Consumer Reports Provides Hearing Aid Purchase Advice

How to Hear Well in a Noisy World

Tuesday, June 23, 2009

Consumer Reports recently set out to test hearing aids and encountered the same challenges that hearing-aid shoppers face every day: a fragmented and confusing marketplace, and difficulty sorting out good hearing-aid providers from less-capable ones.

CR followed a dozen patients for six months as they shopped for and used hearing aids, conducted a national survey of 1,100 people who had bought a hearing aid in the past three years, and lab-tested the features of 44 hearing aids. Here's what these efforts found:

High prices: Shoppers purchased two pairs of hearing aids each, or 48 aids in all, ranging from $1,800 to $6,800 per pair, including professional fitting and follow-up services, in the New York City metropolitan area.

Mediocre fitting: Audiologists checked how well providers fit the shoppers' hearing aids to their individual hearing loss. Two-thirds of the 48 aids they bought were misfit: They amplified too little or too much.

Lack of information: Most of the providers discussed style, such as in-the-ear or behind-the-ear, and features, but a significant minority didn't. One-fourth of respondents to the survey, conducted by the Consumer Reports National Research Center, didn't know whether their aids had feedback suppression, and a third didn't know whether they had directional microphones. Both features can be critical to performance.

So why bother with hearing aids? Medical evidence shows that they can improve your quality of life and relationships with friends and family, so it's worth persevering until you get aids that are properly selected and fitted. Moreover, hearing-aid technology has made major strides in recent years, most notably with the development of very small, open-fit digital hearing aids.

How to buy a hearing aid

1. Select a provider. If you are a veteran, your first step should be to determine whether you are eligible to get your aids at your nearest Veterans Affairs facility. The 13 percent of survey respondents who went to the VA gave it high scores across the board. For everyone else, the suggested choice is a medical office headed by an otolaryngologist (an ear, nose and throat physician, or ENT) who employs an audiologist to fit and dispense hearing aids. Medicare will cover the medical exam and an audiologist's test if it is ordered by a physician. Others should check with their carrier, as coverage may vary.

2. Understand the product. Digital hearing aids have captured more than 90 percent of the market. In those aids, sound goes in the microphone and is digitally processed by a chip, amplified and delivered into the ear. Digital aids also have features to modify that sound, making it more lifelike and correcting for other problems.

3. Get a thorough evaluation. During your first visit, the provider will establish your hearing-loss profile with audiometry testing. You'll sit in a soundproof booth and indicate whether you can hear individual words piped into your headphone, as well as tones played at various pitches and volumes. A graph, called an audiogram, displays which parts of the sound spectrum you're having difficulty hearing.

You should also discuss your needs and lifestyle. Do you like to chat on the phone? Does your social life involve a lot of large gatherings or restaurant meals? Don't count on the provider to ask those questions.

The provider should then show you a few models and ask you to choose. If your chosen style includes an ear mold, she'll make an impression of your ear canal.

When you return to pick up your aids, usually in a week or two, the provider should do several tests to verify that they are working optimally. Of that battery of tests, one stands out as a must-have: the real-ear test, which measures the match between your hearing loss and the response of your hearing aid.

4. Be a smart buyer. Where Consumer Reports could verify the wholesale price of the aids it tested, the average markup was 117 percent, so there's room to bargain. Only 15 percent of its survey participants had tried that, but more than 40 percent of those who did were successful.

Insist on having brand and style choices. And keep in mind that if you're not thrilled with the first provider's evaluation or personality, or if you want to see what other providers offer, you're entitled to a copy of your audiogram to shop elsewhere.

Before you leave, practice inserting and removing the battery, cleaning and storing the aid, putting it into your ear, using its switches and controls, and using the telephone while wearing it.

5. Practice and follow up. Putting on new hearing aids is nothing like putting on new eyeglasses and being able to see clearly right away. Although 26 percent of survey respondents never had a follow-up appointment, Consumer Reports strongly recommends scheduling at least one. Most providers include that service in their fee. Adjustments might include changing the device's electronic settings, reworking an uncomfortable ear mold or getting a completely different hearing aid.

For further guidance, go to ConsumerReportsHealth.org. More-detailed information -- including CR's ratings of prescription drugs, conditions, treatments, hospitals and healthy-living products -- is available to subscribers to that site.

Copyright 2009. Consumers Union of United States Inc.