Hearing aid 101

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nisiprius
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Hearing aid 101

Post by nisiprius » Sun Sep 04, 2016 11:56 am

Someone needs a hearing aid. The local hearing-aid-equivalent-of-Raymond James suggests units ranging in price for $4,000 to $7,000. Online, there seem to be options in the three-digit range, such as Songbird and iHear. And there are even "disposable" units for $79.

This is new territory, and I am terribly frustrated by the lack of specific information (brand names and models).

Resources like mayoclinic.org, consumerreports.org, and the FDA are heavy on totally generic advice about types and features and utterly lacking in any specific mention of brand names, reliability, durability, user satisfaction, etc. etc. What I think is the full Consumer Reports report--from their website via our public library network--starts off well, saying "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 hearing aids worked in various settings." And yet no brands or models are named. It's just vague stuff like "directional microphone: Survey results show it helps for hearing household noises; in loud social settings; and while listening to the TV or radio when there's noise in the rear or off to the sides." No frequency-of-repair record. No accuracy scores like they'd give you for a pair of headphones. No "best buys." C'mon.

None of the sites is clear on whether you are risking anything beyond than the nuisance of returning a product if you try one of the low-three-digits hearing aids...

Any meta-advice on how to shop for a hearing aid? When people buy $500 hearing aids online and are unhappy, what things are they typically unhappy about?

Assume the person doing the shopping has a doctor, no known ear-related medical problems, and will get whatever medical clearances might be necessary to buy a hearing aid. Also, assume the person doing the shopping is a senior, and couldn't care less if people can see the hearing aid; it's all about cost and function, not invisibility.
Last edited by nisiprius on Sun Sep 04, 2016 12:01 pm, edited 2 times in total.
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Re: Hearing aid 101

Post by livesoft » Sun Sep 04, 2016 11:59 am

It sounds like an opportunity to start a web site and forums just all about hearing aids. :) But that web site is already up and running.
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Re: Hearing aid 101

Post by nisiprius » Sun Sep 04, 2016 12:03 pm

livesoft wrote:It sounds like an opportunity to start a web site and forums just all about hearing aids. :) But that web site is already up and running.
I did Google, y'know, and got a boatload of websites that looked iffy and were hard to evaluate. Many of them actually seemed to be run by audiologists and/or places with street addresses that sell hearing aids. Are you talking about allabouthearing4u, or allabouthearing.us, or what, and are you giving me a meta-recommendation about a site that's widely regarded as reliable?

A common theme on the ones I looked at seemed to be disparagement of buying them online, but I suspect self-interest.
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Re: Hearing aid 101

Post by daveydoo » Sun Sep 04, 2016 12:31 pm

nisiprius wrote:A common theme on the ones I looked at seemed to be disparagement of buying them online, but I suspect self-interest.


My understanding is that the fit is very, very important, and this can be a challenge with an online purchase. That said, I did recently come across a report that some of the cheap-ees aren't completely worthless. Maybe that was CR, too?

A very frugal relative struggled with hearing aids for a decade at least and tried all the options. After resisting because of the cost, he eventually bought -- and loved -- a set or two of the (very expensive) digital/directional ones with the pocket remote. The only downside was that they couldn't get wet -- even with sweat -- and he was very active and athletic. This is the route I plan to go when it's my time. Imo, this is what money is for. I'm sure there are places that take advantage, but he eventually found a very patient audiologist who helped achieve good fit and made many adjustments. He told me, "It's not like glasses!" By that he meant that you don't put them on and smile in amazement -- rather, it's an iterative process and there's a learning curve.

Good luck! Please report back what this individual's experience is!

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Re: Hearing aid 101

Post by hicabob » Sun Sep 04, 2016 12:32 pm

The lovable cheapskate, Clark Howard, often does a hearing aid cost rant and tells listeners to try "audio amplifiers" such as hunters use first and for familiarization. Cabela's and similar sell them. Apparently Costco has very good pricing on higher end real hearing aids.

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Re: Hearing aid 101

Post by livesoft » Sun Sep 04, 2016 12:42 pm

nisiprius wrote:A common theme on the ones I looked at seemed to be disparagement of buying them online, but I suspect self-interest.

I agree which is why I thought you could start one that was not like those, but a good name was taken. I was making a recommendation to start a web site and not a recommendation to go to a web site.
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Re: Hearing aid 101

Post by Sheepdog » Sun Sep 04, 2016 12:52 pm

Hearing aid 101. See a Doctor of Audiology. Have your hearing tested by an expert. In my opinion, a user of quality, tested, hearing aids, don't buy over the counter and on-line hearing aids or from hearing aid stores. {My cost was about $1200 each 2 and 3 years ago)
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Re: Hearing aid 101

Post by sport » Sun Sep 04, 2016 1:24 pm

Costco seems to have very good prices on apparently good hearing aids. They have an audiology department in some (most?) stores.

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Re: Hearing aid 101

Post by Toons » Sun Sep 04, 2016 1:28 pm

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Re: Hearing aid 101

Post by HueyLD » Sun Sep 04, 2016 1:54 pm

Nisi,

Have you tried Costco? I know several people with hearing aids from Costco and they all seem to be happy with their choices. Sorry can't make any specific recommendation.

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Re: Hearing aid 101

Post by heartwood » Sun Sep 04, 2016 1:59 pm

Many I know with hearing aids swear by Costco.

There was a Forbes article about two years ago http://www.forbes.com/sites/richkarlgaa ... c6f4df2396

It's mostly about the lower priced units, as are several WSJ stories. I mention the Forbes article in part because it asks whether "audiologists and tests and fittings and six grand seemed … so wrong. It violated the governing law of the modern economy: Moore’s Law." The next section of the article is titled Deaf to Moore's Law.

I said in a previous thread here "The Forbes piece hit a chord with me. I pay $500 or so for a smartphone that’s really a computer with a phone, an excellent camera, can play music, surf the web, text, email, be a GPS and more. Why do hearing aids cost $3000 per ear? They have to be simpler than an iphone."

Try Costco. Their costs are much lower. Their return policy on hearing aids is great. Their units are reported to be th eequal or close to those from audiologists.

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Re: Hearing aid 101

Post by Comhaltas » Sun Sep 04, 2016 2:13 pm

I like this forum http://www.hearingaidforums.com/forum.php as it appears to be real life assessments of multiple brands, but it can require a lot of reading... As someone else pointed out, finding an expert audiologist, willing to spend time with the wearer is critical - more so than the manufacturer and model of aid.

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Re: Hearing aid 101

Post by JPH » Sun Sep 04, 2016 2:22 pm

It is very important to be tested and fitted by a qualified audiologist; not a hearing aid fitter. The initial and subsequent adjustments are important to get a good result (sound quality and comfort). Broad spectrum amplification will give disappointing results. It is more important to have the amplification correctly tuned to your hearing loss. If that is not done, everything will seem too loud, and it will be. My audiologist checks my hearing aids about every six weeks, cleans them, replaces the terminal part of the receiver, makes any adjustments I need, and gives me enough free batteries to last until my next checkup. My hearing aids are called Dream and made by Widex. The list price was $4,320.00 each, but with a discount the charge was $2,250.00 each. Deep discounts are common. Also, carefully check your health insurance for a hearing aid allowance. Medicare does not pay for hearing aids, but my supplemental BC/BS allowed a $1,000.00 benefit.
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Re: Hearing aid 101

Post by mrc » Sun Sep 04, 2016 2:26 pm

My mom has used a $5500 pair from a boutique (but they came with free batteries!), and a $1700 pair from Costco. Both served her equally well. I think she got the idea when the boutique called her saying it's time to replace your (two and one-half year old) pair even though she was hearing well. The new pair were even better and only $6500! At the time, even the Costco pair was over her budget limit. I purchased them for her, but I wasn't willing to shell out $6K unless the exam/units at Costco proved unsuitable. Online doesn't work because you need a good face-to-face examination. I was impressed with the examination in the little booth by the glasses at the Costco. The brand/type/cost depends somewhat on the nature of your particular hearing loss, and to a lesser extent the features you desire (telephone coil, remote adjustments).

As with glasses, you can obtain a hearing exam from anyone you want, and purchase hearing aids anywhere you want. At least in my state.
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Re: Hearing aid 101

Post by Dottie57 » Sun Sep 04, 2016 2:31 pm

nisiprius wrote:Someone needs a hearing aid. The local hearing-aid-equivalent-of-Raymond James suggests units ranging in price for $4,000 to $7,000. Online, there seem to be options in the three-digit range, such as Songbird and iHear. And there are even "disposable" units for $79.
.
.
.

Any meta-advice on how to shop for a hearing aid? When people buy $500 hearing aids online and are unhappy, what things are they typically unhappy about?


My dad has dementia, significant sight loss due to a stroke and very significant hearing loss. His $5000 hearing aids were doing no good.

My parents recently bought him refurbished hearing aids through an audiologist. They originally cost $8000, but refurbished were $2800. A New in the ear piece was molded. It's like a miracle. Hearing aids are not all equal.

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Re: Hearing aid 101

Post by hudson » Sun Sep 04, 2016 7:27 pm

nisiprius wrote:Someone needs a hearing aid. The local hearing-aid-equivalent-of-Raymond James suggests units ranging in price for $4,000 to $7,000. Online, there seem to be options in the three-digit range, such as Songbird and iHear. And there are even "disposable" units for $79.

This is new territory, and I am terribly frustrated by the lack of specific information (brand names and models).

Resources like mayoclinic.org, consumerreports.org, and the FDA are heavy on totally generic advice about types and features and utterly lacking in any specific mention of brand names, reliability, durability, user satisfaction, etc. etc. What I think is the full Consumer Reports report--from their website via our public library network--starts off well, saying "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 hearing aids worked in various settings." And yet no brands or models are named. It's just vague stuff like "directional microphone: Survey results show it helps for hearing household noises; in loud social settings; and while listening to the TV or radio when there's noise in the rear or off to the sides." No frequency-of-repair record. No accuracy scores like they'd give you for a pair of headphones. No "best buys." C'mon.

None of the sites is clear on whether you are risking anything beyond than the nuisance of returning a product if you try one of the low-three-digits hearing aids...

Any meta-advice on how to shop for a hearing aid? When people buy $500 hearing aids online and are unhappy, what things are they typically unhappy about?

Assume the person doing the shopping has a doctor, no known ear-related medical problems, and will get whatever medical clearances might be necessary to buy a hearing aid. Also, assume the person doing the shopping is a senior, and couldn't care less if people can see the hearing aid; it's all about cost and function, not invisibility.


Costco...$2600 for a pair that have served me well for 2 years....with 90 day no questions asked return. The audiologist wanted over $5000 for the same deal. Costco's trained tech did a great job of testing my hearing and programming the hearing aids. Maybe take a look at this discussion? viewtopic.php?p=2234027#p2234027

Hearing aid forums...not as responsive as Bogleheads... http://www.hearingaidforums.com/

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Re: Hearing aid 101

Post by scottinmet » Sun Sep 04, 2016 7:57 pm

Anytime I am in the market for something I'm not familiar with one of the first places I go to is youtube, there are usually a lot of consumer reviews for you to see what you might like.
Here's one for an inexpensive Sams club aid:
https://www.youtube.com/watch?v=Mh9tHInhWFU

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Re: Hearing aid 101

Post by arcticpineapplecorp. » Sun Sep 04, 2016 8:08 pm

Great advice so far. I was going to mention Clark Howard's advice too so thanks hicabob for beating me to it. He does rankle the audiologists when he recommends hunter's hearing aids.

I have heard the common complaints of the user are: 1. fit, 2. lack of hearing improvement. I've also heard you must go back to the audiologist and continue to get it right (or better) and not just accept whatever you're given. There could be several adjustments, different aids tried, etc. to get it right.

I often hear a whistling sound coming from them especially when someone with them in tilts their head downward. Don't know why. Maybe these are cheaper or older versions. So maybe those problems don't exist so much anymore. Something to ask about. When I heard the name of one of the aids called "Songbird" I thought, well, that's what it sounds to me...like a songbird is whistling. It doesn't seem to annoy the wearer (I suppose s/he can't hear it) but boy is it annoying for the others to be around the wearer of the hearing aid when that whistling sound starts up.

I have also heard from a co-worker that when his wife got them she cried because she suddenly realized what she had been missing all those years.

Finally, you're a very smart person Nisiprius so this probably goes without saying, but in case you're not aware there have been studies that show hearing loss (if not addressed properly) can have an effect on other cognitive functioning (link below) because you're using more brain power to interpret sounds than should normally and this takes energy from the parts of the brain that should be doing other things and not spending so much energy interpreting sounds. I hope the hearing improves. Good luck and let us know how it goes.

https://www.google.com/search?q=effects ... n+function
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Re: Hearing aid 101

Post by mrc » Mon Sep 05, 2016 6:37 am

arcticpineapplecorp. wrote:...
Finally, you're a very smart person Nisiprius so this probably goes without saying, but in case you're not aware there have been studies that show hearing loss (if not addressed properly) can have an effect on other cognitive functioning (link below) because you're using more brain power to interpret sounds than should normally and this takes energy from the parts of the brain that should be doing other things and not spending so much energy interpreting sounds. I hope the hearing improves. Good luck and let us know how it goes.

https://www.google.com/search?q=effects ... n+function


Indeed. I was especially taken with the notion of "effortful listening," which I observed my mother performing, and then abandon over time. Her HAs do make it easier for her to hear the words without fatigue, and by reducing fatigue, help increase overall comprehension. Before the HAs, I watched her make choices (where I didn't think she really understood the question), and then express surprise at the outcome. When asked: Why did you make that choice then? She replied: I didn't know I had. Embarrassment over her hearing loss has cost her money in the past.
A great challenge of life: Knowing enough to think you're doing it right, but not enough to know you're doing it wrong. — Neil deGrasse Tyson

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Re: Hearing aid 101

Post by mouses » Mon Sep 05, 2016 7:01 am

arcticpineapplecorp. wrote:
Finally, you're a very smart person Nisiprius so this probably goes without saying, but in case you're not aware there have been studies that show hearing loss (if not addressed properly) can have an effect on other cognitive functioning (link below) because you're using more brain power to interpret sounds than should normally and this takes energy from the parts of the brain that should be doing other things and not spending so much energy interpreting sounds. I hope the hearing improves. Good luck and let us know how it goes.

https://www.google.com/search?q=effects ... n+function


I seriously doubt this. I have a mild high frequency hearing loss. 99% of the time I am not aware of it when there is no substantial background noise like elevator music, and I am pretty sure no one else is either. Every few months, I encounter someone who is just about unintelligible - whether accent, pronunciation, I have no idea why. I am sure I seem mentally impaired when trying to communicate with such a person.

I suspect that's what the observed symptoms are due to - someone just can't hear what is being said and bails by pretending.

Just recently there was an article saying brain imaging in medical studies of behavior was a crock of inaccurate, due to errors in method, failing to rule out interfering activities, etc.

(I did try getting a hearing aid several years ago and it was way out of balance and seemed unbelievably expensive for what it was supposed to do.)

By the way, JPH, needing a tune up every six weeks? Is that a typo for months?

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Re: Hearing aid 101

Post by t3chiman » Mon Sep 05, 2016 9:44 am

nisiprius wrote:... units ranging in price for $4,000 to $7,000....
Any meta-advice on how to shop for a hearing aid? ....


These things are overwhelmingly made in China nowadays.
If you are planning a trip to China anyway [Now is a good time; lots of great airfare bargains.], you can visit any of dozens of hearing aid shops in any of the big Chinese cities. Helps to have a Chinese-speaking companion, of course.
A couple of months ago, I got a nice pair of digital hearing aids in Ningbo for $2000USD complete.

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Re: Hearing aid 101

Post by JPH » Mon Sep 05, 2016 10:12 am

mouses wrote:
arcticpineapplecorp. wrote:
By the way, JPH, needing a tune up every six weeks? Is that a typo for months?


Nope. Every six weeks for the things I mentioned. There is no adjustment of the instruments unless I complain or request it. I believe the neuroscience on cognitive impairment being caused by hearing loss/sensory deprivation.
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Re: Hearing aid 101

Post by mrb09 » Mon Sep 05, 2016 10:24 am

As others have stated, most hearing loss (and certainly mine) is a type of high frequency loss, you need to match the hearing aid profile with your hearing. I worked with an audiologist who sold me some pretty pricey units, I worked with her over a period of four months to tune them in -- the initial adjustment that I ended up with would have been too much of an abrupt change for me to start with -- I'm hearing sounds I haven't heard in years.

I also know folks who have costco hearing aids that are much cheaper, but I don't think they got the same care I did in adjusting the hearing profile. They certainly complain about them more, and I love mine.

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Re: Hearing aid 101

Post by Sheepdog » Mon Sep 05, 2016 12:02 pm

mrb09 wrote:As others have stated, most hearing loss (and certainly mine) is a type of high frequency loss, you need to match the hearing aid profile with your hearing. I worked with an audiologist who sold me some pretty pricey units, I worked with her over a period of four months to tune them in -- the initial adjustment that I ended up with would have been too much of an abrupt change for me to start with -- I'm hearing sounds I haven't heard in years.

I also know folks who have costco hearing aids that are much cheaper, but I don't think they got the same care I did in adjusting the hearing profile. They certainly complain about them more, and I love mine.

Well written.
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Re: Hearing aid 101

Post by Doom&Gloom » Mon Sep 05, 2016 1:32 pm

Sheepdog wrote:
mrb09 wrote:As others have stated, most hearing loss (and certainly mine) is a type of high frequency loss, you need to match the hearing aid profile with your hearing. I worked with an audiologist who sold me some pretty pricey units, I worked with her over a period of four months to tune them in -- the initial adjustment that I ended up with would have been too much of an abrupt change for me to start with -- I'm hearing sounds I haven't heard in years.

I also know folks who have costco hearing aids that are much cheaper, but I don't think they got the same care I did in adjusting the hearing profile. They certainly complain about them more, and I love mine.

Well written.


+1

Thanks to OP for starting this thread as I will undoubtedly be starting down this path within the next year or two.

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Re: Hearing aid 101

Post by roflwaffle » Mon Sep 05, 2016 2:11 pm

First thing's first, go to an audiologist (Costco seems to have some good hearing aids for relatively reasonable prices) and have your hearing tested. I'd try out some hearing aids and get an idea of what those cost too. From there, order a set of inexpensive (about $150 to $500/set) Siemens HAs from ebay as well as a separate *set of tubes/elbows/tips (~$2 per set), and see how well you can dial them in yourself with your hearing test results.

http://www.hearingaidforums.com/showthr ... nd-GH03001
http://www.hearingaidforums.com/showthr ... ctive-Test

At that point, you can go back to the audiologist and compare those hearing aids to what you're audiologist offers. If you like the more expensive HAs enough and/or have trouble adjusting your inexpensive HAs, then get them and either sell the Siemens set or keep them as a less expensive backup. If the less expensive set work for you, you're golden, and you also spent hundreds or thousands less for you HAs.

:beer

*The ones that come with the HAs are awful in my experience.

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Costco for hearing aids?

Post by Taylor Larimore » Mon Sep 05, 2016 2:30 pm

nisiprius:

I have two good friends with hearing-aids bought from Costco and they are very satisfied with their low-cost and service.

"Never ask a barber if you need a haircut." Nevertheless, I decided to give them a visit and see if I needed a hearing aid. After an impressive test the audiologist said "no." That was good news and also reassuring about their ethics.

If I ever need a hearing aid, I will go to Costco keeping in mind that each store is different.

Best wishes.
Taylor
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Re: Hearing aid 101

Post by likegarden » Mon Sep 05, 2016 4:08 pm

Where I live there is no Costco. My health insurance has a low cost supplier of hearing aids, but the first time I tried to use them that location did not seem to exist.

I have Siemens hearing aids for 4 years in both ears, $3,300 then. I could use an upgrade. I use them when visiting stores, grandson's school, doctor, etc. Being a former controls engineer, seeing all that miniature design in telephones and other electronics at relatively very low cost, I can absolutely not understand why no organisation has developed yet a low cost and well working hearing aid which can be applied at low cost, such as for $1,000 for 2 ears. Asking to pay $5,000 to 7,000 is outrageous.

These high cost suppliers do not see the large potential market waiting for them. A lot of people could use hearing aids, but can not afford them.

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Re: Hearing aid 101

Post by celia » Mon Sep 05, 2016 7:53 pm

nisiprius wrote:Resources like mayoclinic.org, consumerreports.org, and the FDA are heavy on totally generic advice about types and features and utterly lacking in any specific mention of brand names, reliability, durability, user satisfaction, etc. etc. What I think is the full Consumer Reports report--from their website via our public library network--starts off well, saying "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 hearing aids worked in various settings." And yet no brands or models are named. It's just vague stuff like "directional microphone: Survey results show it helps for hearing household noises; in loud social settings; and while listening to the TV or radio when there's noise in the rear or off to the sides." No frequency-of-repair record. No accuracy scores like they'd give you for a pair of headphones. No "best buys." C'mon.

The site you are hoping to find will never exist since each hearing aid has to be customized for each user. Buying a hearing aid is like buying glasses. You don't know what you need without a professional exam. The one that works the best for me will likely be terrible for you. So do you expect comparing them to be like comparing cars or washing machines? In addition, buying a "generic" hearing aid from online or through the mail is like buying reading glasses off the rotating rack in the pharmacy. They are ok if you need minor improvement to read the newspaper or hear the tv a little louder, but if you never get tested, you will never know if something will work better for you or not. And the "generic" can possibly make the condition worse. There is no cost to get tested for a Hearing Aid.

I've gone to check out hearing aids with two family members so far this year. Both have had hearing aids in the past. I had heard several years ago that the technology keeps changing so that even if you get a hearing aid with a 3-year warranty and it still works at the end of that time, it would be worth considering getting a new one. (If you have a secondary insurance plan that pays for part of the cost, it usually will only pay out every three years.)

User "A" originally bought a HA from a local chain with many locations over 3 years ago. They only carry one hearing aid as we've learned recently. When the user was originally tested, the "tech" had him try on a recommended hearing aid which seemed fine so it was ordered. Several months (!) later, after the user went to pick it up, a different (supposedly better?) hearing aid was given out by a different "tech". This was a red flag to me but since I didn't go with the user to the appointment, I called up for clarification and was satisfied with the answer. During the time the user went to this location, the "tech" would be different for each appointment. (They were all supposedly moving to a location closer to where they lived after they gained some seniority. That was the official answer we always got as to why the tech wasn't there anymore.) Now when I check, I see that there are only 5 locations for this company, so I believe they have been closing some offices. The "wire" that goes in the ear broke this year and to get it fixed would cost several hundred dollars, so the user opted to start all over and get a new hearing aid with the latest technology instead at another company.

In the intervening time, user "A" seemed satisfied with the hearing aid so I referred user "B" to the same place. She went there and also got a HA but it never worked properly for her. They could never get rid of the "feedback" noise, so she got her money back and has been using a "generic" HA ever since.

At a minimum, a hearing test involves the user sitting in a sound-proof booth with a button he/she presses when a sound frequency is heard. This is recorded on a computer and a graph is later shown to the user to show how his/her hearing compares to "normal" hearing. If you keep a copy of these graphs over time, you can see how your hearing is changing. The test also involves repeating back individual words that the tester says verbally. When I went with user "B" recently for a hearing test, they did the word test in the sound proof both and she missed about 1/3 the words. They also repeated the test in an office with low background noise (I was sitting there and A/C would run, chairs would creak, street traffic noise was slight) and 2/3 of the words were missed. This was to show the user (and me) how much a Hearing Aid would help. Even the slight background noise made it harder for this user to hear.

After discussing features and the situations the user is often in (watching TV at home, frequency of using a phone, restaurants, concerts, driving with people in the back seat, talking to young children with high-pitched voices) the user and "tech" together determine what level of hearing aid is needed. The higher priced-models screen for more types of noise that many seniors do not often encounter (sporting events, concerts).

A sample hearing aid is then chosen for the user to try out. It is first programmed by a computer according to the results found while sitting in the sound-proof booth. But this programming is only a rough estimate of what is best for the user. After putting the HA in the user's ears and a sensor around the user's neck, the tech starts to refine the adjustments according to what the user says is needed. For example, user "B" could hear her own saliva while talking, since it was set to be too sensitive. (The user's own voice will sound different to the user like it does when you leave a message on a phone recorder. This is to be expected.) It is up to the user to notice when the volume or direction is not right. If it is not conveyed to the tech, the correct modifications can't be made. As the user gets used to the hearing aid over several months and her brain starts to change how it processes sounds, the user will need to return for further adjustments. Up to this point there is no cost.

If the user is not sure if the identified HA is what he wants, he should go elsewhere and be tested and fitted again. He should also notice if one "tech" is an audiologist who should be more thorough than a regular "tech" (salesperson). Does another company test differently or have different brands of hearing aids available? These are all legitimate reasons to do some comparisons, not only in the company that will test and fit you, but also in the HA device itself. But all these comparisons should be based on the user's needs, not mine.

Now for the part about costs. All the places we visited offered a discount without even being asked. (This could be because there is a lot of competition around here.) So although the price starts at $4,000 for a pair of basic hearing aids up to $7,000 for the more sophisticated models, rarely does anyone pay that price. I think the automatic offering of a 20% discount is a distraction to make you think you are getting a good deal. Why not ask if they have any AARP or AAA discounts? (These places do not contribute any money towards the cost, but they apparently contract with local businesses in exchange for sending referrals their way. Currently in SoCal, Connect Hearing offers 45% off to AAA members, as we found out when user "A" happened to go there. I later noticed on the AAA web site, they were the only current hearing aid “deal” for our area.)

Before you go in, there are two things you need to do. Plan to pay with a credit card. Call your credit card company to see how long of an extended warranty they would add on to the 2 or 3 year manufacturer warranty. Also ask them since 3 years of office visits is included for hearing aid adjustments as your hearing changes, if the office should close down within 3 years, would the credit card company reimburse any charges that would be incurred by going to another hearing aid office (ie, a different chain).

Also confirm if your medical insurance covers any of the cost or not. Medicare does not cover Hearing Aids (the exams are free), but some Advantage plans contribute something towards any model you choose. Some Medigap plans have an associated discount program that works like the AAA or AARP using referrals to particular providers.

Don’t forget that you can pay for Hearing Aids using funds from a HSA, FSA, or possibly get them for free if you are eligible for VA or Medicaid benefits benefits.

Options There are two options that some users should consider:
If the user has dexterity problems or Alzheimers, a hearing aid with a rechargeable battery should be considered. With a regular battery that lasts about a week, the “door” needs to be left open at night so the batteries don’t get drained. A recharger can be purchased for some HA models for about $100 where the hearing aid is left in the charger at night. Nothing in the HA needs to be plugged into the charger, but the charger is left plugged into the wall at all times. So this would come in handy for someone who has dexterity limitations or just wants to be out and about without worrying that a battery will die in the middle of the day. It has also been noted that some seniors have swallowed batteries, thinking they were pills, so not having to see a battery would benefit them.

Some hearing aid models can also be modified by the user during the day to increase or decrease the volume or directionality if a noisy environment is entered. These changes can be made by a phone app on the more expensive models or on a neck lanyard. The temporary change is reset at night when the cover to the battery is opened.


Recommendations
1. Use a reputable chain that has several offices that are convenient to you, in case some locations close/move and look for personnel who have been in that office several years. Do other patients come in or out of the office while you are there or does business seem "slow"?

2. Have someone else go with the patient to at least the first few appointments to make observations and help ask questions that may not occur to the patient (even if the questioner knows the answers). Preferably do the questioning while the patient is wearing a sample hearing aid, so he/she has a chance to “test” the current settings that can be adjusted by the “tech”.

3. Follow the recommended office visit schedule as your hearing will continue to change as your brain gets used to the change in sounds. It will be helpful to write down any situations when something is noticed so you can relay it to the tech so appropriate changes can be made at the next visit. If you don’t give any feedback, they are helpless to help you.

4. Call your credit card company and insurance company before going for a hearing test so you can account for that when discussing price.


likegarden wrote:Being a former controls engineer, seeing all that miniature design in telephones and other electronics at relatively very low cost, I can absolutely not understand why no organisation has developed yet a low cost and well working hearing aid which can be applied at low cost, such as for $1,000 for 2 ears. Asking to pay $5,000 to 7,000 is outrageous.

Like many people, you are forgetting about the customization that goes into an optimal improvement in hearing. Not only is the initial consultation included as part of the purchase price (“free” needs to be paid for somehow), but two or three years of office visits is included in the price. Whether you use them or not is up to you, but they are included in the up-front price. When you get glasses, you possibly need to go back to have the frames adjusted once, but it is different with a hearing aid.
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Re: Hearing aid 101

Post by nisiprius » Mon Sep 05, 2016 9:03 pm

Thanks to everyone who is contributing, it's interesting and helpful.

I understand the "customization" and "like eyeglasses" analogies, but hearing aids cost ten times as much as eyeglasses. In both cases one has the feeling that it's a bit of a racket, but it's more stressful when it is thousands of dollars at stake instead of hundreds.

The ideal would be to find an audiologist who has no business connection at all with any hearing aid manufacturer or dispensary who would be willing to do the tests and make a professional evaluation of how suitable the $500 Internet-sold hearing aids are, before going ahead with the more expensive and presumably-more-adaptable $5,000 hearing aids... but I suspect that's hard to do.
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Re: Hearing aid 101

Post by island » Mon Sep 05, 2016 9:05 pm

Are you a veteran? The VA provides hearing aids and the hearing loss does not have to be service related. Some people have to pay an office visit copay.
In my area, the veteran contacts the local VA hospital membership or enrollment dept to get the ball rolling on eligibility.

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Re: Hearing aid 101

Post by Miriam2 » Mon Sep 05, 2016 9:21 pm

nisiprius wrote:The ideal would be to find an audiologist who has no business connection at all with any hearing aid manufacturer or dispensary who would be willing to do the tests and make a professional evaluation of how suitable the $500 Internet-sold hearing aids are, before going ahead with the more expensive and presumably-more-adaptable $5,000 hearing aids... but I suspect that's hard to do.

The Ear Institute or Ear Department at a major hospital, especially if affiliated with a university or medical school, would have audiologists with no business connection to a hearing aid manufacturer, or at least should have no such business connection. They should be up to date on audiology testing with the proper equipment and knowledgeable about the latest developments in the field to plan the future.

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Re: Hearing aid 101

Post by sbaywriter » Mon Sep 05, 2016 9:43 pm

Adding my experience since I recently got hearing aids.

I first noticed mild hearing loss about 10 years ago. By 2 years ago it had gotten worse, couldn’t hear anyone with softer type voices which included my manager at work, unless they were sitting facing me directly. Found out my insurance (Cigna) covered 85 percent of the hearing aid cost. Got hearing aids 2 years ago at a medical office but midway through the fitting process found out that hearing aid provider was no longer covered by Cigna, I had to go through their special provider (Amplifon). So canceled it.

This summer trying again. On the aids I tried 2 years ago, I had trouble adjusting the sound settings on the back of the hearing aids. The new audiologist told me that I could do this on my iphone with the Starkey Halo II model (it’s not the only one that does this, I’m sure). So I got that model. The cost was about $5000 so I ended up paying about $800 plus the exam. Amplifon gives a one-year supply of batteries plus one year follow up visits, although there has been a problem with that I am still trying to resolve.

Without hearing aids I was straining to hear what people said. I didn’t realize how tiring that was until I no longer had to do it. Likewise, before hearing aids, I often gave up and smiled vaguely at people during a conversation pretending I could hear them. I only asked to repeat if it was essential that I hear or I wanted very much to hear. I lost interest in social gatherings since I couldn’t hear. Much better now, feel more connected.

I like being able to adjust the volume using the iphone. The other part that hooked me was I was told was that I could have a range of stored settings on the iphone, for example, at restaurants, in the outdoors, in the car. The iphone comes with a built in programmable memory for 4 settings, which the audiologist programs, and then there is an app that offers customizable settings. I have the 4 built-in settings to start with and I am disappointed - not finding them useful at all. I can tell slight differences between them, but not useful differences. So I may need to go back for more fine tuning. Also I found mechanical sounds very loud and clanky and she was able to reduce that somewhat by adjusting a setting, but that setting is as low as it will go and I still notice the microwave buzzer sounds shrill, etc. Haven’t been to any music concerts so don’t know how that will be. The last one I went to without hearing aids I found voices in high ranges shrieky and hard to listen to – I don’t think it was the voices!

If I hadn’t had the insurance coverage, which will be ending soon, I would have gone to Costco. Once you have been through your first round of fitting, a lot of the mystery goes away and you know better what to ask for and require less help. I do think it’s a bit of a racket, but there is some technical training required to do the tests and adjustments, although I doubt as much as optometrists, and I guess they try to build in some of the follow-on visits into the cost of the devices.

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Re: Hearing aid 101

Post by alisa4804 » Mon Sep 05, 2016 10:30 pm

sbaywriter - very informative post, especially about the iPhone app available for different settings for restaurants and such! Thank you.

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Re: Hearing aid 101

Post by Miriam2 » Mon Sep 05, 2016 11:11 pm

^^^ yes, agree, thank you sbaywriter!

And Celia, very informative post, truly "Hearing Aid 101," thank you for taking the time to post it :happy

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Re: Hearing aid 101

Post by celia » Tue Sep 06, 2016 1:43 am

nisiprius wrote:I understand the "customization" and "like eyeglasses" analogies, but hearing aids cost ten times as much as eyeglasses. In both cases one has the feeling that it's a bit of a racket, but it's more stressful when it is thousands of dollars at stake instead of hundreds.

I think it's more that you can physically SEE glasses and hearing aids so you or your relative can SEE what you got for your money. You can't HEAR glasses and hearing aids (although you can hear sounds) so you or your relative can't HEAR if you got your money's worth. Don't worry. If a hearing exam and in-office trial don't immediately WOW you, then maybe you don't need one. But in that case you probably don't need the $500 one either. Just the fact the "someone" is thinking they need a hearing aid, usually means they do.

The ideal would be to find an audiologist who has no business connection at all with any hearing aid manufacturer or dispensary who would be willing to do the tests and make a professional evaluation of how suitable the $500 Internet-sold hearing aids are, before going ahead with the more expensive and presumably-more-adaptable $5,000 hearing aids... but I suspect that's hard to do.

I don't see why you can't do this. Is the $500 hearing aid returnable for 60 days or so? Get one, see if you think it works ok, then take it with you as you go get a professional hearing test and try out their sample. (Relative #2 did this.). If you can't tell a big difference, then just keep the $500 one (assuming it does help you). No one should laugh at you. In fact, they will realize that cost is important to you. But listen to what they say technically about the $500 model. They already know you can return either one. Why would they push you to get theirs only to have to give your money back? For backup, go with your friend or relative and ask them to help you ask questions. You can always leave and think about it. (This is what we usually do. In fact, relative #2 was so impressed she wanted to buy one on the spot. But I wanted to talk to her first as the business location is brand new and I wasn't comfortable with them.)

A lot of people find the lowest cost model satisfactory for them, especially if they are now retired.
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Re: Hearing aid 101

Post by carolinaman » Tue Sep 06, 2016 7:41 am

I am on my 2nd set of hearing aids. I bought the first one from local EENT practice and was tested and fitted by a doctor of audiology. The hearing aid lasted 5 years and required several visits to audiologist for adjustments. When my hearing aid stopped working, I went to Costco. I insisted on being tested by an audiologist (they have different levels of hearing techs). She was very thorough in her test. I felt she was every bit as good as the EENT audiologist. She recommended a pair of Kirkland hearing aids at a cost of $1800. These were made by ReSound and are equivalent to the $6,000 pair of ReSound hearing aids that are sold by the EENT.

IMO, the service and support by Costco has been better than the EENT although both are good. Costco is the leading seller of hearing aids in the US. If there is a Costco in your community, I highly recommend Costco.

You need to take a hearing test to understand your hearing deficiency which varies by person. You then should be fitted for the appropriate device for your hearing problem and it needs to be tuned for you. It sometimes takes 2 or 3 visits to get the devices properly tuned for you. Hearing aids are much more sophisticated than these hearing amplifiers you see advertised. They can be fitted and tuned to deal with your specific hearing problem. I have tried some low cost amplifiers and they might be useful for some, but generally speaking, getting tested and fitted for quality hearing aids is a better way for most people.

I have been told by multiple audiologists that if you do not correct a hearing deficiency, the hearing loss can be permanent even if you later try to correct it. Hence, it is important to deal with the problem now.

My biggest problems are background noise, especially restaurants, and difficulty hearing high pitched sounds, i.e. the female voice. My wife claims the latter is an acquired skill through many years of practice.

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Re: Hearing aid 101

Post by likegarden » Tue Sep 06, 2016 7:54 am

Here I must mention my FANSTEL amplified telephone which I bought because I was not hearing well on a normal telephone with my Siemens hearing aid. That cost me $100, and I can here well even high pitch voices, but without wearing my hearing aid. So there are low cost hearing technics around, but since they do not provide large profits they are not offered, so it seems. I just got another invitation to a free lunch offering me another hearing aid.

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Re: Hearing aid 101

Post by Rupert » Tue Sep 06, 2016 8:27 am

Miriam2 wrote:
nisiprius wrote:The ideal would be to find an audiologist who has no business connection at all with any hearing aid manufacturer or dispensary who would be willing to do the tests and make a professional evaluation of how suitable the $500 Internet-sold hearing aids are, before going ahead with the more expensive and presumably-more-adaptable $5,000 hearing aids... but I suspect that's hard to do.

The Ear Institute or Ear Department at a major hospital, especially if affiliated with a university or medical school, would have audiologists with no business connection to a hearing aid manufacturer, or at least should have no such business connection. They should be up to date on audiology testing with the proper equipment and knowledgeable about the latest developments in the field to plan the future.


+1. I have a child with severe conductive hearing loss in one year. We see an audiologist at a local state university Speech & Hearing Center. We paid about$1300 for one hearing aid, but we never pay anything to see the audiologist (those services are included in the $1300, I think, but it's not separated out). We do have to see the audiologist every 6 months for a new ear mold fitting (kids' ears grow fast) and that costs $75 each time, but that's all I've paid after the initial visit. Since our audiologist is a professor of audiology who teaches all the other audiologists in the local community (including the one at Costco), I am confident we are getting the very best care. I'm not sure how a senior citizen would gain access to the services we receive, but I've seen senior citizens in the waiting room so I know it's possible.

Edited to note this: Just fyi -- I don't think it's terribly helpful for you to base a decision on what price other people have paid for their hearing aids. There is now a wide variety of hearing aid technology available. For example, it is now possible to connect your hearing aids via bluetooth to your telephone, some televisions, computers, etc. In other words, your iPhone rings, you answer it, and you don't have to hold the headset to your ears because the sound is broadcast directly through your hearing aids. Someone who has paid $7000 for their hearing aids has possibly purchased technology, such as the iPhone technology, that you don't need and wouldn't use. A person who had paid $500 for his/her hearing aids has possibly purchased a very barebones pair that doesn't do what you might need or want them to do.

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Re: Hearing aid 101

Post by mouses » Tue Sep 06, 2016 8:38 am

carolinaman wrote:I have been told by multiple audiologists that if you do not correct a hearing deficiency, the hearing loss can be permanent even if you later try to correct it. Hence, it is important to deal with the problem now.


If a sense stops working, eventually the brain will lose the ability to process input from it, or, in the case of babies or very young children, never develop it. However, for adults this takes many years. You don't see people who have had cataracts for years and then have had cataract operations complaining that the operation has not improved their vision. And that is measurable with eye charts.

I am not sure that a partial vs. total hearing loss causes this problem. Audiologists have a financial reason for picking up on this idea and presenting it as Truth, when in fact it may not actually be a factor for a long time if at all.

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Re: Hearing aid 101

Post by S&L1940 » Tue Sep 06, 2016 10:03 am

t3chiman wrote:
nisiprius wrote:... units ranging in price for $4,000 to $7,000....
Any meta-advice on how to shop for a hearing aid? ....


These things are overwhelmingly made in China nowadays.
If you are planning a trip to China anyway [Now is a good time; lots of great airfare bargains.], you can visit any of dozens of hearing aid shops in any of the big Chinese cities. Helps to have a Chinese-speaking companion, of course.
A couple of months ago, I got a nice pair of digital hearing aids in Ningbo for $2000USD complete.

yeah, but, what do you do for adjustments?
Assuming you need more than a sound amplifier, fine tuning and cleaning are necessary over the life of the aids. Not sure a local provider would do that at no charge or even offer you the service as would a reliable dealer who sold you the aids. Probably same issue with online sellers.
As to "invisible" aids, with folks walking around with their cell phones sticking out of their ears, wearing hearing aids is no longer a stigma or a sign of old age.
Don't it always seem to go * That you don't know what you've got * Till it's gone

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Re: Hearing aid 101

Post by LWalker » Tue Sep 06, 2016 12:52 pm

One standard and very excellent brand is PHONAK.

The subsequent visits after you get your set are tremendously important. The hearing aids need to be tuned for you. Also it is routine that the audiologist will only give you minimal amplification at first, if you are a new user. This is in order not to blast your ears, which are currently compensating in every way possible in order to pick up sound, based on neural reflexes we're not consciously aware of. Gradually over time, the audiologist will increase your volume, and also make adjustments which will improve the sound quality.

The first step is to get a hearing test by an audiologist. The second step is to get clearance and an order from an MD. After that you can go to whatever provider you want, but they won't proceed without the order.

My brother is happy with the professionalism & service at Costco and the prices are better.

There are usually about 5 options, from basic up to all-bells-and-whistles. Every couple of years the technology improves, so even the basic level in an expensive pair will be amazing compared to what was available 10 or 15 years ago.

Not only initial fit and subsequent tuning are important - also simple cleaning and maintenance (including cleaning wax from the ear canals, for some people.)

Be careful how you dispose of the disc batteries! They are very, very dangerous to pets and children if swallowed, and leak heavy metals into landfills.

Good luck! I really didn't believe it when they told me I'd get so I forgot I had them in, but it's true.

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Re: Hearing aid 101

Post by MichaelRpdx » Tue Sep 06, 2016 1:20 pm

Go To Costco. I'm on my second set of hearing aids. Costco beats all other options available to a consumer.

Why do I say this?

    The audiologists are as certified as what you'll find in private practice
    The testing is, in my experience, better.
    They have a wide selection of models and styles
    There is NO up selling pressure
    Follow up visits to ensure the aid was adjusted properly for me went very well.
    Cost - less than half of what you'll pay for comparable set

Actually, the up selling pressure is negative. I wanted a blue tooth plug into the TV and get direct transmission to my aides. They suggested I wait until I'd had my aid for awhile. I pushed back, they pushed back. This is the opposite of what you'll find at the private practice place.

At least visit them and find out how the audiology department is at your local Costco.
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Re: Hearing aid 101

Post by billw » Tue Sep 06, 2016 1:44 pm

1+ LWalker post re: PHONAX brand.

Veterans if eligible should check with their local VAMC Audiology Dept

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Re: Hearing aid 101

Post by reggiesimpson » Tue Sep 06, 2016 3:23 pm

Amazon Lifeear brand behind the ear $740 for 2 ( left and right ). Adjustable for sound and environment. Return within 30 days if not pleased for full refund. Tried the $4500 pair both behind the ear and inside ear, tried the Costco $2000+ in the ear etc. My Amazon cheapos are the best hands down.

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Re: Hearing aid 101

Post by t3chiman » Tue Sep 06, 2016 4:33 pm

S&L1940 wrote:
t3chiman wrote:...

These things are overwhelmingly made in China nowadays.
If you are planning a trip to China anyway [Now is a good time; lots of great airfare bargains.], you can visit any of dozens of hearing aid shops in any of the big Chinese cities. ...

yeah, but, what do you do for adjustments?
Assuming you need more than a sound amplifier, fine tuning and cleaning are necessary over the life of the aids...


I was skeptical myself. And it is not a viable strategy if you anticipate lots of adjustments, and the China trip is once in a lifetime. Go to Costco.

But hang out in the international terminal of major airports in the US and Canada. There is an amazing amount of travel to/from China these days. Not just tourists: students, teachers, suppliers, salespeople, engineers, families--lots of cycling back and forth. For general medical tourism, I would steer clear of China; for electronics stuff that will be obsolete in 3 years anyway, it can make sense.

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Re: Hearing aid 101

Post by mouses » Tue Sep 06, 2016 6:14 pm

LWalker wrote:Be careful how you dispose of the disc batteries! They are very, very dangerous to pets and children if swallowed, and leak heavy metals into landfills.


What do you do with them - hazardous waste collection?

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Re: Hearing aid 101

Post by mhalley » Tue Sep 06, 2016 7:32 pm

With the major advances in electronics and miniaturization over the last many years, it is crazy that hearing aids still cost so much. I keep hoping Apple or somebody like that will announce they have been able to come up with an iphone based hearing aid for about the price of a flagship phone.
I came across this website several years ago. I have been considering getting a hearing aid, but so far turning up the tv is still working for me. No idea if this is a good product, but might be worth a try before going with the $$$$ ones, as they supposedly have a money back guarantee.
https://www.mdhearingaid.com/?esvt=136- ... Ar9u8P8HAQ

LWalker
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Re: Hearing aid 101

Post by LWalker » Wed Sep 07, 2016 11:42 am

Careful not to lose track of disc batteries - if one drops, find it.

Yes, like all batteries, dispose in hazardous waste. Sometimes the audiologists' offices have a jar.

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Re: Hearing aid 101

Post by fourniks » Wed Sep 07, 2016 12:34 pm

This is from someone who has had hearing issues most of their life.

1.) Find a fantastic audiologist. They will be able to make suggestions on a hearing aid with sufficient power for your specific type of hearing loss. Your annual hearing test results can be taken to any retail establishment to determine models that will suit you.

2.) Don't scrimp. I don't know what kind of hearing aids Costco sells, but names like Phonak, Widex, Siemens, Oticon, Starkey generally have the best reputation (and will likely be the most expensive).

3.) Programming and "training" after selection is important. The person you buy from should also be a licensed audiologist, and should be familiar with the aids company software for setting up your aid (from your last test), as well as the initial testing. There are tests that can be run inside the ear (v. small tubing) vs outside to get the best setup.

4.) My audiologist is from a research university. They also sell hearing aids. However I was able to go to a smaller mom/pop hearing aid company and at least get the device suggested by the Uni for a significant discount. Again, make sure they are familiar with it and can program it.

5.) Stay away from Miracle ear, beltone, etc. They don't have very good reputations.

6.) I've been wearing a Phonak for about 5 years (its digital and has multiple programs but was not top of the line model). I'm in the market for a new one soon and will likely pay about $3-3.5k (for one). I have about 15% loss and mine will continue to be a behind-the-ear model more powerful than in the ear/in the canal.

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