What are the common types of hearing loss?
Three types of hearing loss are most common.
- Conductive hearing loss involves the outer ear, the middle ear, or both. It usually results from a blockage from earwax, fluid in the middle ear, or a punctured eardrum. Conductive hearing loss often can be corrected medically or surgically.
- Sensorineural – or “nerve” – hearing loss typically involves damage to the inner ear. It can be caused by disease, illness, age, injury from exposure to noise or certain medicines, or a genetic disorder. Usually, sensorineural hearing loss cannot be cured medically or surgically, but its impact often can be reduced – and hearing improved – with hearing aids.
- Mixed hearing loss is a combination of sensorineural and conductive hearing loss.
Only a small portion of adult hearing problems, like ear infections and middle ear diseases, are medically or surgically treatable. If the hearing loss can’t be treated medically or surgically, a hearing aid may be beneficial.
If you think you are losing your hearing, consider seeing a doctor or other health professional who specializes in hearing loss. A hearing aid may be one part of a rehabilitative program that could also include things like auditory training or instruction in lip-reading.
What is a hearing aid?
A hearing aid is a small electronic device worn in or behind the ear. The most common type of hearing aid has three parts: a microphone, an amplifier, and a speaker. The device receives sound through the microphone, which converts the sound to electrical signals and sends them to the amplifier. The amplifier increases the power of the signals and sends them to the ear through the speaker.
The device doesn’t work unless you have some ability to hear. And because hearing loss affects people in different ways, you need to get a device that’s appropriate for your condition and your lifestyle. For example, if you have hearing loss in both ears, two hearing aids may be recommended. Improving both ears’ ability to hear provides a more natural signal to the brain.
The price of a hearing aid can range from hundreds to thousands of dollars, depending on the style and features of the device itself and – sometimes – the range of services that may be included as part of a hearing aid package. As with many tech devices, a more expensive model might be worth the price to you, or it might contain fancy features you don’t really need.
Price is a factor, but it’s not the only one to consider when determining your best option for a hearing aid. Shop around. Prices vary widely. You can ask for a discount. Don’t buy a hearing aid with more features than you need. A more expensive device isn’t always better. If you are a veteran, check with the Veteran’s Administration (VA) first. You may be entitled to free or discounted hearing aids. Many health plans do not cover hearings aids, but some do. Check with your health plan provider.
How to determine the most appropriate product
There are many sources of information on hearing aids and hearing health care. Your doctor may refer you to a hearing health professional for an examination and evaluation. That professional may be an otolaryngologist, an audiologist, or a hearing aid dispenser.
- An otolaryngologist is a physician who specializes in diagnosing and treating diseases of the head and neck, especially those involving the ears, nose, and throat (ENT).
- An audiologist is a trained professional who measures hearing and can fit hearing aids. An audiologist has at least a master's degree and has specialized training in hearing loss; many now have an AuD (doctorate) degree, too. Some may have a PhD.
- A hearing aid dispenser is someone authorized by state law to measure hearing and to fit and sell hearing aids. The credentials for becoming a hearing aid dispenser vary by state, but typically involve working as an apprentice to a certified dispenser and passing a test about hearing aids. Although many audiologists sell hearing aids, a hearing aid dispenser is not necessarily an audiologist.
Age-related hearing loss is common. But sometimes, hearing loss is a symptom of a medical condition. A medical examination may uncover underlying illnesses or medical problems associated with your hearing loss.
Food and Drug Administration (FDA) guidance indicates that a medical evaluation isn’t always necessary for people 18 years of age or older before buying hearing aids. However, if you experience certain conditions, you should consult a medical professional. For more information, see the FDA publication, Medical Devices: Hearing Aids: Benefits and Safety Issues.
What’s a good way to shop for a hearing aid?
Once you’ve determined that a hearing aid will help you, look for a reliable provider. Ask family and friends for referrals, talk with your doctor, and check out potential sellers (retailers, audiologists, and dispensers) online before you visit. Your state licensing or certification boards, or the American Speech-Language-Hearing Association (ASHA) may have records of complaints against licensed hearing health professionals, and can tell you how they responded to the complaints. You also may be able to enter the professional’s name and the manufacturer’s name into a search engine online, and find out what other people have to say.
Take your time when you are shopping for a hearing aid. Resist sales pressure. It’s an expensive purchase, so buy only when you’re satisfied with the answers to your questions. Make sure the person you are dealing with puts their promises or guarantees about service and maintenance into the written purchase agreement.
Buying a hearing aid online or through the mail can be risky, especially if the seller does not offer options for adjustments. In fact, some states don’t allow hearing aids to be sold through the mail at all.
What about a purchase agreement?
At a minimum, your contract should contain information about:
- the trial period – Most states require a 30- to 60-day trial period. Most hearing health professionals offer this even in states that don’t require it. Find out what fees are refundable if you return the aid during the trial period. Make sure the refund policy is written into the purchase agreement.
- the warranty – Get the details. How long is the warranty? Can it be extended? Does it cover maintenance and repairs? Is it honored by the manufacturer or by the licensed hearing health care professional? In some cases, a manufacturer may not honor its warranty unless the hearing aid is purchased from an authorized seller. You also may be protected by implied warranties created by state law.
- a loaner – Ask if you’ll get a free loaner hearing aid if your device needs servicing or repair.
- the total price – What is included in the price? Hearing aid(s), fitting services, follow-up, more? Get an itemized list, and make sure you get any verbal quotes and promises in writing.
Health insurance plans, including Medicare, typically pay for diagnostic hearing evaluation, but many plans do not cover hearing aids. If you can’t afford a hearing aid, contact the National Institute on Deafness and Other Communication Disorders (NIDCD) for information about organizations that offer financial assistance.
What are government standards for hearing aid sales?
The FTC enforces regulations that prohibit the use of misleading sales and advertising practices, including making inaccurate claims about hearing loss, hearing aid performance, refund policies, or warranty coverage.
The FDA enforces regulations that deal with the manufacture and sale of hearing aids. Retailers can only sell hearing aids that meet FDA requirements. Before selling a hearing aid, a dispenser must provide an instruction brochure with the hearing aid that illustrates and describes its operation, use, and care. The brochure must list sources for repair and maintenance.
Many states also have laws governing hearing aid sales and implied warranties. Your state Attorney General’s office can tell you what laws apply in your state.