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A Smarter Way to Shop for a Hearing Aid

Have you ever suspected you might benefit from a hearing aid but then decided against it? You’re not alone.

Less than 30 percent of adults 70 and older with hearing loss have worn hearing aids, according to the National Institutes of Health. At least half of the people who could benefit from one say they haven’t gotten around to it because of the price.

But delaying treatment won’t make the problem go away. “By the time people come in for a hearing test, they often have significant hearing loss,” says Lee Akst, M.D., director of the Johns Hopkins Voice Center and assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore.

If you’re tired of suffering in silence, our guide will help you find the best hearing aids and treatment for you without spending too much along the way.

Step 1. Get tested

Start off by visiting your primary care doctor for a basic screening. “This will show if you need further diagnostic evaluation,” says Neil DiSarno, Ph.D., chief staff officer for audiology at the American Speech-Language-Hearing Association. Medicare Part B covers the cost of a diagnostic hearing exam if your doctor orders one.

Next, visit a specialist for a hearing test. You will sit in a soundproof booth and wear earphones; the test could take 20 minutes to 1 hour, depending on your needs. Here’s what you should receive after your test, according to the Hearing Loss Association of America, a nonprofit advocacy and education group:

A copy of the test results, called an audiogram, which is in chart form

What your audiogram means

An explanation of what type of hearing loss you have

Questions about the effect of hearing loss on your life

Why you sometimes can “hear” but not understand

What hearing aids can and can’t do

Step 2. Know where to shop

Compare cost and services among different hearing care providers—because prices can vary greatly. A Consumer Reports fall 2015 survey of more than 131,000 of its subscribers with hearing problems found that people spent an average of $2,710 out of pocket, and 16 percent paid $5,000 or more.

That’s because health insurance usually doesn’t cover the entire cost, though if you have a flexible spending account through your job, you can use $2,600 in pretax money to help buy hearing aids in 2017.

Medicare doesn’t cover them, but some Medicare Advantage plans might. Eligible veterans can get free hearing aids through a Veterans Health Administration medical center or clinic.

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One strategy worth trying is to first find an audiologist who will “unbundle,” or separate the cost of the hearing aid itself from the price of fittings and follow-up care. Most audiologists sell hearing aids and adjustments as a package, but DiSarno sees a new trend emerging. “More and more offices are unbundling,” he says. “If you don’t need as much rehabilitation, you may not need as many visits.”

Consumer Reports subscribers gave top marks to Connect Hearing, a nationwide chain of stores that specialize in hearing aids, and Costco. Respondents gave both places very good to excellent ratings for hearing evaluations, discussion of options, follow-up services, and staff courtesy.

Some university medical centers have audiology clinics that offer discounted hearing aids. You’ll be treated by a faculty audiologist who is supervising doctoral audiology students.

“We have options for every budget,” including two hearing aids for less than $1,000, says Stephanie Sjoblad, Au.D., professor at the University of North Carolina at Chapel Hill School of Medicine.

Some nonprofit organizations provide financial assistance for hearing aids. To find help, call the National Institute on Deafness and Other Communication Disorders at (800) 241-1044 or write: NIDCD Information Clearinghouse, 1 Communication Avenue, Bethesda, MD 20892-3456.

Step 3. Get a comprehensive needs assessment

Talk to a hearing health professional about what you can expect from a hearing aid. Do you have difficulty hearing lectures, movies, television, or music? Or is your biggest challenge a phone conversation?

“We spend time reviewing a patient’s lifestyle to find out where they hope to hear better and if there are situations they avoid because they don’t hear well,” Sjoblad says. The type of hearing aid you get should reflect the environments you’re in most of the time.

Some hearing aids are better at screening out background noise, while others excel at enhancing music or soft speech. “It’s a complex process because each person’s individual, unique communication needs should inform their choice,” says Cynthia Compton-Conley, Ph.D., professor of audiology at Gallaudet University in Washington, D.C.

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Also discuss with your provider which of several different hearing aid styles is best for your needs. Each has advantages and disadvantages. Keep in mind that fancy features like Bluetooth capability may make it more expensive. Here are the two main styles:

• Behind-the-ear (BTE). The most common, this type made up 82 percent of all hearing aid sales in 2016, according to Carole Rogin, president of the Better Hearing Institute, the educational arm of the Hearing Industries Association. BTEs are connected to the ear by a nylon wire that feeds the sound into your ear through a small plastic dome that sits on the end of the wire and fits into the canal.

Sjoblad says BTEs are popular because they offer directional microphones, which make the audio signal in front of you louder than the noise in the back or from the sides, enabling you to be more successful at screening out background noise.

About two-thirds of BTEs sold are receiver-in-the-canal (RIC) instruments. They look the same, but the receiver (the speaker that sends sounds to the inner ear) is placed in the ear canal, closer to the eardrum, allowing for better speech discrimination.

Besides being more comfortable and attractive than other styles, Rogin says, RICs are more likely to have wireless connectivity, which can deliver sound directly to the hearing aid from various sources, such as your television and hearing-aid-compatible phone.

They are also more likely to offer a telecoil, a small copper wire that can pick up sound directly from telephones and public places with Assistive Listening Systems, such as theaters, auditoriums, and sports stadiums.

• In-the-canal (ITC). This type accounted for 13 percent of total sales in 2016, a reversal from about 15 years ago, when it made up 80 percent of sales, Rogin says. An ITC hearing aid is custom molded and sits deep in the canal, making it less noticeable. Some can include directional microphones.

Step 4. Obtain a real ear measurement

One of the best practices that is frequently overlooked is getting a real ear measurement, where a probe microphone is inserted into the ear to determine the actual performance of a hearing aid after it’s fitted.

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“Real ear measurement enables you to find out what’s actually happening inside the ear,” Sjoblad says. “Just programming a hearing aid to a patient’s hearing loss doesn’t take into account the patient’s ear canal acoustics. If we don’t make the sounds audible, the patient will not hear, even with the best technology. Our clinic uses real ear measurement 100 percent of the time, and good rehabilitative audiologists will include it as part of their standard fitting protocol.”

To find out more

HearingTracker. Not affiliated with any manufacturer, it collects reviews of hearing aids and indicates whether a practice meets the gold standard of care and uses real ear measurement.

HearingAidForums. An independent, ad-free consumer forum about hearing aids. It offers hundreds of reviews of different brands and sellers, with in-depth information from users, many of whom are audiologists and sound engineers.

Find out which hearing aids to avoid and whether an over-the-counter amplifying device could be a good fit for you.

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