Article at a Glance
- Hearing aids can improve access to sound and speech, but they do not restore normal biological hearing.
- Adults in the United States can choose between prescription hearing aids and FDA-regulated over-the-counter hearing aids intended for adults age 18 and older with perceived mild to moderate hearing loss.
- Hearing aids come in several styles, including behind-the-ear, receiver-in-canal, in-the-ear, and in-the-canal designs.
- The right hearing aid depends on much more than price. Hearing needs, ear anatomy, communication goals, dexterity, comfort, technology preferences, and professional support can all matter.
- A well-selected hearing aid still needs appropriate setup, realistic expectations, maintenance, and adjustment over time.
Choosing a hearing aid can feel complicated.
There are prescription and over-the-counter options, multiple physical styles, different levels of professional support, rechargeable and disposable-battery models, wireless features, assistive accessories, and wide differences in price.
The goal is not to identify one hearing aid that is “best” for everyone. It is to understand which combination of hearing technology, features, support, and fit makes sense for your individual hearing and communication needs.
What Does a Hearing Aid Do?
A hearing aid is a wearable electronic device designed to improve access to sound for people with hearing loss.
Modern digital hearing aids generally contain:
- One or more microphones that collect sound
- A digital processor that analyzes and modifies the signal
- An amplifier
- A receiver, or miniature speaker, that delivers sound to the ear
- A battery or rechargeable power source
Digital processing allows hearing aids to provide different amounts of amplification across frequencies and to use features such as directional microphones, feedback management, noise reduction, wireless connectivity, and multiple listening programs.
What Hearing Aids Can and Cannot Do
Hearing aids can make important sounds more accessible and improve communication for many people with hearing loss.
They can be particularly helpful for speech, television, telephone communication, environmental sounds, and everyday interaction.
However, hearing aids do not repair damaged cochlear sensory cells or restore normal biological hearing.
They also cannot completely remove background noise or guarantee perfect speech understanding in every environment.
Results vary according to the type and degree of hearing loss, speech-understanding ability, device selection, fitting, listening environment, communication needs, and other individual factors.
Who May Benefit From Hearing Aids?
Hearing aids may be appropriate when hearing loss interferes with communication or everyday activities and amplification is expected to improve access to useful sound.
Possible signs that hearing evaluation may be worthwhile include:
- Frequently asking people to repeat themselves
- Difficulty understanding speech in restaurants or groups
- Increasing television or device volume
- Difficulty understanding telephone conversations
- Feeling that other people mumble
- Missing environmental sounds
- Listening fatigue
- Avoiding conversations because hearing is difficult
A hearing test can help determine whether hearing loss is present and provide information useful when considering amplification.
Learn more about hearing tests and audiograms.
Types of Hearing Aids
Hearing aids are available in several physical styles.
No style is automatically better than another. Each has advantages and limitations involving size, power, comfort, battery capacity, maintenance, controls, features, and visibility.
Behind-the-Ear Hearing Aids
Behind-the-ear, or BTE, hearing aids place the main electronic components behind the ear.
Sound is delivered through tubing connected to an earmold or other earpiece.
BTE devices are available across a wide range of amplification capabilities and can be particularly useful when greater output, larger controls, or custom earmolds are needed.
Their larger size can also make them easier to handle for some users.
Receiver-in-Canal and Receiver-in-the-Ear Hearing Aids
Receiver-in-canal and receiver-in-the-ear devices are often abbreviated RIC or RITE.
The primary hearing-aid body sits behind the ear while the receiver is positioned in or near the ear canal and connected by a thin wire.
These devices can accommodate a broad range of hearing needs and commonly offer rechargeable batteries, wireless connectivity, directional microphones, and other digital features.
In-the-Ear Hearing Aids
In-the-ear, or ITE, hearing aids use a custom shell that fits within the outer ear.
The larger shell can provide room for controls, batteries, microphones, and other components.
Whether an ITE device is appropriate depends on hearing needs, ear anatomy, dexterity, desired features, and personal preference.
In-the-Canal and Completely-in-Canal Hearing Aids
In-the-canal, or ITC, hearing aids fit partly within the ear canal.
Completely-in-canal, or CIC, devices sit more deeply within the canal and are generally less visible.
Their small size can limit battery capacity, manual controls, wireless features, directional microphone arrangements, or other technology depending on the particular device.
Small hearing aids can also be more difficult to handle for people with limited dexterity or vision.
Bone-Conduction Hearing Systems Are Different
Bone-conduction hearing systems are sometimes discussed alongside conventional hearing aids, but they work differently.
Instead of sending amplified sound through the ear canal in the usual way, these systems transmit sound through vibration of the skull to stimulate the inner ear.
They may be considered for certain conductive or mixed hearing losses and some cases of single-sided deafness.
Options can include surgically implanted and nonsurgical systems.
Appropriate candidacy requires individualized hearing and medical evaluation.
Prescription vs. Over-the-Counter Hearing Aids
Adults in the United States now have two broad pathways for obtaining hearing aids: prescription hearing aids and over-the-counter hearing aids.
Over-the-Counter Hearing Aids
FDA-regulated OTC hearing aids are intended for adults age 18 and older who perceive that they have mild to moderate hearing loss.
They can be purchased without a medical examination, prescription, or professional fitting.
OTC hearing aids may be preset or allow users to adjust the device themselves, depending on the product.
They can be a reasonable option for some adults who fall within their intended population and are comfortable selecting and managing their own devices.
Prescription Hearing Aids
Prescription hearing aids are obtained through hearing-care professionals and can address a broader range of hearing needs.
Professional services may include:
- Comprehensive hearing evaluation
- Device selection
- Physical fitting
- Programming
- Verification
- Education
- Follow-up adjustments
- Repair and maintenance support
The amount and type of professional support included varies by provider and pricing model.
When Professional Evaluation Is Especially Important
OTC hearing aids are not intended to replace appropriate medical or audiological evaluation when symptoms suggest that something more than routine age-related or noise-related hearing difficulty may be occurring.
Seek appropriate professional evaluation for concerns such as:
- Sudden or rapidly developing hearing loss
- A substantial difference in hearing between ears
- Ear pain
- Ear drainage
- Persistent or significant dizziness
- Visible abnormalities of the ear
- Hearing loss following significant head or ear injury
- Other concerning or unexplained ear symptoms
Sudden unexplained hearing loss should receive prompt medical evaluation.
OTC Hearing Aids Are Not the Same as Personal Sound Amplification Products
Over-the-counter hearing aids and personal sound amplification products, or PSAPs, are not the same category of product.
OTC hearing aids are regulated medical devices intended to compensate for perceived mild to moderate hearing loss in adults.
PSAPs are consumer products intended to amplify sound for people without hearing loss during activities such as birdwatching or other recreational situations.
Consumers should check how a product is classified rather than assuming that anything marketed as a sound amplifier is a hearing aid.
How Much Do Hearing Aids Cost?
There is no reliable universal price for a pair of hearing aids.
Costs vary considerably according to:
- Prescription versus OTC purchase
- Technology and features
- Professional services included
- Warranty and repair coverage
- Accessories
- Follow-up care
- Geographic location
- Insurance or hearing benefits
When comparing prices, determine exactly what is included.
A lower device price may not include professional fitting, follow-up adjustments, repairs, supplies, or accessories, while another price may bundle some or all of those services.
Does Insurance Cover Hearing Aids?
Hearing-aid coverage varies widely.
Original Medicare generally does not cover hearing aids or routine hearing exams for fitting hearing aids.
Certain diagnostic hearing and balance evaluations may be covered when Medicare requirements are met.
Medicare Advantage plans may offer hearing benefits, but benefits differ among plans.
Medicaid coverage varies by state, and private insurance and employer-sponsored plans also differ.
Veterans may have hearing-care benefits through the U.S. Department of Veterans Affairs when eligibility requirements are met.
Because benefits change, verify current coverage directly with your insurer or benefit program before making a purchasing decision.
Important Hearing-Aid Features
Modern hearing aids offer many features, but more features do not automatically mean better results.
The most useful features are those that address your actual listening needs.
Directional Microphones
Directional microphone systems are designed to emphasize sound arriving from particular directions while reducing emphasis on sound arriving from others.
They can improve speech access in some noisy environments, particularly when the desired speaker and competing noise are spatially separated.
Performance depends on the environment and the particular hearing-aid system.
Digital Noise Reduction
Digital noise-reduction systems analyze incoming sound and attempt to reduce certain unwanted signals.
These systems may improve listening comfort and reduce annoyance from some background sounds.
They should not be expected to eliminate all background noise or guarantee speech understanding in difficult environments.
Bluetooth and Wireless Connectivity
Many hearing aids can connect wirelessly to smartphones, tablets, televisions, remote microphones, and other compatible devices.
This can allow phone calls, music, television audio, or other signals to be streamed directly to the hearing aids.
Compatibility varies by hearing aid, phone, operating system, accessory, and wireless protocol, so confirm compatibility before purchasing.
Rechargeable Batteries
Many current hearing aids use rechargeable batteries.
Rechargeable designs eliminate the need to regularly handle small disposable batteries and can be particularly convenient for people with dexterity or vision limitations.
Operating time varies considerably according to the device, battery condition, wireless streaming, settings, and use patterns.
Ask about expected battery performance and the procedure and cost for eventual battery service or replacement.
Disposable Batteries
Some hearing aids continue to use replaceable zinc-air batteries.
Common battery sizes include 10, 312, 13, and 675.
Battery life varies according to device power requirements, wireless use, amplification, environmental conditions, and individual use.
Fixed claims about the exact number of days a battery will last should therefore be treated cautiously.
Telecoils and Hearing Loops
A telecoil, sometimes called a T-coil, is a small component that allows compatible hearing aids to receive electromagnetic signals from hearing-loop systems and certain other devices.
Hearing loops can be installed in theaters, houses of worship, meeting rooms, service counters, transportation facilities, and other public spaces.
When a compatible loop is available, the telecoil can deliver the audio signal directly to the hearing aid and may reduce the effect of distance and surrounding noise.
Not everyone needs a telecoil, but it can be valuable for people who regularly use loop-equipped venues.
Remote Microphones
Remote microphone systems can be particularly useful when the person speaking is some distance away or when background noise makes speech difficult to understand.
The microphone is positioned near the speaker and sends the speech signal wirelessly to the hearing aids or another listening device.
This technology can be useful in classrooms, meetings, restaurants, vehicles, and other challenging environments.
Smartphone Apps and Remote Adjustments
Some hearing aids offer companion apps that allow users to adjust volume, change listening programs, monitor battery status, modify certain sound settings, or communicate with a hearing-care professional.
Available functions vary substantially by manufacturer and model.
Choosing a Hearing Aid Based on Your Hearing
An audiogram provides important information when selecting hearing technology, but hearing thresholds are only part of the decision.
Selection may also consider:
- Speech understanding
- Differences between ears
- Ear anatomy
- Listening environments
- Communication goals
- Dexterity
- Vision
- Comfort
- Tinnitus
- Technology preferences
- Budget
- Professional support needs
A chart that automatically assigns a particular hearing-aid style to a particular decibel range can be misleading because fitting decisions are more individualized than that.
Learn more in Hearing Loss: The Complete Guide.
One Hearing Aid or Two?
Whether someone should use one hearing aid or two depends on the hearing in each ear and the individual’s communication needs.
When both ears have aidable hearing loss, bilateral amplification is commonly considered because input from both ears can support spatial hearing and communication.
However, two hearing aids are not automatically appropriate for every person with bilateral hearing loss.
Asymmetrical hearing loss, very poor speech recognition in one ear, medical factors, personal preferences, or other circumstances may influence the recommendation.
People with single-sided deafness may also be evaluated for technologies such as CROS systems, bone-conduction systems, or other options depending on individual circumstances.
Lifestyle Matters
Your daily activities can help determine which hearing-aid features are useful.
Someone who spends most of the day in quiet one-on-one conversations may have different priorities from someone who frequently attends meetings, restaurants, performances, religious services, sporting events, or large family gatherings.
Consider questions such as:
- How often are you in background noise?
- Do you frequently use a smartphone?
- Do you stream television or music?
- Do you attend venues equipped with hearing loops?
- Would a remote microphone be useful?
- Do you have difficulty handling small batteries?
- Is moisture resistance important?
- How comfortable are you using smartphone apps?
What Happens During a Professional Hearing-Aid Fitting?
A professional fitting generally begins with hearing-test results and a discussion of communication needs.
The hearing aids are programmed according to the individual’s hearing profile and fitting targets.
The appointment may also include:
- Physical fit and comfort assessment
- Programming adjustments
- Verification of hearing-aid output
- Insertion and removal instruction
- Charging or battery instruction
- Cleaning and maintenance education
- Smartphone or accessory setup
- Communication counseling
- Planning for follow-up adjustments
Real-Ear Measurement
Real-ear measurement is an important verification method used in professional hearing-aid fitting.
A small probe microphone is placed in the ear canal to measure the sound produced by the hearing aid near the eardrum.
This allows the clinician to compare actual hearing-aid output with prescribed fitting targets rather than relying only on manufacturer software predictions.
Verification methods and clinical procedures can vary, but consumers receiving professionally fitted hearing aids can ask how the fitting will be verified.
Adjusting to Hearing Aids
Hearing aids introduce sounds that may have been difficult to hear for a long time.
Some people adapt quickly, while others need more time and several adjustments.
Early experiences may include:
- Your own voice sounding unfamiliar
- Environmental sounds seeming unusually noticeable
- Difficulty deciding which program or setting works best
- Physical awareness of the device
- Listening fatigue in challenging environments
There is no universal adjustment period that applies to everyone.
Persistent discomfort, feedback, poor sound quality, excessive loudness, or continued communication difficulty should be discussed with the hearing-care professional rather than simply tolerated.
Hearing Aids and Tinnitus
Tinnitus and hearing loss commonly occur together.
For people who have both conditions, hearing aids may make tinnitus less noticeable by increasing access to environmental sound and reducing the contrast between tinnitus and the surrounding sound environment.
Some hearing aids also include optional sound-generation or tinnitus-management features.
These features can be useful for some people but should not be described as a cure for tinnitus.
Tinnitus treatment should be individualized according to symptoms, hearing status, medical history, and the degree of distress or functional difficulty involved.
Learn more in Tinnitus: The Complete Guide.
Hearing-Aid Maintenance
Regular maintenance can improve reliability and reduce preventable problems.
Follow the cleaning and maintenance instructions provided for your particular device because recommendations vary by style and manufacturer.
Earwax Management
Earwax can block hearing-aid receivers, tubing, vents, microphones, or earmolds.
Many devices use replaceable wax guards or filters.
Replacement frequency depends on the individual and the device rather than a fixed schedule.
Keep Hearing Aids Dry
Moisture can interfere with hearing-aid electronics.
Store devices according to manufacturer instructions and avoid exposing them to excessive humidity, water, or heat unless the particular device is designed for that exposure.
A drying system may be useful for some users, especially in humid environments, but compatibility with rechargeable devices should be confirmed.
Cleaning Products
Do not apply household cleaners, alcohol, water, or other liquids directly to a hearing aid unless the manufacturer specifically states that the product and cleaning method are safe.
Use the recommended tools and procedures for your device.
How Long Do Hearing Aids Last?
There is no fixed lifespan for a hearing aid.
Longevity depends on factors including:
- Device construction
- Moisture exposure
- Earwax
- Daily wear
- Maintenance
- Battery condition
- Repair history
- Availability of replacement parts
- Changes in hearing
- Changing communication needs
A hearing aid does not need to be replaced simply because it reaches a particular age.
Replacement may make sense when a device becomes unreliable, cannot adequately address current hearing needs, can no longer be serviced, or when newer technology offers features that provide meaningful practical benefit.
Should You Choose a Hearing Aid by Brand?
Major hearing-aid manufacturers offer devices across multiple technology levels, styles, and price ranges.
Brand can matter for compatibility, available features, accessories, service options, apps, wireless protocols, and product support.
However, choosing a hearing aid solely because one manufacturer is described as “best” for Bluetooth, tinnitus, artificial intelligence, sound quality, or another feature can be misleading.
Performance depends on the particular device, hearing profile, fitting, verification, listening environment, and user preferences.
Instead of starting with a brand ranking, consider:
- Whether the device can appropriately address your hearing loss
- Whether the physical style is comfortable and manageable
- Whether the features match your real listening needs
- Whether it is compatible with your phone and other technology
- What warranty and repair support are provided
- What professional services are included
- Whether the device can be adjusted if your hearing changes
- The total cost of ownership rather than only the purchase price
Questions to Ask Before Buying Hearing Aids
- What type and degree of hearing loss do I have?
- Is this device appropriate for my hearing and communication needs?
- Why is this particular style being recommended?
- What services are included in the price?
- How will the hearing aids be fitted and verified?
- What follow-up care is included?
- What is the return or trial policy?
- What warranty is included?
- What happens if the hearing aid needs repair?
- Are accessories included or sold separately?
- Is the device compatible with my smartphone?
- Does it support telecoil, Bluetooth, remote microphones, or other features I need?
- What are the ongoing maintenance costs?
Frequently Asked Questions
Can Hearing Aids Reverse Hearing Loss?
No. Hearing aids do not reverse permanent sensorineural hearing loss.
They improve access to sound by amplifying and processing sound according to the user’s hearing needs.
Some conductive hearing losses may improve when the underlying medical condition is treated, so the cause of hearing loss matters.
Do I Need a Hearing Test Before Buying an OTC Hearing Aid?
Adults purchasing an OTC hearing aid are not required to obtain a hearing test or medical examination first.
However, a professional hearing evaluation can provide useful information about the type and degree of hearing loss and may identify findings that deserve medical attention.
People with sudden hearing loss, substantial asymmetry, ear pain, drainage, significant dizziness, or other concerning symptoms should seek appropriate professional evaluation.
Are OTC Hearing Aids Lower Quality Than Prescription Hearing Aids?
OTC and prescription hearing aids serve different populations and purchasing pathways.
OTC hearing aids can provide meaningful benefit for some adults with perceived mild to moderate hearing loss.
Prescription devices offer access to a broader range of technology and professional fitting options and can address hearing needs outside the intended OTC population.
Quality cannot be determined solely from whether a device is sold OTC or by prescription.
How Much Should I Spend on Hearing Aids?
There is no amount that everyone should spend.
Compare the device, professional services, warranty, follow-up care, accessories, repair coverage, and features you will actually use.
The most expensive hearing aid is not automatically the most appropriate one.
Are Cheap Hearing Aids Worth Buying?
Price alone does not establish quality.
A lower-cost FDA-regulated OTC hearing aid may be appropriate for some adults within the intended OTC population.
Consumers should distinguish actual hearing aids from personal sound amplification products and from products that make misleading hearing-health claims.
Should I Wear One Hearing Aid or Two?
The answer depends on hearing in each ear.
When both ears have aidable hearing loss, bilateral amplification is commonly considered, but individual circumstances can make another approach appropriate.
A hearing professional can evaluate the hearing and speech-understanding ability of each ear before making a recommendation.
Do Hearing Aids Help With Tinnitus?
Hearing aids may help some people who have both tinnitus and hearing loss.
Amplifying environmental sound can reduce the contrast between tinnitus and surrounding sound, and some hearing aids offer optional sound features intended for tinnitus management.
Results vary, and hearing aids are not a cure for tinnitus.
How Often Should Hearing Aids Be Replaced?
There is no universal replacement schedule.
Replacement should be based on device condition, repairability, hearing needs, reliability, available support, and whether newer technology would provide a meaningful benefit.
What Should I Do if My Hearing Aid Does Not Seem to Help?
Do not assume that hearing aids simply cannot work for you.
Problems may involve physical fit, programming, earwax blockage, receiver or microphone problems, unrealistic expectations, difficult listening environments, or changes in hearing.
Professional evaluation and adjustment may identify correctable problems.
What Should I Do if My Hearing Suddenly Gets Worse?
Sudden unexplained hearing loss should receive prompt medical evaluation.
Do not wait for a routine hearing-aid appointment or assume that the hearing aid itself is responsible for a sudden change.
Reliable Sources and Further Reading
- National Institute on Deafness and Other Communication Disorders — Hearing Aids
- U.S. Food and Drug Administration — Hearing Aids
- FDA — OTC Hearing Aids: What You Should Know
- NIDCD — Sudden Sensorineural Hearing Loss
- Medicare — Hearing Aid Coverage
Apex Provides Education, Not Individual Hearing-Aid Recommendations
Apex Brain & Hearing Health provides independent educational information about hearing loss, hearing aids, hearing technology, and related health topics.
We do not recommend a particular hearing-aid brand or model as the best choice for every reader.
The appropriate hearing technology depends on individual hearing, communication needs, medical history, preferences, budget, and other factors.
Seek appropriate professional evaluation for persistent or concerning hearing changes. Sudden unexplained hearing loss should receive prompt medical attention.
