Hearing aids can

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Hearing aids are expensive (average cost: $4,700 for two—and HealthyHearing.com says as much as $4,000 each), they require a prescription, and they’re not covered by Medicare. If a commercial insurance plan covers anything, it’s usually the hearing exam and maybe a small portion of low-end hearing aids. Many people don’t use hearing aids because they aren’t aware they have a loss of hearing, but another major reason is sheer cost.

In fact, fewer than 20 percent of adults with hearing loss use hearing aids. That may change, however, thanks to a bill passed by President Trump (see sidebar). For now, though, a study published in the Journal of the American Medical Association (JAMA) may cause you to seriously consider personal sound amplification products (PSAPs).

Researchers led by Nicholas S. Reed, Au.D., of the Johns Hopkins School of Medicine, Baltimore, compared five PSAPs, costing $30 to $350, with a conventional hearing aid ($1,910). The study included 42 adults with mild-to-moderate hearing loss.

What Are PSAPs?

Personal sound amplification products are not hearing aids, nor can they be called hearing aids. In fact, PSAPs cannot be marketed to people with hearing loss. PSAPs are sold over the counter and cost considerably less than hearing aids, which piques the interest of many people experiencing hearing loss. However, some PSAPs seem technologically comparable with hearing aids.

The Johns Hopkins researchers found that the change in accuracy in speech understanding from unaided to aided tends to vary by device. Three of the PSAPs were associated with improvements in speech understanding comparable to the hearing-aid results. One PSAP demonstrated little improvement, and one was worse.

Before you run out and buy a PSAP, however, it’s wise to know the cause of your hearing loss. The AARP says PSAPs “are ready-to-wear right out of the box. They don’t require any testing or fitting. That’s the main concern expressed by audiologists and hearing health professionals: That in the rush to get low-cost hearing help, a potentially debilitating condition might go unexamined. A professional hearing test can determine if your hearing loss is simply age-related or the result of another medical cause, which can range from ear wax to a tumor.”

Choosing Hearing Aids

So, the first step is to go to an audiologist and get a hearing test. You can find qualified professionals at the American Academy of Audiology. Don’t be shy when you make an appointment. Ask about the person’s training and degrees. An audiologist must have a doctorate in audiology, which means the letters “Au.D.” appear after his or her name. It’s wise to ask your primary-care physician, and your friends, too, for recommendations.

If you’re diagnosed with hearing loss and hearing aids are recommended, discuss your lifestyle, activities, and preferences with the audiologist. What exactly are you having trouble hearing? The TV? The kids in the upstairs back bedroom? Phone calls? Are you physically active—playing tennis twice a week, or walking an hour a day, for example?—or is the most physical thing you do involve a garden club meeting? Would you consider yourself pretty tech-savvy, or is even the thought of changing a tiny battery beyond your ability?

Hearing Aids: Fit First

When it comes to hearing aids, comfort is paramount. If it feels bad, you’re not going to wear it. Most audiologists have sample hearing aids that you can try on and learn about, so you’re comfortable using, caring for, and wearing them.

The less visible the hearing aid, the more expensive it tends to be. There are even some “invisible” hearing aids that fit deeply enough in the ear canal that no one can see them. But, again, comfort and the hearing aid’s ability to resolve your hearing issues are your primary concerns.

All hearing aids have pros and cons to their use, which is why discussing your lifestyle with your hearing professional is vital. While invisible hearing aids may sound perfect for those who want to hide the fact, they may not be powerful enough for your level of hearing loss.

Cost Factor

If you have health insurance, consult your policy or call your health-insurance company to learn how much of your hearing aids may be covered by insurance. It varies so widely, we cannot even speculate here. Ask whether all brands of hearing aids are covered. Find out whether your deductible is used against the cost of the hearing aids and how much your co-insurance may be.

When you go to purchase your hearing aids, remember that you are not required to purchase them at the audiologist’s office, although that may be the simplest solution. If you do decide to purchase the hearing aids there, you can still shop around for prices on the exact same hearing aid you selected (this is important; it must be the same make and model).

Consumer Reports notes the average markup on hearing aids is 117 percent. That means if the hearing aid is selling for $2,000, the seller may have paid $924 for the device. However, this tidbit of information isn’t a strong bargaining tool. It’s just an eye-opener as to what sellers feel they can command.

It’s smart, then, to shop around, get the best price possible for that hearing aid, and use that to negotiate a better price at the place you want to work with. You aren’t going to save $1,076 on the device, because you must factor service and expertise into the final price. That bargain-basement low price you found may get you equally low service in return, especially if you round it online.

Future: Silk in Hearing Aids?

A study at the State University of New York (SUNY) at Binghamton shows that fine fibers, like spider silk, improve the quality of microphones for hearing aids.

“We use our eardrums, which pick up the direction of sound based on pressure, but most insects actually hear with their hairs,” explains SUNY professor Ron Miles. Spider silk is thin enough that it also can move with the air when hit by soundwaves. “This can even happen with infrasound at frequencies as low as 3 hertz,” said. Sound at that frequency is typically inaccessible. The study used spider silk, but any fiber that is thin enough could be used in the same way.

“We coated the spider silk with gold and put it in a magnetic field to obtain an electronic signal,” said Miles. “It’s actually a fairly simple way to make an extremely effective microphone that has better directional capabilities across a wide range of frequencies.”