Hearing Aid Buying Guide

Once hair cells in the inner ear are dead, there’s no bringing them back. But hearing aids may significantly improve your ability to hear by making sounds louder and easier to understand.

Hearing aids have a microphone to pick up sound, an amplifier to make sound louder, and a receiver that sends the sound into the ear canal. In modern digital aids, microphones transmit sound to a computer chip, which adjusts the volume and amplifies the sound frequencies needed to help improve your hearing. (Though analog aids are less common and less complex than digital aids, they do have advantages, including fewer advanced features. That can make them more user-friendly.)

A hearing professional can program a digital aid to filter out wind and other background noise, as well as fine-tune the aid to match your specific hearing loss pattern. More and more models can sync wirelessly with your smartphone, enabling you to take calls, stream audio, and even adjust your aid’s settings using an app.

The right hearing aid for you depends on several factors, including the type and severity of your hearing loss, your lifestyle, and your manual dexterity. But a hearing aid that one person likes might not work for someone else, even if both have almost identical audiograms (charts that show the degree of hearing loss for low-, middle-, and high-pitched sounds).

Most hearing aids will never completely remove background noise and allow you to hear only the person—or people—talking. “It’s going to bring people back to hearing, but because of the way we process sound, it’s not going to bring them back to normal hearing,” says Patricia Chute, EdD, an audiologist and a former provost and vice president for academic affairs at Dalton State College in Dalton, Ga.

Comparing hearing aids can be very challenging, especially because there can be several versions of a given model even within the same brand. Our buying guide can help you figure out where to get a hearing aid and what to look for.

Our scoring of hearing aid brands and retailers is based on a survey we conducted in December 2021 and January 2022. 

For these ratings, we used survey results from 26,788 Consumer Reports members who provided us with information about their prescription hearing aids. These responses comprise our scoring of hearing aid brands. 

Members rated brands on overall satisfaction, as well as on features such as battery life, durability, reliability, ease of cleaning, value, and sound quality and clarity. A hearing aid brand’s score for value, which we defined as performance of the hearing aid vs. money spent on it, was the strongest predictor of overall satisfaction with a hearing aid brand, followed by clearness of sound, reliability, and richness of sound quality.

Also, 9,407 members provided us with information about the retailers where they purchased their hearing aids. These responses inform our ratings of hearing aid retailers. Respondents scored their overall satisfaction with hearing aid stores, along with aspects including the quality of their evaluation and discussion with the provider, hearing aid options and selection, staff courtesy, and price transparency. 

Finally, 24,483 CR members with prescription hearing aids gave us feedback on their satisfaction with different types of hearing aid retailers (for example, big-box stores, stand-alone clinics, etc.). Those scores don’t appear in our ratings but are discussed below. 

For any hearing aid brand or retailer to receive a score in our ratings, it had to have been rated by at least 100 respondents in our survey. We received enough responses to rate 16 hearing aid brands, 10 hearing aid retailers, and seven types of retailers. (Note that one brand—Costco’s Kirkland hearing aids—is no longer available.)

Digital hearing aids come in five major styles and are categorized by where on or in the ear they’re worn. In our survey, a majority of respondents who evaluated hearing aid brands (71 percent) used the mini behind-the-ear type.

Mini Behind-the-Ear Hearing Aid (mBTE)
This type goes by various names, including receiver-in-the-canal (RIC), receiver-in-the-ear (RITE), receiver-in-the-aid (RITA), and canal receiver technology (CRT). Here, the receiver (the speaker that sends sound to the inner ear) is inside the ear canal. It attaches to the ear via a thin wire and a custom-made earmold (a piece of soft material made to fit snugly in the ear and channel sound into it) or a noncustom dome-style ear-canal piece.

Pros: Comfortable and barely visible. Prevents a plugged-up feeling, especially when using an open eartip, which is appropriate if you can hear well in the low pitches. Larger versions are easy to insert.

Cons: Wax and moisture buildup may limit the life of the receiver. Doesn’t allow for significant amplification, especially in the low frequencies.

Traditional Behind-the-Ear Hearing Aid (BTE)
With this group of aids, which sometimes includes receiver-in-the-aid (RITA) hearing aids, all electronic components are in a plastic case worn behind the ear. Sound is sent to the ear through the tubing that connects the case to the receiver and a custom earmold worn in the ear canal.

Pros: Offers flexible features and considerable low- and high-frequency amplification, making it good for those with severe hearing loss. On larger, traditional models, controls are easy to manipulate and the telecoil mode is easily selected and used. (See below for more information on the telecoil.) The custom-made earmold can be easily cleaned. Accommodates larger batteries for more power. Feedback is rare because of the snug fit.

Cons: Some custom molds are visible. (Clear molds aren’t.) Vulnerable to sweat and wax buildup, but the tubing and mold are easily cleaned. The earmold must fit snugly and fill the entire ear canal, which can cause a plugged-up feeling.

Completely-in-the-Canal Hearing Aid (CIC)
Pros: Recessed into the ear canal and fits deep and tight in the ear. Minimal feedback when used with a phone. Because it’s in the canal, it has low visibility and can be removed with a removal string. Less sensitive to wind noise.

Cons: Too small to include a directional microphone (which reduces background noise by picking up sound from a specific direction) but often has some directional sensitivity. The ear might feel plugged up unless the hearing aid is vented. Vulnerable to wax buildup and moisture. It can accommodate only a small battery, so battery life is relatively short. Because of its small size, the battery can be difficult to insert and remove. The aid may be challenging to handle and adjust.

In-the-Canal Hearing Aid (ITC)
Pros: Barely visible and causes less of a plugged-up feeling because the aid sits deep in the canal. Larger units can include directional microphones.

Cons: Discomfort is a problem for many people, along with the concerns that are typically associated with completely-in-the-canal models. These models are susceptible to moisture, and the receiver is vulnerable to clogging from earwax. The battery tends to be small, so battery life is relatively short. May be challenging to handle and adjust.

Traditional In-the-Ear Hearing Aid (ITE)
All electronic components are included within a case, which rests in the bowl of the outer ear.

Pros: Offers more room for features such as a telecoil, directional microphone, and wireless streaming. Creates less of a plugged-up feeling when vented. Relatively easy to insert.

Cons: Some people consider ITE units to be more visible, and the telecoil might not be as powerful as those on BTE hearing aids because it’s smaller in size.

In our brand ratings survey, 43 percent of people who wear hearing aids said that smartphone compatibility, such as being able to adjust the hearing aids from a smartphone, was one of the most important features to them when they purchased their current hearing aids. The runner-up, which 31 percent of people said was important, was rechargeable batteries. About 1 in 5 respondents marked either wireless connectivity to other devices (such as a TV or music player, via Bluetooth) or automatic adjustments to a room’s noise level as one of the most important features. 

Other key features that can be helpful include:

Telecoil
An option on many modern hearing aids, a telecoil is a small sensor or copper wire in the hearing aid. When activated, it wirelessly picks up a magnetic signal from hearing-aid-compatible telephones and public address systems—such as those that may be in conference rooms, concert halls, museums, taxis, and even subway trains—and converts that energy into sound. An audio induction loop, or hearing loop, which is a wire that circles a telecoil-compatible room or space, emits the signal that the telecoil picks up.

Such technology helps people—especially those with moderate to profound hearing loss—to better understand a speaker’s voice by making it louder and eliminating most background noise and reverberation. Ask your provider for a manual T-switch, which enables seamless connection to loop systems. Your provider should also activate your telecoil and show you how to use it. 

Directional Microphone
Many modern hearing aids have a directional microphone, which helps you converse in noisy environments by making the audio signal in front of you louder than the noise from the rear or sides. This technology works best when you’re close to the sound source. Almost all hearing aids with this feature are able to automatically switch between directional and omnidirectional settings, depending on the environment. Advanced versions can focus behind the listener or on the listener’s side. A negative: It’s prone to picking up wind noise.

Feedback Suppression
Feedback suppression, or digital feedback reduction, helps quell high-pitched whistling sounds. Most modern hearing aids include this feature, but its effectiveness differs from aid to aid. It’s useful for minimizing feedback if you’re close to the telephone or if the aid is slightly dislodged from your ear when you move your jaw. It can also allow for much more venting, comfort, and better sound quality for listeners who have good hearing in the lowest pitches. A proper fit can also reduce feedback.

Digital Noise Reduction
This improves listener comfort and communication in noisy environments by blocking out some background noise. That makes it easier to hear and understand speech, though it’s not a fix for all situations.

OTC hearing aids are now available, though they’re not right for everyone. In our member survey, which was conducted before OTC options were widely available but when some people opted for direct-to-consumer aids, 92 percent of the 33,716 members who used some kind of assistive hearing device said they used a prescription hearing aid. That is, they went the traditional route of buying a hearing aid through an audiologist or other licensed hearing aid dispenser. 

Traditional (prescription) hearing aids can be bought from and are customized at doctor’s offices, clinics, big-box stores, name-brand hearing aid retailers, and the Veterans Administration (VA). 

In our ratings of types of hearing aid retailers, the VA was at the top of the chart, along with wholesale clubs such as Costco and BJ’s. If you’re eligible, it’s wise to take advantage of the VA.

The high score for wholesale clubs is likely driven by the high marks that Costco stores received in our survey (topping the chart in our retailer ratings). Costco is another good option for a hearing aid provider if you don’t have access to the VA.

On the other hand, overall satisfaction was lowest with name-brand hearing aid stores. Various types of clinics—hospitals or clinics, ear nose, and throat (ENT) or otolaryngologist clinics, primary care or other medical doctors’ offices, and freestanding offices or stores—scored higher than name-brand hearing aid stores but lower than the VA or wholesale clubs.

You’ll also want to consider the type of provider who helps you pick out your hearing aids. While most hearing loss is irreversible, sometimes it can be the result of a treatable medical condition.  An audiologist can help determine whether you might have an underlying medical problem (such as a bacterial infection, impacted earwax, or a tumor in your ear) that’s causing your hearing loss. A few online tools are also available that can help you figure out if you might need to see a doctor about a possible medical condition.

Many audiologists work in private practices (freestanding offices). They may also be on staff at wholesale clubs or at hearing aid stores owned by such manufacturers as Oticon, Phonak, ReSound, Starkey, and Widex.

Some big-box stores often have employees known as hearing aid or hearing-instrument specialists. Both audiologists and hearing aid specialists can evaluate your hearing needs and fit your hearing aids. But their training varies significantly. Audiologists typically have a doctoral degree (AuD) and significant clinical training. Requirements for hearing aid specialists depend on your state but can range from passing an exam to at least two years of supervised training.

Working With a Hearing Healthcare Provider

When you go to get your new hearing aid, take notes and consider bringing a family member, significant other, or friend to help you understand and keep track of what’s said. Ask for written material that covers the points your provider went over during the appointment (including a list of facilities in your town that are looped).

Here are some qualities, practices, and services to look for in a hearing aid provider:
• The provider or the office should offer walk-in repair service.
• The provider should discuss the effect of hearing loss on your lifestyle and relationships, and how best to manage difficult listening situations. The conversation should touch on the level of challenges you experience in hearing over the phone.
• The provider should ask about your manual dexterity and vision status because these can affect your ability to handle hearing aids successfully. The dispenser should also discuss realistic expectations and ask about your lifestyle, which can affect your choice of style and recommended features.
• The office should test your hearing in a soundproof booth and give you a copy of the results.
• The provider should verify that the hearing aids are working effectively for you (including in a noisy environment). They are also required to review the instructional brochure that accompanies the hearing aids.

Three out of 4 members who rated prescription hearing aid brands told us there was a delay between noticing they had hearing loss and actually getting their device; 35 percent of them said the top reason for that delay was the cost. If you need an aid, these tips can guide you to some affordable solutions.

1. Check out your coverage. Most insurance doesn’t cover hearing aids, though some children, federal workers, and veterans, as well as residents of Arkansas, Connecticut, New Hampshire, and Rhode Island, can get them covered. A few plans, including some from Medicare Advantage, offer at least partial coverage or discounts.

If you have a high-deductible insurance plan, you can put up to $3,850 per individual or $7,750 per family in a health savings account to pay for aids with pretax dollars. (If you’re 55 or older, you can contribute an additional $1,000 to an individual or family plan.) With a flexible spending account, you can use up to $3,050 in pretax dollars for aids, batteries, and maintenance.

2. Get a detailed written contract. Make sure it allows you to return your aids and get most of your money back if you’re not satisfied. It should also detail the length of the trial period, the length of the warranty and what it covers, adjustment services, loss and damage insurance coverage, and what exactly is included in the price you’re given. (If you decide to try getting OTC hearing aids, make sure the return policy provides enough time to give the hearing aids a few weeks’ trial and lets you return them if they’re not working for you.)

3. Buy only what you need. Bluetooth capability is a convenient extra, but it can add hundreds of dollars to your bill. If you don’t think you’ll use it, skip it.

Economy hearing aids may provide what you need. Ask your provider to compare your performance on speech-in-noise tests using a premium aid and an economy aid. The provider should also help you determine how much, if anything, your insurance will pay.

4. Ask for a price break. Though only 12 percent of members who rated prescription hearing aid brands tried to negotiate a lower price, 42 percent of those were successful when they did. So wherever you buy, try bargaining or asking for a lower-priced model.

Note that some audiologists and dispensers may carry only a few brands, which can limit your ability to comparison shop. Ask your provider to explain why they recommend one brand over another and the pros and cons of each. 

5. Look for bargains. Costco offers free screenings at select locations and very competitive prices on hearing aids. Only certain stores have on-site audiologists or hearing specialists, so make a phone call before you go.

6. Seek out organizations that may offer assistance. A number of government, state, and independent groups, such as the Lions Clubs, may help you pay for hearing aids or offer discounts. (Find information on participating programs here.)

When You Pick It Up
Ask your hearing aid provider to do a real-ear test, also called a real-ear measure. This involves placing a thin probe in your outer ear while you wear your hearing aid to measure whether your hearing aid is responding appropriately to your level of hearing loss. Your provider should also test your understanding of speech in both quiet and noisy areas.

The provider should ensure that the aid is comfortable. They should explain how to use, clean, and store it; where to buy batteries in the correct size; how to store, change, or recharge batteries; and how to minimize squealing and feedback. They should also go over the importance of keeping the aid dry and removing it before radiological or other diagnostic testing.

Speak up about any discomfort or difficulties with use, and practice talking on the phone while you’re in the office. Your provider should make any adjustments while you wait.

Office staff should schedule a follow-up and check in with you by phone a few days after the fitting. If the hearing aid isn’t comfortable or helpful, the provider can make adjustments.

Also, make sure that your aid is compatible with your cell phone and cordless phones, and that the T-switch is enabled. Discuss using your hearing aid with assistive listening devices such as FM and infrared systems and hearing loops. If your hearing aid comes with a smartphone or smartwatch app, make sure you know how to use it.

At Home With a New Hearing Aid
Practice everyday activities using your new hearing aid and be aware that it takes time to adjust. Some sounds might seem too loud at first because your brain isn’t used to processing sounds you haven’t heard in a long time. If you’re unsure whether your hearing aid is working as well as possible, take it in for an adjustment, especially if your voice sounds funny or if your ear feels clogged.

If you think you have a problem but aren’t ready to spend thousands on hearing aids, here’s what to know about some cheaper alternatives:

Personal Sound Amplification Products (PSAPs)
These over-the-counter products, which generally have fewer features and less functionality than hearing aids, may offer a lower-cost solution for some people with situation-specific hearing difficulties. PSAPs, which are designed for people who want to amplify certain sounds, can’t be marketed as devices that help people with hearing loss because they aren’t subject to the same standards as hearing aids.

To find out whether PSAPs can help, we tested two cheaper models (in the $20 to $30 range) and two higher-end ones ($200 to $350). Three CR employees with mild to moderate hearing loss used these PSAPs at home, at work, and in our lab, where we tested how well the devices could assist with hearing conversations in a noisy environment. An outside hearing aid expert also assessed each device in areas such as amplification, battery and microphone function, and sound distortion.

With the right fit and adjustment, we found that the higher-end models can help those with mild to moderate hearing loss, especially when watching TV. Some adjustable models can even have the same functionality as an entry-level hearing aid. But beware the penny-saver PSAPs: The cheaper options didn’t measure up, and more important, our expert found that they could potentially damage hearing if used long-term by overamplifying some loud sounds, such as a fire engine siren.

Self-Fitting Hearing Aids
This is a new class of hearing aids recently created by the Food and Drug Administration and intended to be sold direct to consumers, without the intervention of a hearing care professional. A number of OTC hearing aids fit into this category. The term “self-fitting” refers to the fact that users are able to adjust the amplification settings of the hearing aid themselves, rather than relying on an audiologist or hearing aid specialist. The first of these products was introduced by Bose and is now sold by Lexie. They retail for $849 per pair (or $999 for the option of a rechargeable battery). A newer entrant into the market, the HP Hearing Pro, costs $699 per pair. Those are significant savings from the median price CR members paid for their hearing aids: $2,680.

Preset OTC Hearing Aids
These are the other main types of OTC hearing aids available (aside from self-fitting). They come with a few preset audio profiles that you can toggle through to find which one works best for you. That means they’re less tailored to your specific hearing loss, but they also tend to be simpler to use and less expensive than self-fitting hearing aids. For example, Go Hearing devices start at $199.

Other Assistive Listening Devices
If you need just a little help with hearing, a number of other lower-cost listening options are available. These include apps that let you amplify sound with your smartphone and earbuds, and portable wireless devices that let you listen to your TV and other audio devices with earphones. You can also find amplified, flashing, and vibrating versions of basic household items such as telephones, alarm clocks, and doorbells.