Types of Hearing Aids and How to Choose What’s Best for You

If you have hearing loss, your doctor may recommend a small electronic device called a hearing aid that you wear in or behind your ear.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), the device magnifies sound vibrations entering the ear, helping to improve hearing and speech comprehension.

Hearing aids, regardless of the type, have three different parts:

• a microphone
• an amplifier
• a speaker

Sound comes through the microphone, which then converts to electrical signals. These signals go to the amplifier, which increases the power of the signal. The amplifier then sends the signals to the ear through a speaker.

Hearing aids are differentiated by where you place them, how they work, and special features. The four primary types of devices are:

• behind-the-ear (BTE)
• in-the-canal (ITC)
• in-the-ear (ITE)
• receiver-in-canal (RIC)

We’ll go over each of these types in the following sections.

Behind-the-ear (BTE)

Behind-the-ear hearing aids, also called BTE aids, sit behind the ear. They feature a clear tube that connects to the earmold. All of the components are contained in a compartment that sits behind the ear.

BTEs are easy to clean and handle, and they’re also relatively sturdy. According to the Food and Drug Administration (FDA), BTEs are recommended for children since you can replace the earmold as they grow.

A variation of the BTE is an open-fit hearing aid that allows the ear canal to remain open by fitting behind the ear completely. A narrow tube goes into the canal. Sometimes this style is recommended if you have a lot of earwax or are prone to buildup.

In-the-canal (ITC)

An in-the-canal (ITC) aid is a lightweight plastic shell that sits inside of the canal. They’re known for being comfortable and easy to use. Plus, they’re made to fit the size and shape of your ear. However, since they’re small, some people find them harder to use.

ITCs work for moderate to severe hearing loss, but aren’t recommended for profound hearing loss.

Variation of the ITC hearing aid

A variation of the ITC hearing aid is an aid that’s seated deeply into the canal. Also called completely-in-the-canal (CIC), this style is small, minimally visible, and provides no feedback when using the phone.

However, a CIC is more expensive and may cause your voice to sound too loud (also known as the occlusion effect).

This style is more appropriate for mild to moderate hearing loss.

In-the-ear (ITE)

In-the-ear (ITE) hearing aids are slightly larger than ITC aids, but they’re easy to handle. The parts are contained in a shell that fills in the outer part of the ear.

According to the NIDCD, one of the advantages of ITEs is the ability to install a telecoil. This allows you to receive sound through the circuitry of the hearing aid, as opposed to the microphone. It also makes it easier to hear when talking on the phone.

ITEs work best for people with mild to severe hearing loss.

Receiver-in-canal (RIC)

The receiver-in-canal (RIC) type of hearing aid where the receiver sits inside the ear canal. The tube is nearly invisible, and the receiver is very small. They’re typically smaller than a BTE and appropriate for mild to moderate hearing loss.

While this type of hearing aid may be more likely than some others to develop moisture and wax buildup, it does tend to run into fewer feedback issues.

Hearing aids use electronics, but how they work will depend on which type. Analog or digital electronics are the two primary types. Both convert sound waves, but do so in their own way. Here are a few key differences between analog and digital hearing aids.

Analog hearing aids

With an analog hearing aid, the device converts sound waves into electrical signals. These signals are then amplified. In general, these are less expensive than digital hearing aids, but they’re also not as common as digital hearing aids, according to the FDA.

Digital hearing aids

A digital hearing aid converts sound waves to numerical codes. These codes are then amplified.

An audiologist can program the device to amplify some frequencies more than others, making this a popular choice for people who want a hearing aid that better matches their needs and listening environments.

Not all hearing loss is the same. Deciding on the best hearing aid takes some trial and error, but there are a few tips to ensuring the process goes smoothly.

Get a checkup

One of the best ways to know if a hearing aid is right for you is to see a doctor and have your hearing tested. They can provide recommendations for what will work best for your hearing.

Take it for a test drive

Once you decide on a style, ask about taking the hearing aids for a test drive. Most companies provide trial periods. But before you leave the store with them, ask for details about the trial period and make sure the product is fully refundable if you decide to return it.

Beware of advertisements with misleading claims

Internet and TV ads are full of companies claiming to sell quality hearing aids. While many are reputable, some are not.

If you’re considering purchasing a hearing aid online, talk with a doctor or audiologist before moving forward. They can help you determine if the product and company are reputable.

Also, check out Consumer Reports or Consumers Advocates for information on hearing aids.

The style and type of hearing aid are typically deciding factors when purchasing a hearing aid. That said, there are other features to keep in mind, including:

• a telecoil
• noise reduction
• directional microphones
• rechargeable batteries
• a plug-in audio output
• remote controls

Trial periods

If this is your first time with hearing aids or you’re trying a new style, make sure to ask about the trial period. Most manufacturers offer a trial for at least 30 days. That said, some may have nonrefundable fees, so ask about those before leaving the store.

Warranties

Another critical feature is the duration of the warranty and what it covers. Read the fine print and ask any questions before purchasing. You may also want to consider extending the warranty if this is an option.

Repairs and adjustments

Be sure to ask about repairs and adjustments. Does the audiologist you purchased the hearing aid from offer free or reduced-cost adjustments or repairs, and for how long?

You may end up with a higher price tag for a hearing aid that comes with ongoing support, but the peace of mind is often worth it.

The best thing to do when deciding on a hearing aid for a child is to work with an audiologist who specializes in caring for children. An audiologist will take an impression of the outer ear canal to ensure a good fit. During the next appointment, the audiologist will:

• make sure the earmolds fit your child’s ears correctly
• program the hearing aids to suit your child’s needs
• teach your child how to place the devices in their ear and how to use them

According to the American Speech-Language-Hearing Association (ASHA), the best hearing aids for children are behind-the-ear (BTE) since they can attach to different earmold types. BTEs are also easy to replace, safe for small ears, and easy to handle and clean.

If price is preventing you from getting hearing aids, there are ways to make them more affordable. Since most private health insurance plans and Medicare don’t cover hearing aids, many people look to other organizations to afford a device.

If you have a child with hearing loss, look into the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Under this service, Medicaid will pay for the diagnosis and treatment of hearing loss, including hearing aids. Your child may also be covered by your state’s early intervention program or State Children’s Health Insurance Program.

A new type of hearing aid called a bone-anchored, or cochlear, hearing aid requires surgery to implant the device. Because of this, Medicare has declared it a prosthetic device, allowing coverage for some adults.

Some nonprofit organizations, government and state groups, and independent groups offer assistance with hearing aids, such as covering costs or providing used or refurbished aids. For more information, contact the NIDCD.

Can hearing loss be prevented?

Not all hearing loss is preventable, such as age-related hearing loss, which can be hereditary and unavoidable, according to NYU Langone Health. However, you can take steps to protect yourself from noise-induced hearing loss.

Loud noises can damage the inner ear, which is responsible for processing sound. This includes noise at or above 85 decibels, according to the NIDCD.

Wearing protective noise-canceling earplugs or earmuffs while working in a noisy environment can help. Also, turning down the volume of music when using headphones or earbuds can make a difference.

Which is the best type of hearing aid for severe hearing loss?

Severe hearing loss requires a more powerful hearing aid than one that would suffice for mild to moderate loss. Some hearing aids are only appropriate for mild to moderate loss, so it’s critical to read the fine print when shopping for a device.

Behind-the-ear devices are often more appropriate for a variety of hearing loss types, like severe to profound hearing loss. The smaller, more discreet styles may not provide enough power.

If you have severe to profound hearing loss, working with an audiologist is ideal. They will be able to test your hearing, fit you for the best device, make adjustments, and provide ongoing support.

Which type of hearing aid is the least expensive?

Hearing aids are a pricey investment. On average, it’s not uncommon to spend over $1,000 for one device, with some of the top hearing aids costing close to $6,000 or more per pair.

Fortunately, some online manufacturers and retailers like Eargo, Lively, MDHearingAid, and Audicus offer affordable hearing aids ranging in price from $399 to $1,500 per device.

Another way to save money is to go minimal on features like Bluetooth and voice recognition. Sometimes, behind-the-ear hearing aids are more affordable than more discreet or custom-made styles.

That said, it’s best to talk with a hearing care specialist about your particular situation. They will help you determine if a budget pair will work for you or if you would be better off investing in a more expensive brand and model.

A hearing aid is a small device designed to improve hearing by amplifying sounds that are difficult to hear.

A doctor or audiologist will recommend a specific type of hearing aid depending on your hearing loss and the features you want to include. In general, most hearing aids are now digital, as opposed to analog.

Hearing aids are costly, so it’s to your advantage to shop around and compare prices.

If you have questions about hearing aids or how they may work for you, talk with your doctor. They can begin the process of testing your hearing and refer you to an audiologist who can help fit you for hearing aids.