Are you noticing changes in your hearing, and considering purchasing hearing aids for the first time? Or have you worn hearing aids for years, and now you’re ready for an upgrade?
Regardless of your reason, purchasing a new set of hearing aids is an investment, and as a consumer it can be a very challenging purchase to navigate. On average, a new set of hearing aids from a professional audiologist without insurance coverage costs between $3,000-$7000.
Because purchasing hearing aids is confusing, and there isn’t much transparent information available online, many people decide to just purchase the “best” hearing aids they can find at the lowest price possible. In other words they look at hearing aids as a commodity, like a phone or a car.
The problem is, treating hearing loss is actually very complex. If you buy hearing aids that aren’t right for your specific case, you'll likely be disappointed in the results. Even more troublesome, it’s possible (or even likely) that you might buy great hearing aids, only to have them fit and programmed incorrectly. That means you might invest thousands of dollars, buy the ideal technology, and still not get the results you’re looking for.
So what can I do?
As a consumer, knowledge is power.
Be aware that when you participate in a hearing consultation, you will be speaking with someone who is motivated for you to buy what they’re selling.
This isn’t meant to be cynical. I’m an audiologist (and I think a pretty good one). When a new patient comes into my clinic with hearing problems, I absolutely want them to leave in the best possible treatment solution for their needs.
That’s no different than going to an orthopedic surgeon with a shoulder injury and them recommending a surgical procedure. They aren’t (necessarily) being greedy or recommending a treatment you don’t need for their own gain.
However, regardless of the setting, when you walk into a consultation with a healthcare provider it’s important to enter that appointment armed with information and a good set of questions.
These questions could save you thousands of dollars!
In the hearing care industry, only about 20% of providers follow “best practices”. That means, in 80% of the providers you meet haven’t invested the time and money needed to help you get the very most out of your investment in hearing aids.
Question #1: Do you use real ear testing when you do hearing aid fittings?
Real ear measurement is one of the most important components of a successful fitting.
When hearing aids are programmed, the hearing aid manufacturer’s software will predict a “first fit” or “best fit” setting. This is an ESTIMATE of what your prescription might be.
However thousands of hearing care providers use a “best fit and adjust” approach to hearing aid fitting.
They program the devices to your estimated prescription, and then ask for your feedback about how you think they sound to adjust the settings.
The problem is, you are used to your hearing loss.
Your brain doesn’t know what normal hearing should sound like. You aren’t able to self-prescribe because you don’t know what you should be hearing. The sound you initially “prefer” won’t be your best hearing prescription, guaranteed.
That means you just bought those $7000 hearing aids...but you might as well have ordered something online for $5500 less...
Real ear measurement allows your audiologist to program your hearing aids with 100% accuracy based on:
- Your ear canal shape and acoustics
- The unique performance of your hearing devices
- Your hearing loss
Watch this video to learn more about real ear measurement:
Question #2: How did you choose which hearing aids you recommended for me?
The hearing care provider you are working with may be limited in what technology they can fit you with.
Maybe they are part of a franchise or other group that restricts the technology they can fit.
They might even be owned by a hearing aid manufacturer.
Or in other cases they may only fit one product line, and that’s all that they’re familiar with.
However, the best hearing solution is not one size fits all.
Your hearing care provider should be able to provide a meaningful explanation of the reason they have recommended that specific make and model of hearing aid technology for your unique listening needs.
Question 3: What follow-up care is included with hearing aids?
Hearing aids are typically sold either “bundled” or “unbundled”.
Bundled service programs include some or all of your follow-up care.
Unbundled hearing aids typically include very limited follow-up care, and then you will need to pay for follow-up services.
This distinction makes a huge difference in the up-front cost of hearing aids. It’s important that you understand what services are included with your devices.
In my clinic, we fit devices with bundled service plans. That means there is typically a larger price tag up front, however it also guarantees that you have high-quality service for years to come without feeling nickel and dimed.
This may include clean and check appointments, annual hearing testing and prescription updates, and hearing aid adjustments.
In my experience, patients who are on unbundled service plans tend to come back less often for follow-up care because, from a psychological standpoint, even though you spent less up front you tend to want to avoid spending extra money on additional follow-up visits.
This tends to lead to lower long-term satisfaction with your devices, and might actually end up causing you to seek new hearing aids sooner and spend more money on hearing aids in the long-run.
Question 4: What is your process to make sure I’ve adjusted to hearing aids?
Many hearing care facilities don’t have a structured brain-retraining program to ensure that you adjust to the new sounds that you’re hearing with hearing aids.
In my professional experience, this is another of the largest differentiators between success and failure with hearing aids.
When your brain has gotten used to not hearing properly, hearing aids can sound foreign, distracting, and even uncomfortably loud if you don’t acclimate to them gradually.
I would highly recommend finding a hearing care provider that has a structured brain-retraining program including follow-up visits and gradual acclimatization to your devices.
This component will likely be the difference between hearing aids that you wear daily with high satisfaction, and devices that end up in the dresser drawer.
Question 5: What is your training and highest level of education?
Hearing aids can be fit by a broad range of providers, including:
- Doctors of Audiology
- Audiologists (Masters Degree)
- Hearing instruments specialists/hearing aid dispensers
The largest divide in education is between hearing aid dispensers (sometimes called HIS, audioprosthologists, hearing aid specialists) and audiologists.
Most audiologists have gone through at least 8 years of formal education and over 2500 supervised clinical hours before seeing patients independently.
Audiologists are highly trained in anatomy, physiology, neurology, acoustic physics, psychoacoustics, and digital hearing aid programming.
They are also able to identify, diagnose, and in some cases treat more complex and medical conditions related to the auditory system.
Hearing instrument specialists are able to complete a 3 month online program and pass a state exam to begin fitting hearing aids in Texas.
Often there is no price difference between hearing aids sold by audiologists as compared to dispensers.
Although there are certainly very good dispensers as well as very bad audiologists out there, in my opinion it is advisable to start your hearing aid journey with a well-reviewed or recommended audiologist.
Question 6: How long are the warranties, and what do they include?
Hearing aids are small electronic devices that are worn on your ear and exposed to sweat, skin, and earwax for 12 hours or more a day.
Although the technology for dirt and moisture resistance has improved considerably, it’s still reasonable to expect that your hearing aids may need to be repaired at some point during the first few years you have them.
It is important to understand what warranties are included with the devices, what they cover, how much you may owe if they are used, and if you will be allowed to use backup or loaner devices while yours are being repaired.
Many hearing aids will also include a Loss and Damage coverage that can cover the replacement of a lost device with a relatively small deductible.
On average, hearing aid warranties from the manufacturer range from 1-3 years.
Question 7: Are your hearing aids private labeled or locked?
Some hearing aid providers sell hearing aids that are “locked”. This means that you have to go back to that provider or someone who works with that particular product to have them serviced.
This may not be an intrinsic problem. Maybe they’re part of a large national network and you could have the devices serviced at any of their locations.
However if you decide that you don’t like their services or need to move or travel where they don’t have a service provider you could be out of luck.
In most cases, being fit with unlocked or non-private label devices allows you the most flexibility to have them programmed and serviced with the broadest range of providers.
Question 8: Why do you recommend this style of hearing aid?
Hearing aids are able to be made in a variety of sizes and styles. In most cases, each manufacturer has products across the entire range of styles.
Some consumers want a style that is as invisible as possible.
It is important to understand that the style of device that you choose will be one of the greatest deciders of fit, comfort, features, and sound quality.
For example, a small receiver in the ear device will likely have the broadest fitting range, meaning it can comfortably fit most hearing losses, and will also have advanced features like Bluetooth and automatic directional noise reduction.
The tradeoff is if you have short hair, the behind the ear portion may be visible.
However invisible in canal devices may be limited by older technology, fit, and longer adjustment to sound quality.
These pro’s and con’s should be openly discussed with your hearing care professional so that you can make an informed decision about your hearing aid solution.
Question 9: (If using a hearing aid benefit) Are there any restrictions to my follow-up care with my hearing aid insurance benefit?
Many of the major health insurance carriers are changing their hearing aid programs away from a “traditional” benefit (ie, $2500 every 3 years for hearing aids), to third party administrator plans.
These plans are essentially hearing aid discount plans.
So, for example, you may be eligible to purchase premium hearing aids (retail $6700) for $3700 through your insurance plan.
With most of these plans, your follow-up care is defined by your plan. Some only cover 3 follow-ups, while others allow for unlimited follow-ups for a certain period of time.
It’s important you understand your benefit, and what types of devices and care are covered under your plan.
If you visit a participating provider, they will be limited to working under the restrictions of your policy. So even if it is a provider who normally provides lifetime follow-up, they will only be able to provide the level of care offered under your insurance policy.
You will also be limited to working with providers who have agreed to take the (often very small) reimbursement packages that these policies offer.
Our clinic accepts a few of these plans so that we can provide care for patients in our community. However, in our clinic we often have limited appointment availability for beneficiaries of these plans.
Overall, having a third party hearing aid benefit isn’t necessarily good or bad, but it is important for you to know and understand the pros and cons of your policy.
Question 10: What are my service options after the end of my warranty or service plan?
Hearing aids are replaced, on average, every 3-5 years. Part of the reason devices are replaced so often is because technology improves, and people wish to upgrade.
Another reason people choose to upgrade is that out of warranty hearing aid repairs can be very expensive ($300-$600 for a single repair, depending on the device). In these cases people often opt to just upgrade to new technology rather than pay for repairing older devices.
Three years might sound like a long way off, but it is important to understand what your extended warranty and service plan options are before you start working with a provider. You want to ensure that you’ll be taken care of long-term.
Choosing to treat your hearing loss
Treating hearing loss is one of the most important health decisions you can make. Effective hearing loss treatment will improve your social life, energy levels, brain health, and overall sense of well-being.
Before you make this big decision, make sure you’re prepared! Bringing these 10 questions to your hearing care consultations will be a big help in finding the provider you’ll be working with for the years to come.
Dr. Brad Stewart, audiologist, is the founder and owner of ClearLife Hearing Care in Allen and Lewisville Texas. Dr. Stewart is also the creator of the NeuroHearing™ and NeuroTinnitus™ treatment programs.