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Hearing aids

Hearing aid buying guide

Last updated: June 2014

Getting started

If you're older than 45, there's about a one in five chance you suffer from some amount of hearing loss--and that rate climbs steadily as you age. Almost one-third of people ages 65 to 74 report difficulty hearing, and the number rises to about half at 75, according to the National Institute on Deafness and Other Communication Disorders.

Hearing loss can wreak havoc with your social life, causing you to avoid activities such as going to restaurants or parties. It can also increase your risk of falls, possibly by making you less aware of your surroundings and impairing balance, and it can make driving dangerous. A recent study at Johns Hopkins University even linked untreated hearing loss to a higher risk of developing dementia.

What causes hearing loss

Most cases of hearing loss in adults stem from damage to the inner ear, where tiny hair cells turn sound vibrations into impulses that nerve cells then carry to the brain. The most common causes of that damage are aging and chronic exposure to loud noises--think rock concerts, sports events, and lawn mowers. A family history of severe hearing loss could signal that you're at increased risk. So does being male.

A second, easier-to-treat type of hearing loss originates in the middle or outer ear and stems from reversible problems such as impacted earwax, fluid buildup from an infection, or the use of certain medications. Older adults often have a mix of both types of loss.

If you're experiencing signs of hearing loss (or have been told as much by a concerned family member), first see a board-certified otolaryngologist--an ear, nose, and throat physician who will check for impacted earwax and other reversible causes. If none are found, the doctor will probably refer you to an audiologist, a professional who specializes in testing and treating hearing problems.

The new hearing helpers

Once hair cells in the inner ear are dead, there's no bringing them back to life. But hearing aids and other devices can dramatically improve your ability to hear and carry on a normal life. Consumer Reports scanned the marketplace and consulted hearing experts to help you determine which are worth considering.

Digital hearing aids. Unlike older hearing aids, which amplified the volume on everything (including background noise), today's digital models have microphones that transmit sound to a computer chip, which moderates the volume and amplifies the frequencies needed to help improve your hearing. They can be programmed to filter out wind and other background noises, and some can sync up wirelessly with Bluetooth to your smart phone, enabling you to hear calls through the hearing aid and to use your phone to adjust the aid's settings. Some accessories also allow you to stream audio from your MP3 player, laptop, or TV right to your hearing aid.

Another boon for people with hearing aids is a technology called the Hearing Loop. It provides a magnetic signal that's picked up by a tiny coiled wire in the hearing aid, which transmits the sound into the wearer's ear. It's available in some sports and concert venues.

Smaller size in aids is another innovation. You can find aids that fit in the ear canal and are barely visible--though you may give up some features and power.

How to choose: Depending on the sophistication of the device and where you get fitted, expect to pay $1,000 to $6,000 for a pair of custom-fitted hearing aids. Medicare and most private insurers don't cover hearing aids, but check your health plan. Veterans may be eligible to get free hearing aids at their local Veterans Affairs facility.

Personal sound amplifiers (PSAPs). These over-the-counter products generally have fewer features and less functionality than hearing aids, although some of the technology may be similar. They're sold online and at some mass retailers, and can be a lower-cost solution for people with mild hearing loss who aren't ready to spring for a prescription hearing aid, according to Barbara E. Weinstein, Ph.D., professor of audiology at the City University of New York. The Food and Drug Administration cautions that PSAPs aren't designed for people with hearing loss, but rather for people who want to amplify certain sounds--and they aren't subject to the same safety and effectiveness standards that hearing aids are. So consult an audiologist first if you're considering one.

How to choose: Options range from behind-the-ear models (about $25 to $500) to in-ear models such as The Bean ($375 and more), which claims to amplify hard-to-hear sounds, including soft voices, while lowering the volume on loud noises. Ask your audiologist which type might make sense for you.

Assistive listening devices. If you need just a little help with hearing, there are a number of low-cost listening devices to aid you. They include apps that let you amplify sound with your smart phone and earbuds, and portable wireless devices that let you listen to your TV and other audio devices with earphones. You can also find amplified, flashing, or vibrating versions of basic household items such as telephones, alarm clocks, and doorbells.

How to choose: You can buy listening aids for smart phones and other electronics at many websites. Prices range from about $80 to $900. Amplified or flashing household items cost about $40 to $300.

Types

In our hearing-aids comparison, we found that the ideal one for you depends on the severity of your hearing loss, your lifestyle, and your manual dexterity. Hearing aids are categorized by the place on the ear they are worn, and possibly by the number of pieces (behind-the-ear aids are two pieces; an in-the-ear aid is one piece). Smaller aids offer fewer features and might be more difficult to manipulate. People with more severe hearing loss might get better results with a behind-the-ear model with earmolds or an in-the-ear model. In our survey, owners of behind-the-ear, open-fit designs reported the most improved hearing in loud social settings. Prices listed below are for a single hearing aid and usually include professional services, such as evaluation, selection, fitting, training, and care. Make sure you know what the price includes before buying. Note that more features usually means higher costs.

Behind-the-ear


The receiver is inside the ear canal. It goes by various acronyms: behind-the-ear (BTE), receiver in the ear (RITE), receiver in the canal (RIC or RITC), and canal receiver technology (CRT). It has a banana-shaped case and a piece that inserts into the ear canal. Behind-the-ear hearing aids attach to the ear via a custom-made earmold that fits snugly in the ear, or a "dome style" or non-custom canal piece.

Pros: Comfortable, barely visible. Prevents a plugged-up feeling, easy to insert, and compatible with telephones. You usually can get a hearing aid in one day, because custom earmolds are not necessary.

Cons: Wax and moisture may limit life of receiver. Does not allow for significant amplification in the low frequencies. Limited in terms of the potential to add amplification.

Price: $1,850 to $2,700

Standard-tube or thin-tube behind-the-ear


Pros: Also called receiver in the aid, or RITA, it can provide considerable low- and high-frequency amplification. Good for people with moderately severe to severe hearing loss who require considerable amplification across many frequencies. On larger models, controls are easy to manipulate and telecoil mode is easily selected and used. Earmold can be easily cleaned. Accommodates larger batteries, so it's easier to handle.

Cons: Custom mold tends to be visible. Vulnerable to sweat and wax buildup. Plugged-up feeling from earmold unless vented.

Price: $1,200 to $2,700

Completely in the canal


Pros: This hearing aid does not need telecoil. Low visibility, ease of insertion and removal, and insensitive to wind noise.

Cons: Too small to include a directional microphone. Ear might feel plugged up unless hearing aid is vented. Vulnerable to wax and moisture. Because the receiver is in the ear canal, it could be difficult to control. It can only accommodate a small battery, so battery life is relatively short. Batteries can be more difficult to insert and remove.

Price: $1,365 to $2,860

In the canal


Pros: Barely visible and easy to insert, it can build up volume control to increase ease of use. Larger units can include directional microphones.

Cons: Same issues as with completely-in-the-canal models, though less severe. Telecoil selector switch makes manipulation more difficult. These models are susceptible to moisture and wax buildup. Battery tends to be smaller, so battery life is relatively short.

Price: $1,300 to $2,750

In the ear


Pros: This offers more room for features such as telecoil, directional microphone, and volume control. Less of a plugged-up feeling when vented. Relatively easy to insert.

Cons: More visible. Vulnerable to wax build-up and moisture.

Price: $1,200 to $2,700

Editor's Note: Price source: Hearing Journal, 2008.

Illustrations: Aaron Ashley

Features


We evaluated major features of 44 hearing aids of varying styles and brands. We also asked our 1,100 survey respondents which hearing-aid features they had and how well their aids worked in various settings. Selected features may increase the price of a hearing aid.

Telecoil

A telecoil is a small wire that enables the hearing aid to pick up signals from the telephone. Our survey suggested it helped. Our tests, performed in an outside lab, found all telecoils were effective.

Telecoils also can be used in rooms equipped with an audio induction loop (also known as a hearing loop or room loop), a cable that circles a room and emits a magnetic signal to the hearing aid. They help reduce noise and reverberation, and can enhance the ability of people with moderate to profound hearing loss to understand what they're hearing.

A telecoil can be manual or automatic, but to use it with a loop, it must be manual. Look too, for a program selector on the hearing aid to allow users to switch between the acoustic signal from phones and the magnetic signals of room loops.

Directional microphone

A directional microphone helps you converse in noisy environments by making the audio signal in front of you louder than the noise in the rear or from the sides. Many hearing aids come with switchable directional and omnidirectional modes; that's a plus unless the user has difficulty switching between the two. A negative feature of a directional microphone: It's prone to wind noise. Survey results show it helps in loud social settings, while listening to the TV or radio when there is noise in the rear or off to the sides, and for hearing household noises.

Feedback suppression

Feedback suppression, or digital feedback reduction, uses a power-on delay to help quell squeals when inserting the hearing aid. Most aids have this feature. It's useful if the hearing aid is close to the telephone, or if the hearing aid displaces slightly when you move your jaw. Another advantage: You can raise the volume without having to worry about feedback.

Other hearing-aid features worth noting

  • Digital noise reduction improves listener comfort and sound quality in noisy environments. For many, it also may improve speech understanding in noise.
  • Low-battery indicator sounds to alert you that it's time to change batteries. Most newer hearing aids have this feature.
  • Wax guard helps keep the aid free of ear wax, a cause of malfunctions and a major complaint of our survey respondents. Ask the hearing-aid dispenser to teach you how to remove and replace the wax guard, and how often you'll need to change it.
  • Automatic volume control (compression) provides more amplification for low sound levels than high sound levels, which prevents high sound levels from being intrusively loud. Most aids had this feature.
  • Vents are tiny tunnels in ear molds or the one-piece hearing aids that sit in the ear. They help minimize the stuffed-up sensation one feels when wearing hearing aids. They could contribute to improved speech understanding, depending on the vent size.
  • Manual volume control lets you adjust the volume to your preferences in a given environment. Some hearing aids have a self-learning feature that automatically adjusts the hearing aid amplification based on how they're typically used.

Behind-the-ear models only

  • Bluetooth capability allows hands-free use of cell and regular phones, and streaming from the television.
  • Direct audio input allows the aid to be connected by cable to FM systems (effectively, mini-radio stations used in an enclosed space, specifically for hearing-aids users); MP3 players; and other audio devices.

Shopping tips

This consumer checklist is drawn from our Consumer Reports testing and shopping experience, our audiology consultants, and from the resources of the Hearing Loss Association of America, an advocacy and support group. Ideally, you should make sure the provider offers what's listed below:

1. Initial visit to the provider (typically an audiologist or hearing aid/instrument specialist)

The provider or the office:

  • Has convenient business hours.
  • Makes it easy to schedule an appointment.
  • Describes the provider's training and experience, and provides a business card with this information.
  • Provides information on demand on up-to-date state licenses.
  • Offers walk-in repair service.

You:

  • Bring a family member, significant other, or friend.
  • Take notes during visits.

2. Medical clearance and other basics

The provider:

  • Requires a medical examination, or asks if your ears have been checked recently by an ear, nose, and throat doctor or other licensed physician.

OR:

  • Has you sign a waiver required by the Food and Drug Administration in lieu of a medical exam. (The waiver allows you to exercise the right to make your own decisions but only after stating, for example, that your best health interests would be served if you had a medical evaluation by a licensed physician before purchasing a hearing aid or aids.)

3. Testing and lifestyle information

The provider:

  • Discusses with you the effect of hearing loss on your lifestyle and relationships at home, work, school, or when going out, for example (or has you complete a questionnaire). The questions should include how well you hear conversations on the telephone.
  • Asks about your manual dexterity (your ability to handle small batteries or controls, for example) and/or vision problems that might affect your ability to handle hearing aids.
  • Gives you the opportunity to discuss your lifestyle, interests, and activities, which might affect the choice of styles and features.
  • Gives you the opportunity to discuss the listening situations, such as noisy or large rooms, theaters, or meetings, in which you have the most difficulty hearing.
  • Tests your hearing in a soundproof booth and conducts other hearing tests (to gauge your ability to understand certain words and sentences, for instance).
  • Gives you a copy of the hearing test results and fully explains them.
  • Discusses realistic expectations (what hearing aids will and will not do).

4. Picking brands, styles, features, and controls

The provider:

  • Mentions which hearing-aid brands he or she works with, and why he or she recommends a particular brand for you.
  • Reviews the pros and cons (including cost trade-offs) of different hearing-aid styles and features (such as Bluetooth, remote control, telecoil, feedback suppression, noise reduction, and manual-volume control).
  • Considers your personal preferences concerning style, aesthetics, color, cost, and features.

You:

  • Bring a family member, significant other, or friend.
  • Take notes during visits.

5. Picking up your new hearing aid

Testing:

  • The provider conducts a real-ear test to properly adjust the aid as well as other tests of hearing and understanding speech in quiet and noisy environments.

6. Use and maintenance

The provider:

  • Asks you if the aid and/or ear molds fit comfortably, and makes necessary adjustments while you wait.
  • Discusses the battery type for your hearing aid, battery life, the handling of batteries, where to buy them, where to store them, and the importance of keeping spare batteries handy.
  • Explains controls (for volume and program changes, for instance) and has you practice using them.
  • Discusses what squealing (feedback) means, and what to do about it.
  • Reviews how to insert the aids, including discerning right from left.
  • Teaches you how to clean and store the hearing aids and keep them free of wax.
  • Explains precautions, such as not getting the units wet and removing them during radiological and other diagnostic testing.
  • Has you practice using the telephone with your aids.
  • Discusses why you don't need a telecoil (if your chosen aid doesn't have the feature).
  • Outlines a schedule for wearing the aids until you get used to them.
  • Advises you to keep track of when and where the aids help and don't help, so adjustments can be made.

7. Financial issues and contract details

You:

  • Get a written contract detailing the cost of the aids, the cost of the provider's services, the number of follow-up visits included in the cost, the brand and model of the hearing aids, and the date and place of sale.
  • Try bargaining for a lower price with the provider, or ask for a lower-priced model.

The provider:

  • Helps you determine what your health insurance will pay toward the aids.
  • Mentions other potential ways to offset the cost of your hearing aids.
  • Offers to sell you loss/damage insurance that will go into effect when the warranty expires.

8. Disclosure

The provider:

  • Explains and offers written information about the trial period, fees charged if you return the aids within the trial period, options for trying a different model, and whether the trial period is suspended if you have to wait for a repair.
  • Explains the length of the warranty period and what is and is not covered (e.g., replacing a lost aid and repairing or replacing a nonfunctioning ones).
  • Offers to be flexible about the trial period and/or other aspects of purchase.
  • Gives you a copy of the product brochure and reviews its contents with you in detail.
  • Schedules a follow-up appointment with you to make sure everything is working properly.
  • Calls you at home a few days after the initial fitting to see how you are doing.

9. Proper fitting, adjustment

The provider:

  • Conducts verification tests, including a real-ear test. This test, also called a real-ear measure, involves placing a thin probe in your ear while you're wearing your hearing aid to measure the match between your hearing loss and the response of your hearing aid.
  • Asks you how the hearing aids improve your understanding of others at home, at work, in meetings, in restaurants, and in other quiet and noisy situations.
  • Answers your questions and concerns about any discomfort and/or difficulty of use.
  • Makes adjustments to the aids based on your comments.
  • Teaches you troubleshooting strategies to fix problems yourself.
  • Reviews use and maintenance tips.

10. Using hearing aids with other technologies

The provider:

  • Discusses the compatibility of your aids with cell phones and other cordless phones.
  • Discusses using or supplementing your hearing aids with assistive listening devices such as FM and infrared systems, and audio loops.
  • Mentions other assistive and safety devices, such as light-up doorbells, special smoke alarms, and vibrating alarm clocks.

11. Other support

  • The provider offers group hearing-aid orientations.
  • You go to orientations or plan to go.
  • You join a support group in your area and/or online.

Select a hearing-aid provider

If you are a veteran, first dermine whether you are eligible to get your aids at your nearest Veterans Affairs facility. The 13 percent of survey respondents who went to the VA gave it high scores across the board.

For everyone else, our suggested choice is a medical office headed by an otolaryngologist (an ear, nose, and throat physician) who employs an audiologist.

About one in five survey respondents got their hearing aids from a doctor's office. They gave those providers higher marks on their thoroughness in evaluating hearing loss than did respondents who went to other types of providers. Another plus: An ear doctor can rule out medical conditions such as a tumor or bacterial infection in the ear that might be affecting your hearing. He can also clear your ears of wax so that you're ready for your hearing test.

Medicare will cover the medical exam and an audiologist's test if ordered by a physician. Some private Medicare Advantage plans might cover part of the hearing-aid cost. People with other types of private insurance should check with their carriers because coverage might vary.

If you can't find a conveniently located doctor's office that dispenses aids, consider an independent hearing-aid provider. Thirty percent of respondents got their aids from that type of provider, which is usually staffed by non-M.D. hearing professionals. We consider it important to have some choice of brands, and independent providers generally carry two to four different ones. (The Food and Drug Administration requires patients to have a physician's exam before acquiring a hearing aid but lets adults who don't want one sign a waiver.)

The professionals you might encounter at independent hearing-aid providers could fall into two categories: audiologists and hearing-aid specialists (also called hearing-instrument specialists).

Both types of professionals can evaluate your hearing and fit your hearing aids. But their training varies significantly. Newly minted audiologists must have a doctoral degree (generally the Au.D.), pass national and sometimes state tests, and have more than 1,000 hours of clinical training. Hearing-aid specialists generally have from six months to two years of supervised training or a two-year college degree and in most states must pass licensing tests. They can also seek national certification.

You might not necessarily know when you walk in the door which professional you are dealing with. Our shoppers occasionally encountered two or three types working at the same office. Our survey respondents had a difficult time even making distinctions among professionals; 87 percent said they'd visited audiologists, though many had gone to vendors known in the industry to be staffed primarily with hearing-aid specialists.

Does it matter whether the office is staffed by an audiologist or a hearing-aid specialist? Audiologists have broader training and, unlike hearing-aid specialists, can treat auditory conditions that might be better addressed without hearing aids, such as balance problems.

But both types of professionals made mistakes in fitting the aids purchased by our 12 shoppers. Audiologists made fewer serious fitting errors than did hearing-aid specialists, but in about two-thirds of all of the fittings, patients ended up with incorrect amplification.

Consider practical things, too. Check with your state to make sure the professionals' licenses are current, and with the Better Business Bureau or state attorney general's office for complaints.

Make sure the location and office hours are convenient. Ask whether the office does walk-in repairs. Ask about hearing-rehabilitation services or support groups.

Understand the product

Digital hearing aids, which have captured more than 90 percent of the market, come in five major types (see "Which Type Is Best for You?"). In those aids, sound goes in the microphone and is digitally processed by a chip, amplified, and delivered into the ear. Those aids also have features to modify that sound, making it more lifelike and correcting for other problems.

Because individuals' sound perception is, well, so individual, a hearing aid that thrills one person might seem just so-so to another with almost identical hearing-test results. Even within brands, there might be several versions of a model. That kind of variation makes judging hearing-aid models and brands almost impossible. "There are differences between brands, but they're not significant enough that you can say what are the best brands," says Todd Ricketts, Ph.D., associate professor of hearing and speech sciences at Vanderbilt University.

Our laboratory tests didn't compare brands, but we did evaluate features. Among the most useful were the telecoil and directional microphone. Don't pay for unnecessary features, as some of our shoppers were pressured to do. The more features you buy, the more you'll probably pay, but you might not need every one.

Even with features appropriate for you, you might need to temper your expectations. In crowds, for instance, your digital hearing aids will never completely eliminate jarring background noise. "It's going to bring people back to hearing, but because of the way we process sound, it's not going to bring them back to normal hearing," says audiologist Patricia Chute, dean of the School of Health and Natural Sciences at Mercy College in Dobbs Ferry, N.Y.

Get a thorough evaluation

A hearing-aid provider is only as good as her evaluations--how she determines your hearing loss and verifies that the prescribed aids work.

During your first visit, the provider will establish your hearing-loss profile with audiometry testing. You'll sit in a soundproof booth and indicate whether you can hear individual words piped into your headphone, as well as tones played at various pitches and volumes. A graph, called an audiogram, displays which parts of the sound spectrum you're having difficulty hearing so that the provider can calibrate your aid properly.

A good evaluation includes several other hearing tests, too; you might be asked to listen to speech while a noisy recording plays. You might be asked to repeat words the tester says, with and without being able to see her lips move. You might answer questions about how your hearing difficulty affects your everyday life.

You should also discuss your needs and lifestyle. Do you like to chat on the phone? Does your social life involve a lot of large gatherings or restaurant meals? One lesson from our shoppers: Don't count on the provider to ask those questions.

The provider should then show you a few models and ask you to choose. If your chosen style includes an earmold, she'll make an impression of your ear canal. You might have to pay a deposit.

When you return to pick up your aids, usually in a week or two, the provider should do several hearing tests to verify that they are working optimally. Of that battery of tests, one stands out as a must-have: the real-ear test, which measures the match between your hearing loss and the response of your hearing aid. "There is evidence that you get a better fitting with a real-ear test and people are more satisfied," says Todd Ricketts, Ph.D., associate professor of hearing and speech sciences at Vanderbilt University.

More than half of hearing-aid providers have real-ear testing equipment, but less than a quarter use it regularly, according to 2006 data from the Hearing Review, an industry publication. So make sure in advance that your provider will use it to verify your hearing aid's fit.

Be a smart buyer

Where we could verify the wholesale price of the aids we tested, the average markup was 117 percent, so there's room to bargain. Only 15 percent of our survey participants tried that, but more than 40 percent of those who tried succeeded. Cheryl Wruk, 62, a county board member from Crivitz, Wis., got her aids discounted to $1,500 from $1,750 by declining promotional extras such as a $100 gas debit card.

Make sure you clearly understand the terms: extra visits not covered by the hearing-aid price, length of warranty, the cost to replace a lost or damaged aid, the cost of batteries, the length of the trial period during which you can exchange or return your aids, and the return fee, if any. Make sure your contract allows you to return your aids and get all or most of your money back if you're not satisfied.

Consider your future needs; ask whether the chosen hearing aid has enough residual amplification to handle a hearing loss that gets worse.

Insist on having brand and style choices. Survey respondents gave lowest marks for choice and selection among all aspects of their shopping experience. Just less than half of our shoppers were not offered a choice of hearing-aid style. "They sold me a completely-in-the-canal model without asking if I minded using that style," a shopper reported to us.

Keep in mind that if you're not thrilled with the first provider's evaluation or personality, or want to see what other providers offer, you're entitled to a copy of your audiogram to shop elsewhere.

Before you leave with your new aids, practice inserting and removing the battery, cleaning and storing the aid, putting it into your ear, using its switches and controls, and using the telephone while wearing it. Most of our shoppers got no telephone training or help with volume controls.

Practice and follow up

Putting on new hearing aids is nothing like putting on new eyeglasses and being able to see clearly right away. "I thought that everything seemed too loud," a shopper said. "The audiologist said it takes time for my brain to get used to processing things I have not heard for a long time."

Although 26 percent of survey respondents never had a follow-up appointment, we strongly recommend scheduling at least one. Most providers include that service in their fee. Adjustments for a hearing-aid fitting might include changing the device's electronic settings, reworking an uncomfortable earmold, or getting a completely different hearing aid.

Practice everyday activities using the aids. "A hearing aid is not just an electronic device," says Brenda Battat, executive director of the Hearing Loss Association of America, a support and advocacy group. "It's part of a whole rehabilitative treatment." She suggests calling and listening to long-winded toll-free messages at the Social Security Administration or IRS.

Note any environments where you have problems. One of our shoppers, a musician, couldn't tolerate a flutter heard at certain pitches with the first set of aids he purchased. The provider told him that was just the way the aids sound. But the second pair our shopper purchased for our study worked fine, with no flutter.

A shopping summary

Where to go when buying hearing aids. Veterans, try the VA. Others, first consider a medical hearing practice that also dispenses hearing aids.

What to expect from the provider. An audiology degree or hearing-aid-specialist certification. A choice of several brands, styles, and features. Convenient hours. Walk-in repairs. Soundproof booth and several types of hearing tests. Real-ear test done at the fitting. Rehab classes or therapy after fitting. Flexible trial period. Money-back guarantee.

At the first visit. Discuss your activities and needs. Focus on features, not brand. Ask about a telecoil, directional mike, and feedback suppression. Ask for residual amplification. Insist on product choices.

At the fitting visit. Practice talking on the phone and other activities. Review the product manual, warranty, trial period, and return and repair policies.

At home. Practice using the hearing aids in different environments. If not satisfied, don't just leave them in a drawer. Return at least once for a follow-up check, and go back as often as needed thereafter.

Paying for your hearing aid

Unless you're a military veteran who qualifies for virtually free hearing aids from the U.S. Department of Veterans Affairs, you'll have to find a way to pay for them yourself.

Traditional Medicare excludes the price of hearing aids from coverage, but, like many private insurers, will pay for the doctor's exam required for obtaining hearing aids. Medicare also will pay for an audiologist's hearing tests, if prescribed by a physician. Private Medicare Advantage plans have varied coverage; check with your plan administrator.

Your private health insurance may pay nothing toward hearing aids or batteries, or it may reimburse some portion of the hearing aid costs. In Rhode Island, group health insurance plans are required to include coverage for hearing aids for adults and children. For adults (age 19 and older), the benefit is $700 per hearing aid, per ear, every three years. For children (anyone under the age of 19), the benefit totals $1,500. Ten other states--Connecticut, Delaware, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New Mexico, and Oklahoma--require health benefit plans in their state to pay hearing-aid costs for children. However, requirements and coverage vary. Other states have no mandate. Check with your insurance carrier to see what your coverage might be.

Some examples of hearing-aid benefits provided by private insurers:

  • As of Jan.1, 2009, the Blue Cross/Blue Shield Federal Employee Program, which covers more than half of all federal employees and retirees, began offering a hearing-aid benefit for adults ages 22 and over, up to $1,000 total per ear, including batteries, every three years. The Federal Employees Health Benefits Program, which acts as a central exchange for BC/BS and some 270 other private health insurers covering federal employees, is encouraging participating insurers to add or enhance their hearing-aid coverage for adults this year. (Last year the FEHBP pushed for hearing benefits for children.) In spite of this initiative, the coverage is optional. So if you're a federal employee, check with your carrier to see what's covered.
  • Your union may have negotiated hearing-aid benefits. For example, in New York City the United Federation of Teachers offers a supplemental plan for eligible members and dependents, for example, that pays up to $500 per aid, to be replaced no more frequently than every three years.

Other means of financing your aids

  • Use a medical flexible spending account. Many employers let you contribute a portion of your pretax income to such plans. The proceeds can be used toward all manner of health-care costs, including hearing aids and batteries. A taxpayer in the 28-percent bracket who set aside $5,000 in such an account and used all of it for a $5,000 pair of hearing aids would reap an effective savings of $1,400.
  • Deduct the cost. Health-care costs that exceed 7.5 percent of your adjusted gross income can be deducted from your federal income taxes if you itemize. Both hearing aids and their batteries can be deducted this way. The best way to reach this threshold is to bunch hearing-aid costs together in a single year. So if you know you need elective surgery and hearing aids, pay for them all in the same year. Check IRS Publication 502, Medical and Dental Expenses, for details.
  • Contact your state's rehabilitation services. These offices provide assistance for workers with disabilities. Depending on your state, you may be able to get help paying for hearing tests and hearing-aid purchases. Maryland, for instance, provides low-interest loans for hearing aids and assistive technology. The Pennsylvania Rehabilitation Council provides links to state vocational-rehabilitation departments. (If the Web site from your state has a search engine, type in "hearing aid" to find relevant materials.)

Getting help if you have limited means

  • Lions Affordable Hearing Aid Project, a project of the Lions Club International Foundation, assists hearing-aid users who can't afford aids. The program provides two specific behind-the-ear styles of aid from Rexton, Inc. (Keep in mind that the style offered may not be best for your hearing loss.) Contact your local Lions chapter for more information.
  • Hear Now, sponsored by the Starkey Hearing Foundation, offers hearing aids to people of very limited means. Assistance comes through manufacturer gifts, hearing health-care providers, and donors of used aids from across the U.S. In 2009, for instance, an individual would need to have total income of $18,403 or less; a couple would need to have total income of $24,675.
  • Sertoma (short for "service to mankind") provides mostly refurbished hearing aids to people who need assistance.
  • State Medicaid programs may provide hearing aids to people of very limited means. Contact your county social services for an appointment to determine your eligibility for Medicaid. The Hearing Loss Association of America, a support and advocacy group, provides a list of Medicaid-provided hearing services for qualifying individuals in all 50 states and the District of Columbia.

Hearing-loss resources

In-person and online support groups

Alexander Graham Bell Association for the Deaf and Hard of Hearing
www.agbell.org
For families dealing with childhood hearing loss and hard-of-hearing adults who choose to communicate through spoken language and speech reading. Extensive resource list.

Alt.support.hearing-loss
newsgroups.cryer.info/alt/support.hearing-loss
Discussion group for people with hearing loss.

American Tinnitus Association
www.ata.org
The nonprofit ATA is an organization working to cure tinnitus, as well as a support group for sufferers.

H.E.A.R.
www.hearnet.com
For musicians and music-lovers with hearing loss or who want to avoid hearing loss.

Hearing Loss Association of America
www.hearingloss.org
Hearing-loss support and advocacy group and links to hearing professionals.

The Listen-Up Web
www.listen-up.org
For families of deaf and hard-of-hearing children.

National Association for the Deaf
www.nad.org
Advocacy group for deaf and hard-of-hearing people, with a focus on American Sign Language users.

Say What Club
www.saywhatclub.com
Online support group of late-deafened, hard-of-hearing, and deaf adults.

General information on hearing loss

Better Hearing Institute
www.betterhearing.org
Hearing-aid industry-sponsored site. Includes non-product-specific information.

National Institute on Deafness and other Communication Disorders
www.nidcd.nih.gov
Government clearinghouse on hearing-loss issues.

Other government agencies

U.S. Department of Labor Office of Disability Employment Policy
www.dol.gov/odep
Resources for disabled people in the workforce.

U.S. Department of Veterans Affairs
www.va.gov
Information on hearing aids for service veterans.

Professional organizations

American Academy of Audiology
www.audiology.org
Find an audiologist.

   

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