Best Hearing Aids Based on In-Depth Reviews

On a rainy evening in February 2020, we interviewed Lourdes Rodriguez, a 70-year-old woman   with moderate hearing loss who has been wearing hearing aids since 2017. Her son had noticed that she always increased the volume of the TV and constantly asked him to repeat himself. Concerned, he talked to Lourdes about this, and together they decided to book an appointment with an audiologist. During our interview with Lourdes, she said something that we wanted to convey through our guide for hearing aids:

Lourdes’ statement is only a symptom of a much larger problem. In the United States alone, more than 48 million people have significant hearing loss, and the average waiting period before seeking professional help is seven years. The time between acknowledging hearing loss, discussing it with loved ones, and getting help can be crucial, since prolonged lack of sound stimuli can impact brain function. 

How Hearing Loss Happens:

Hearing loss can occur in many ways and for many reasons. It can be the result of gradual earwax buildup, constant exposure to noises at or above 85 decibels (dB) —like motorcycle motors and police sirens—, or it can even come naturally with aging. Because of its variability, hearing loss is classified into three types in relation to its location in the ear: conductive (involving the external or the middle ear), sensorineural (involving the inner ear) and mixed (a combination of the two).

In terms of sound intensity and frequency, hearing loss is divided into five levels: mild, moderate, moderately severe, severe, and profound hearing loss. Hearing care providers measure these levels using an audiogram, a chart that determines the sounds and pitches you can and can’t hear. Normally, a person’s hearing can detect sounds from -10 to 20 decibels (dB), and they can distinguish pitch from 125 to 8,000 hertz (Hz). Human speech falls on what is known as the “speech banana,” which ranges from 20-60 dB and 125-5,000 Hz. Vowels fall on the lower-pitch section of the banana, while consonants fall on the high pitches.    

The chart below indicates the different risk factors for hearing loss, and it locates various causes for hearing loss in each of the 3 sections of the ear. It also provides an audiogram with the sound range for each hearing loss level, as well as sounds that are found in those levels.

Hearing Aids: A Breakdown

No matter the style or model, digital hearing aids usually have the same components inside: a microphone, amplifier, speaker, and battery. How do they work? The microphone first picks up the sounds around you and sends them to a microchip that amplifies and converts them into electrical signals. The microchip adjusts these signals to comply with the programming set up by your hearing care provider, and then they’re converted back into soundwaves and transmitted to your ear through the speaker. Unlike analog devices, digital hearing aids are sophisticated enough to identify particular sounds, like someone’s voice, and amplifies that sound while decreasing all other noises around you. Some hearing aids also include additional components that don’t alter this process, such as extra microphones, Bluetooth, volume switches, program buttons, ear hooks, and a battery hatch.

Although all hearing aids work the same way, that doesn’t mean that they come with the same features. For example, canal hearing aids have less programs you can cycle through and they usually don’t have Bluetooth capabilities, since, as Dr. Arroyo explains, “The chassis is way smaller and so the circuitry has to be placed closer together, and that’s why they’re usually less potent and have less features. Some of them have Bluetooth, but most don’t.”

BTE’s, on the other hand, have a bigger chassis and can include Bluetooth, extra microphones, and even lithium-ion rechargeable batteries. These two hearing aid styles have their own strengths and weaknesses, so we’ve broken down their components and their pros and cons into the following diagram.

How to Get Hearing aids:

Getting a hearing aid can be as easy as buying a direct-to-consumer device, but you should follow these steps to ensure that what you’re getting will actually help you and not just give you a temporary fix. Money-wise, hearing aids can be a great investment, but if you know what you’re doing, you can save up from the moment you make your purchase.

Consult a reputable Hearing Care Professional:

Your first step is to consult a licensed professional, like an audiologist or an otolaryngologist. They have the means and the expertise to diagnose the severity of your hearing loss, as well as inform you of the best solutions available for your particular situation. However, when you consult a hearing care professional, you need to make sure that they conduct what is known as Real Ear Measurements, as this guarantees that your hearing aid will be fine-tuned to the best of its capabilities. 

“Real ear measurements are how we verify that hearing aids are programmed correctly to a patient’s hearing loss prescription,” said Dr. Olson, “Without performing real ear measurements, hearing aid programming is basically a guessing game. Your ear canals are different from everybody else’s ear canals on the planet; it’s just like a fingerprint. So, it becomes this verification method to ensure that your hearing aid achieves the proper amount of audibility that you need.”

There may be cases where real ear measurements won’t hit your exact prescription, but the process assures that the hearing care provider maximizes the benefits you receive from your hearing aids.   

Plan Ahead

Since hearing aids can cost from $1,000 to $6,000 for a single device, you need to plan how to tackle their price from the moment of purchase to the time they need replacing. When well-maintained, a hearing aid can last up to seven years, so this is a good timeline for you to plan financially for your hearing aids. First, know the length of the manufacturer’s warranty and extend it according to your budget. Normally, manufacturer warranties last for one year and they don’t include loss and damage protection, but you can extend warranty lengths and add extra protection at a price. Having your hearing aids under warranty is crucial, since paying for repairs or even buying a new hearing aid can really dent your wallet.  

Second, check to see if your hearing care provider lets you upgrade your hearing aid to a new model, or if they have discounts for trading in your old hearing aids. Not only will you be receiving a better hearing aid for cheaper, but you’ll also free yourself from having to keep old models around your home for no reason.

Third, search whether or not your health insurance can partially or fully pay your hearing aids. Insurance companies usually don’t cover hearing aids, but instead cover part of the costs or other expenses, like clinic visits, batteries, and RIC receivers. Since every health plan is different, you should contact them personally or by phone to confirm whether or not they’ll be able to assist you.

Another possibility is to check whether your hearing care provider offers payment plans for hearing aids, as this will ease the initial payment of the device. Both traditional and direct-to-consumer hearing aids can offer payment plans, so don’t shy away from asking them. “Private health insurance can help a lot, usually they’re able to pay part or even all of your device expenses. But if the patient’s insurance doesn’t cover it, we always do our best to help out the patient with financing,” said Dr. Arroyo.

Check for Financial Assistance:

If you’re unable to pay for your hearing aids, there are various national organizations and federal programs that can help you obtain hearing aids. Each of these organizations has its own requisites and restrictions, so it’s important to read them to see if you qualify. For example, the Starkey Hearing Foundation’s “Hear Now” program only considers people with a low annual or monthly income, who also don’t have funds invested in money market accounts, IRAs or CDs. Here is a list of some programs that offer hearing aids at a price, or even for free, if you meet their requisites:

• Audient Alliance Audient Program
• Easterseals Hard of Hearing and Deaf Services
• Hearing Charities of America's "The Hearing Aid Project."
• Medicaid Benefits per state
• Military Audiology Association "Retiree Assistive Listening Devices (RALD)" program
• Starkey Foundation Hear Now program

Technology-Level Programs

We discussed technology level pricing in the methodology section, but we didn’t mention the programs that are included with each level. This chart breaks down the standard programs included per level, although you should remember that they can always vary per model and brand. Also, be aware that hearing aid companies tend to change program names just to make their products seem unique. For example, a company might list a hearing aid program named “Ultrafocus 360”, when in reality it’s just a program that reduces background noise. 

Companies might also claim that their programming is far superior to other devices, but as Dr. Olson stated, “I wouldn’t get caught up in the ‘what does this or that manufacturer have from a noise reduction standpoint,’ they all generally use the same types of noise reduction, maybe there’s a small difference in the methodology of how they employ it, but at the end of the day they come with their marketing terms for it, but there’s not a whole lot of difference there.”

Channels vs. Bands

Did you notice the channel and band amounts in the chart above? These are features that improve sound and frequency quality. Channels are used by a hearing aid’s microchip to divide frequency levels into more processable blocks. This, in turn, helps programs, like noise cancellation and background noise reduction, to recognize and reduce bothersome noises. Channels, on the other hand, are used directly by hearing care providers to adjust sound frequencies to your hearing loss prescription. This means that the more bands a hearing aid has, the more precise its fine-tuning can be. Think of channels and bands as a TV screen resolution: a higher number means that the TV can produce a more detailed image. 

However, for hearing aids, it’s best to have more bands than channels, since, as Dr. Olson said: “Research would suggest that having additional channels, like anything above 18 channels doesn’t help, because the amount of benefit becomes smaller and smaller for each channel that is added, and you get diminishing returns… With bands, I subscribe to the belief that the better I can customize the device for my patient’s hearing loss, the better they will ultimately perform.”

If you can afford the highest technology level for your hearing aid, then there shouldn’t be a problem with bands and channels. But if you can’t spend as much or if you want to save by purchasing a lower technology tier, you should consult your hearing care professional to see how many channels and bands you would actually need to optimize your prescription.  

Consider learning ASL

If you have severe to profound hearing loss, if your hearing loss keeps increasing year by year, or if you would like to learn something new and unique, an engaging alternative is to learn American sign language (ASL). Not only will you learn a new language altogether, but you’ll also be able to communicate with a community that understands hearing loss and deafness, and that can help you stay active and motivated through years to come. 

Just like with any other language, learning ASL takes time and practice, so determination is key. If you’re interested in learning ASL, you can search for ASL courses near your area. There are many places you can learn ASL from, including local and state colleges, community centers for the Deaf, and speech and hearing centers.