How Do Hearing Aids Work? Breaking Down Different Options

Do you have trouble understanding what other people are saying? Do you turn up the volume on your TV loud enough that you disturb your neighbors? If so, you may be one of the nearly 40 million adult Americans with hearing loss. In fact, 1 in 4 people who think their hearing is good or excellent have experienced some degree of hearing damage.¹ And that can diminish quality of life and affect your chances of living life to the fullest.¹

Good news: In most cases, hearing aids can significantly improve your ability to hear, and recent advancements in hearing aids provide better hearing care, comfort and performance than ever before. They can help you get back to living your best life, spending time with friends and family without straining to hear what they are saying — and even help reduce your risk of developing conditions like dementia.² Here we discuss how hearing aids work, different types of hearing aid styles, average hearing aid costs and how to choose the best hearing aid for you.

What Is a Hearing Aid?

A hearing aid is an electronic device that amplifies sound for those who have some degree of hearing loss. Hearing aids are worn either outside of the ear or inside the ear. Depending on the type of hearing loss you have, your doctor may recommend you wear one in one or both ears.

Hearing aids work best for those dealing with sensorineural hearing loss. This type of hearing loss is caused by damage to the sensory cells of the inner ear due to disease, injury or aging.³

However, hearing aids may also help those with conductive hearing loss, which occurs when the outer or middle ear can't transmit sound properly to the inner ear, or a mixture of the two.⁴

You can learn more about the differences between sensorineural and conductive hearing loss here.

How Do Hearing Aids Work?

The basic function of a hearing aid is to amplify sounds so that they're audible (but not too loud) while minimizing background noise. Sound waves enter through a microphone, which converts acoustic signals into electrical signals.

Hearing aid controls let you conveniently adjust the volume and microphone settings. Hearing aids also improve the ability for a person to understand speech, and recent technology makes it easier to hear clearly in noisy environments.³

Analog hearing aids

Analog hearing aids convert sound waves into electrical signals and then amplifies them, making them louder and easier to hear. You can program them for different types of environments like relaxing at home or being in the middle of a crowded theater.³

Digital hearing aids

Digital hearing aids are slightly more complex and generally more expensive than analog ones. They convert sound waves into a code of numbers, similar to binary computer code, and then back into sound waves before amplifying them. Because the code produced contains information about the frequency of the sound waves, it also lets you program the hearing aid to only amplify sounds only within the frequencies you can't hear, rather than all of them.³

Digital hearing aids will also automatically respond to your environment and adjust their volume and programming, depending on whether you're in a crowded space or sitting at home. This allows digital hearing aids to be more customized to each user's needs.⁵

Parts of a hearing aid

The different parts of hearing aids include:⁶

• Microphone: picks up the sounds around you and sends them to the computer processor
• Computer processor: receives sounds and analyzes them, then transmits them to the amplifier
• Amplifier: increases the volume of sounds
• Speaker: sends the amplified sounds to your ear, allowing you to hear them
• Battery: powers the device and allows it to function properly

Different Types of Hearing Aids

There are several types of hearing aids — some worn in the ear canal and some worn behind the ear. They don't all perform in the same way, and choosing the best hearing aid style for you can depend on factors like severity of hearing loss, ear shape, age, price and personal preferences. Your audiologist can help recommend the best kind for you during your appointment with them.

The types of hearing aids and costs to consider include:

Behind-the-ear (BTE) hearing aid

This type of hearing aid hooks over your ear and sits behind it. They are suitable for those with all types of hearing loss, including severe hearing loss. Behind-the-ear hearing aids also work well for people of all ages, especially children, whose ears are still growing.⁷

While they are visible when worn, they feature volume and directional controls that other styles may not come with. They also may come with rechargeable batteries. Expect to pay around $2,698 to $3,247 for a behind-the-ear hearing aid.²

In-the-ear (ITE) hearing aid

These custom-made hearing aids fill some or most of the outer part of your ear and work best for those with moderate to severe hearing loss.⁷ They feature longer-lasting batteries, volume controls and directional microphones for better hearing amplification. However, they are visible when worn, pick up wind noise and may become frequently clogged with ear wax. Their cost is around $3,167 per hearing aid.²

Open-fit (mini-BTE) hearing aid

Open-fit hearing aids, also known as mini-behind-the-ear hearing aids, are similar to full-size BTE aids but are smaller and less visible. They sit behind the ear and have a tube that inserts into the ear canal.³

These aids work best for those with mild to moderate high-frequency hearing loss. That's because these aids leave the ear canal open, allowing you to naturally hear low-frequency sounds while amplifying the higher-frequency sounds.⁷ Expect to pay about the same as other types of BTE aids, around $2,698 to $3,247.²

In-the-canal (ITC) hearing aid

These types of hearing aids are small and unobtrusive, fitting partially inside the ear canal. They are best for adults with mild to moderate hearing loss. Because of their small size, they may be hard to adjust and can become clogged with ear wax, so they'll need more frequent cleaning.⁷ Costs vary from $2,500 to $4,900 for each in-the-canal hearing aid.²

Completely-in-canal (CIC) or mini-CIC hearing aid

Smaller than in-the-canal hearing aids, these hearing aids are very inconspicuous to wear but may not include features like volume and directional controls. Some, known as mini-CIC or invisible-in-canal hearing aids, are not visible at all because of their small size. They won't pick up wind noise but use small batteries that run out quickly.⁷

These hearing aids work best for those with mild to moderate hearing loss. Expect to pay anywhere from $1,500 to $4,000 for completely-in-canal hearing aids, depending on how you customize them.²

Receiver-in-canal (RIC) hearing aid

The receiver-in-canal type fits similarly to the behind-the-ear style but with the speaker (receiver) in the ear canal itself. Note that the speaker may become clogged with ear wax due to its positioning within the ear canal and you'll need to clean it accordingly.⁷

They are smaller and less noticeable than behind-the-ear styles and typically come with rechargeable batteries, manual controls, and directional microphones. Expect to pay around $2,466 for each aid.²

Surgically implanted hearing aids

For those dealing with profound hearing loss, most removable hearing aids may no longer help. In these cases, your doctor may recommend a surgically implanted hearing aid, including:³

• Middle ear implants: A surgeon attaches these aids to one of the bones of your middle ear to help send vibrations to the inner ear.
• Bone-anchored implants: These aids attach to the bone behind the ear and send sound vibrations to your inner ear through your skull. Part of the implant is placed under the skin, and you wear the other part externally in your ear.
• Cochlear implants: A surgeon implants electrodes in your inner ear and places a transmitter under the skin. The hearing aid microphone is then worn behind the ear.

In many cases, cochlear implants work well for children with severe hearing loss. For any type of surgically implanted hearing aid, expect to pay upwards of $40,000 or more, due to the cost of the device and the costs associated with the surgery itself.⁸

Do Hearing Aids Restore Hearing Loss?

While hearing aids can't completely restore hearing or stop the progression of hearing loss, with consistent use they can greatly enhance your quality of life by reducing background noises and amplifying sounds that were inaudible before. Even with hearing loss in only one ear, two hearing aids are generally recommended to improve the ability to locate the source of sounds as well as understand speech with background noise.⁷

Benefits of Hearing Aids for Hearing Loss

Unlike the hearing aids of years past, today's hearing aids are small in size but much more powerful than their predecessors. Hearing aids have come a long way in recent years — from technology to comfort and style.

Most importantly, they've been shown to significantly enhance the social, emotional and physical well-being of people with mild to severe hearing loss.² That's because they allow you to go back to socializing with friends and family without the need to worry about not understanding what anyone around you is saying.

Do You Need a Hearing Aid?

If you're concerned about your or a loved one's hearing or are experiencing any signs of hearing loss like the ones below, schedule an appointment with an audiologist. Your hearing care provider can give you a comprehensive hearing evaluation and ask you about any family history of hearing loss. The provider will also discuss treatment options, which may include hearing aids.

Common signs of hearing loss include:

• Frequently asking people to repeat what they've just said⁹
• Preferring the television or radio louder than those around you⁹
• Difficulty understanding group conversations⁹
• Straining to hear conversations⁹
• Having trouble hearing voices on the phone¹⁰
• Experiencing signs of tinnitus, or ringing in your ears^1,10
• Having pain with certain sounds¹⁰

How to Choose the Right Hearing Aid

When choosing a hearing aid, there are several factors to consider because they are a big financial investment. These include:

• The trial period: You need time to figure out if your hearing aid is comfortable and helps you hear more clearly. Most hearing aids offer a trial period of 30 to 60 days, during which time you can determine if the hearing aid works best for you.³
• The warranty: See how long the device is covered for parts and labor, which usually ranges from two to four years. Also, some providers may bundle follow-up office visits and device maintenance with the price of the device you buy through their office.⁷
• The style that suits you best: Young children may need a device that allows for growing ears, while adults might prefer a smaller and more inconspicuous model that might be more comfortable and less bulky. Note that some smaller models have tiny controls that might be hard for some to manage, so a larger model might work best.⁷
• The ability to increase its power in the future: Speak with your doctor to determine whether they can adjust your device accordingly if your hearing loss worsens.⁸ Remember, your hearing aid should last up to six years, so you want to use it for this entire duration to save money in the long run.¹¹
• Bluetooth connectivity: Many newer hearing aids allow for Bluetooth connectivity with devices like your phone or television so you can use your hearing aids as earphones. This makes them great for listening to music.⁷
• Noise reduction: While most models offer some degree of noise reduction or wind reduction, it will vary. Speak with your doctor to determine the best model for you.⁷
• Directional microphones: Devices with directional microphones allow you to hear sounds coming from in front of or behind you. These work best in environments with lots of noise.⁷
• Programmable settings: Some types of hearing aids allow you to choose from a variety of pre-programmed settings to allow you to hear better in different types of environments (like theaters or while in an office setting).⁷
• Rechargeable batteries: Some models may come with rechargeable batteries that allow you to continually use the same batteries without replacing them as often.⁷
• Remote control capabilities: Many models allow you to control them with a remote control or through an app.⁷
• Ability to synchronize: If you wear two hearing aids, you'll want to ensure that you can synchronize their controls for things like volume control, making adjusting them easier for you.⁷
• Availability at retailers: Hearing aids will now be available directly through retailers both online and in person for adults with mild to moderate hearing loss. You could save money by purchasing one this way instead of through an audiologist's office.¹²

How Much Do Hearing Aids Cost?

The cost of a hearing aid can range from around $1,000 to $4,000 per ear, with some costing as much as $6,000 per ear.¹³ Fortunately, the U.S. Food and Drug Administration (FDA) passed legislation to allow adults with mild to moderate hearing loss to purchase a hearing aid directly from a retailer rather than having to visit an audiologist, potentially saving you up to $2,800 per pair of hearing aids.¹²

To pay for the cost of your hearing aid, you may have a few options:

• A health savings account (HSA) or flexible spending account (FSA): Use this type of account to pay for your hearing aids if you have either option available.¹⁴
• Health insurance: Although Medicare does not cover the cost of hearing aids, some health insurance policies may cover part of the expense for your hearing aids. Medicaid will cover devices for those under 21 years old.¹³
• Cash or standard credit cards: If you have the funds available, you can use them to pay for your hearing aids or you can finance them with a standard credit card.
• The CareCredit credit card: The CareCredit credit card is a great option when paying for hearing aids.

CareCredit Financing for Hearing Aids

The CareCredit credit card is an easy way to pay for hearing health checkups, hearing tests, hearing aids and other hearing loss treatments.^* Use the Acceptance Locator or download the CareCredit Mobile App to find an audiologist or other hearing provider near you that accepts CareCredit.

Author Bio

Susan Paretts is a freelance writer with 18 years of experience covering health and wellness, pet care, and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, The San Francisco Chronicle, Chewy, and more.