Hearing loss can be frustrating and isolating. You can’t participate fully in life around you when you can’t hear what’s going on. It’s a common problem. Nearly one-third of people age 65 to 74 and almost half of those 75 and older have trouble hearing, according to a study cited by Consumer Reports.
Fortunately, technology has transformed hearing aids. The newest contain microcomputers to deliver accurate sound and comfort without the kind of aggravating feedback problems common in older models. At the high end, hearing aids can be really costly, but many people get satisfaction with midrange or budget hearing aids, and relatively cheap sound amplifiers can help people with mild hearing loss.
We’ll discuss costs more below. First, let’s look at how to shop wisely.
Get a medical exam
Hearing aid salespeople will want to give you a hearing evaluation before selling you a product. First, get a medical examination, preferably by a board-certified ear, nose and throat physician (ENT).
This exam should determine whether your hearing problem can be medically treated before you spend thousands of dollars on hearing aids. Workplace insurance may cover the exam, and Medicare Part B insurance covers diagnostic hearing exams ordered by a doctor, but does not cover routine hearing tests, hearing aids, or exams for fitting hearing aids. (Here are the rules, at Medicare.gov.)
Until recently, federal regulations required salespeople to get a written statement from you, signed by a licensed physician, before selling you hearing aids. That rule has been suspended, the FDA announced in December 2016, as part of an effort to spark greater innovation, affordability and accessibility in the hearing device marketplace.
Next step: a hearing evaluation
Nonetheless, your doctor is a good place to start. If he or she recommends you pursue hearing aids, the next step is a hearing evaluation. This is a thorough assessment of your hearing by an audiologist or a hearing aid dispenser who is credentialed in your state to measure hearing, fit hearing aids and sell them.
What they recommend will depend in part on what type of hearing loss you have. One common type of hearing loss among adults is sensorineural — damage to the nerves of the inner ear — from disease, age, injury or a genetic disorder. Another is conductive hearing loss, caused by infection or a build-up of fluid or ear wax and affects the outer or middle ear. Some people experience a combination of these types of hearing loss.
Costs vary but expect to pay around $150 to $225 for the evaluation, according to the University of Texas‘ Callier Center for Communication Disorders.
Because these are such costly products, deal only with reputable professionals. Check dealers’ names against records of complaints at your local or state consumer protection agency (find it here at USA.gov), state attorney general’s office, state licensing agency or the American Speech-Language-Hearing Association. You can find certified audiologists, credentialed professionals trained in evaluating hearing and fitting hearing aids, in your area at the ASHA website.
- If you feel sales pressure, leave and shop elsewhere.
- Look for hearing aids with trial periods of 30 to 60 days.
- Find out how much money you’ll get back if you return the product during the trial period.
- Get all promises and guarantees written into your purchase agreement.
A wide variety of hearing aids are available. Few of the devices sold today are the older analog type. Digital aids now dominate the market.
- Behind-the-ear (BTE): Helpful with mild to profound hearing loss, these devices may use Bluetooth technology to connect directly to a mobile phone.
- In-the-ear (ITE): For mild to severe hearing loss.
- In-the-canal (ITC): These models, for mild to moderately severe hearing loss, are nearly hidden in the ear canal.
Digital hearing aids use microphones to pick up sound and amplify it. Sound is adjusted through the hearing aid settings and sent directly to your ear or through a small tube or wire connected to an ear mold. The in-the-canal type and in-the-ear type are the most popular, although many adults also like the BTE open-fit style, ASHA says.
“Extended-wear” aids are nonsurgically placed in the ear canal by an audiologist. Other types of aids are used for more complex types of hearing loss.
A 2015 report from the President’s Council of Advisors on Science and Technology found the average price of a single hearing aid to be $2,300, AARP reported. And most people need two hearing devices. That is a serious chunk of change!
The hefty price tag can be attributed in part to development cost of sophisticated technology, but it is also related — traditionally — to a few companies controlling the market, a lack of transparency in the market and the need for individualized fitting by an audiologist.
“You can buy a hearing aid anywhere, but it will only be as good as the person fitting it,” audiologist Gyl A. Kasewurm tells AARP.
However, there are ways to hold down costs — and more are emerging as the market evolves.
1. Shop online
If you are comfortable shopping online for something as individualized as a hearing aid, it can be a path to serious savings.
In a major departure from tradition, many global manufacturers are now embracing direct-to-consumer online sales, according to AARP:
“Our members have some very cool internet sites,” says Carole Rogin of [the Hearing Industries Association]. (See the HIA website for the list.) A consumer can even get their hearing tested at some manufacturers’ sites. They then buy a recommended hearing aid from the site and then take it to a professional in their area for a fitting fee in the range of $500, Rogin says. (A check of one site showed that the online price was about $700 less than the retail price.)
If you are shopping in person, be sure to ask for a better deal. The average markup on hearing aids reviewed by Consumer Reports was 117 percent, which means retailers have room to give a little and still profit. Only 15 percent of the shoppers in Consumer Reports’ survey of costs tried to negotiate on price, but of those who did, 40 percent got a discount.
Compare prices at warehouse sellers such as Costco, CR says. They tend to have competitive prices and some have on-site audiologists.
3. Consider analog
Digital hearing aids tend to be more expensive, but they are not always better. Ask your seller to show you comparable analog units.
“Insist on a comparison between digital and analog models to see if you would not be just as happy with an analog hearing aid costing hundreds if not thousands less,” Massachusetts’ Health and Human Services Department advises.
Ask for the manufacturer’s technical specifications for both models and compare the maximum amplification (shown in decibel levels or dB) for each.
4. Try a personal amplification device
Advances in Bluetooth and other technologies are giving a boost to “personal sound amplification products” or PSAPs (or “sound-enhancers” or “personal listening devices”). Like hearing aids, these relatively inexpensive devices (roughly $50-$500 and up) fit in your ear to amplify sound. You can program your own settings through a Bluetooth app.
Note, however, that PSAPs are not hearing aids. They work for people without serious hearing loss who just want things a bit louder. No medical exam or hearing evaluation is required, but it’s smart to see a doctor first to rule out serious medical problems.
Money Talks News founder Stacy Johnson, with 50 percent hearing loss in one ear, uses a $350 PSAP called the Sidekick. He likes it for watching TV. His wife likes it, too, because he can turn up the volume for himself without affecting her.
“I have never used a hearing aid so I can’t compare,” Stacy says, but if you think a PSAP might help, why not try one before spending thousands of dollars out-of-pocket on hearing aids?
Where to get help covering costs
Some organizations and insurance plans will help with costs under certain circumstances. Here’s a rundown:
Medicare: No coverage for hearing aids, although your evaluation may be covered with a doctor’s order.
Workplace medical insurance: Most insurers don’t cover hearing aids, but there are exceptions so check your policy. New Hampshire, Rhode Island and Arkansas require insurers to provide adults with hearing aid coverage. AARP has details.
Lower income assistance: Some states cover hearing aids for Medicaid recipients. (See your state’s rules at the Hearing Loss Association of America.)
Veterans: Qualified military veterans can get hearing aids nearly free of charge from the U.S. Department of Veterans Affairs. See eligibility criteria here, at the VA website.
Obamacare: Through the Affordable Care Act a few state health insurance exchanges provide limited coverage. The Hearing Loss Association of America has state-by-state details.
Flexible spending accounts: Medical expenses considered deductible by the Internal Revenue Service that are not paid by your medical insurance are eligible for reimbursement from a flexible spending account.
“You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it,” says IRS Publication 502: 2014 guidance on deductible medical and dental expenses.
Consumer Reports: The magazine has compiled a comprehensive list of ideas and sources for financing, including nonprofit organizations.
Do you find yourself missing things and wondering if you might need a hearing aid? Do you have experience with buying one? Share with us in the comments section below or on our Facebook page.
Kari Huus contributed to this post.