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Hearing Aid Buying Guide

How hearing aids work

Hearing aids use the same basic parts to carry sounds from the environment into your ear and make them louder. Most hearing aids are digital, and all are powered with a hearing aid battery.

Small microphones collect sounds from the environment. A computer chip with an amplifier converts the incoming sound into digital code. It analyzes and adjusts the sound based on your hearing loss, listening needs and the level of the sounds around you. The amplified signals are then converted back into sound waves and delivered to your ears through speakers.

Hearing aid styles

Hearing aids vary a great deal in price, size, special features and the way they're placed in your ear. The following are common hearing aid styles, beginning with the smallest, least visible in the ear. Hearing aid designers keep making smaller hearing aids to meet the demand for a hearing aid that is not very noticeable. But the smaller aids may not have the power to give you the improved hearing you may expect.

Completely in the canal (CIC) or mini CIC

A completely-in-the-canal hearing aid is molded to fit inside your ear canal. It improves mild to moderate hearing loss in adults.

A completely-in-the-canal hearing aid:

  • Is the smallest and least visible type
  • Is less likely to pick up wind noise
  • Uses very small batteries, which have shorter life and can be difficult to handle
  • Doesn't contain extra features, such as volume control or a directional microphone
  • Is susceptible to earwax clogging the speaker

In the canal

An in-the-canal (ITC) hearing aid is custom molded and fits partly in the ear canal. This style can improve mild to moderate hearing loss in adults.

An in-the-canal hearing aid:

  • Is less visible in the ear than larger styles
  • Includes features that won't fit on completely-in-the-canal aids, but may be difficult to adjust due to its small size
  • Is susceptible to earwax clogging the speaker

In the ear

An in-the-ear (ITE) hearing aid is custom made in two styles — one that fills most of the bowl-shaped area of your outer ear (full shell) and one that fills only the lower part (half shell). Both are helpful for people with mild to severe hearing loss.

An in-the-ear hearing aid:

  • Includes features that don't fit on smaller style hearing aids, such as a volume control
  • May be easier to handle
  • Uses a larger battery for longer battery life
  • Is susceptible to earwax clogging the speaker
  • May pick up more wind noise than smaller devices
  • Is more visible in the ear than smaller devices

Behind the ear

A behind-the-ear (BTE) hearing aid hooks over the top of your ear and rests behind the ear. A tube connects the hearing aid to a custom earpiece called an earmold that fits in your ear canal. This type is appropriate for people of all ages and those with almost any type of hearing loss.

A behind-the-ear hearing aid:

  • Traditionally has been the largest type of hearing aid, though some newer mini designs are streamlined and barely visible
  • Is capable of more amplification than are other styles
  • May pick up more wind noise than other styles

Receiver in canal or receiver in the ear

The receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles are similar to a behind-the-ear hearing aid with the speaker or receiver in the canal or in the ear. A tiny wire, rather than tubing, connects the pieces.

A receiver-in-canal hearing aid:

  • Has a less visible behind-the-ear portion
  • Is susceptible to earwax clogging the speaker

Open fit

An open-fit hearing aid is a variation of the behind-the-ear hearing aid with a thin tube. This style keeps the ear canal very open, allowing for low-frequency sounds to enter the ear naturally and for high-frequency sounds to be amplified through the hearing aid. This makes the style a good choice for people with mild to moderate hearing loss.

An open-fit hearing aid:

  • Is less visible
  • Doesn't plug the ear like the small in-the-canal hearing aids do, making your own voice sound better to you
  • May be more difficult to handle and adjust due to small parts

Additional features

Some hearing aid optional features improve your ability to hear in specific situations:

  • Noise reduction. All hearing aids have some amount of noise reduction available. The amount of noise reduction varies.
  • Directional microphones. These are aligned on the hearing aid to provide for improved pick up of sounds coming from in front of you with some reduction of sounds coming from behind or beside you. Some hearing aids are capable of focusing in one direction. Directional microphones can improve your ability to hear when you're in an environment with a lot of background noise.
  • Rechargeable batteries. Some hearing aids have rechargeable batteries. This can make maintenance easier for you by eliminating the need to regularly change the battery.
  • Telecoils. Telecoils make it easier to hear when talking on a telecoil-compatible telephone. The telecoil eliminates the sounds from your environment and only picks up the sounds from the telephone. Telecoils also pick up signals from public induction loop systems that can be found in some churches or theaters, allowing you to hear the speaker, play or movie better.
  • Wireless connectivity. Increasingly, hearing aids can wirelessly interface with certain Bluetooth-compatible devices, such as cellphones, music players and televisions. You may need to use an intermediary device to pick up the phone or other signal and send it to the hearing aid.
  • Remote controls. Some hearing aids come with a remote control, so you can adjust features without touching the hearing aid.
  • Direct audio input. This feature allows you to plug in to audio from a television, a computer or a music device with a cord.
  • Variable programming. Some hearing aids can store several preprogrammed settings for various listening needs and environments.
  • Environmental noise control. Some hearing aids offer noise cancellation, which helps block out background noise. Some also offer wind noise reduction.
  • Synchronization. For an individual with two hearing aids, the aids can be programmed to function together so that adjustments made to a hearing aid on one ear (volume control or program changes) will also be made on the other aid, allowing for simpler control.

Before you buy

When looking for a hearing aid, explore your options to understand what type of hearing aid will work best for you. Also:

  • Get a checkup. See your doctor to rule out correctable causes of hearing loss, such as earwax or an infection. And have your hearing tested by a hearing specialist (audiologist).
  • Seek a referral to a reputable audiologist. If you don't know a good audiologist, ask your doctor for a referral. An audiologist will assess your hearing and help you choose the most appropriate hearing aid and adjust the device to meet your needs. You may get best results with two hearing aids.
  • Ask about a trial period. You can usually get a hearing aid with a trial period. It may take you a while to get used to the device and decide if it's right for you. Have the dispenser put in writing the cost of a trial, whether this amount is credited toward the final cost of the hearing aid, and how much is refundable if you return the hearing aid during the trial period.
  • Think about future needs. Ask whether the hearing aid you've chosen is capable of increased power so that it will still be useful if your hearing loss gets worse.
  • Check for a warranty. Make sure the hearing aid includes a warranty that covers parts and labor for a specified period. Some offices may include office visits or professional services in the warranty.
  • Beware of misleading claims. Hearing aids can't restore normal hearing or eliminate all background noise. Beware of advertisements or dispensers who claim otherwise.