may seem like you’re saving money if you’re getting a deal online, but if you then need someone to fit your hearing aid, it might have been the same price as just getting it from a local facility to begin with,” Schnitzspahn says.

Bad advice. Don’t let someone steer you toward a hearing aid you can’t afford; choose a place where people aren’t paid on commission. Ask if the hearing aid provider will sell you a reconditioned hearing aid if you can’t afford a new one or put you in touch with places that offer interest-free loans or charities that provide refurbished hearing aids.

What you do want: a hearing aid provider who will listen to your hearing complaints, make you feel comfortable, do a hearing verification test to objectively measure how well your hearing aid is working and advise you through the whole process of fitting and then refitting if necessary. “Don’t go to a place where you see a different person every single time. It’s hard to solve problems that way,” Ronis-Kass says. “You want a person who is willing to explore what your problems are and be resourceful enough to figure out how to fix them.”

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What to Look for in a Hearing Aid originally appeared on usnews.com

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