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How do hearing aids work?

Hearing loss is a widespread issue today, with approximately 15% of American adults reporting some trouble with hearing. ( 1 ) This condition impacts the ability to communicate and has significant emotional and social repercussions. ( 2 ) Hearing aids stand out as a vital tool for managing hearing loss and enhancing quality of life. ( 3 )
Hearing aids are sophisticated devices designed to improve hearing by amplifying sound. They play a crucial role in helping individuals maintain an active, connected lifestyle. ( 4 ) Hearing aids may help combat the social isolation and relationship strains that can be caused by hearing loss,” says Dr. Raj Dasgupta. “They enhance speech comprehension and strengthen connections with loved ones, often boosting their confidence and reducing feelings of loneliness.”

This article explains how hearing aids work, explores their benefits, examines the types available, and guides through the considerations involved in choosing the right one. We’ll also discuss the cost of hearing aids. By understanding how hearing aids function and the improvements they offer, we aim to help you make informed decisions about your hearing health so you can choose the best hearing aid for you.

Meet the expert

Guiding the insights in this piece is Dr. Raj Dasgupta , the Chief Medical Advisor for Fortune Recommends TM . Dr. Raj brings a wealth of medical expertise to the discussion of hearing aids, drawing from his extensive background in internal medicine and his involvement in clinical research. His direct experience in patient care and his role in medical education provide a deep understanding of the challenges associated with hearing loss and the technological solutions available. Dr. Raj’s multidisciplinary approach enriches our exploration of how hearing aids can significantly improve the lives of those with hearing impairments.

Pros and cons of hearing aids

Pros
Enhances the ability to hear speech, improving communication and reducing misunderstandings
Increases independence by allowing users to manage daily activities and interact in social settings without constant assistance
Reduces auditory strain, which can decrease fatigue and improve overall comfort
Enhances participation by enabling more active involvement in social gatherings and public events, combating feelings of isolation
Better overall quality of life by helping users stay connected with their environment and loved ones
Cons
Requires an adjustment period to get accustomed to the amplified sounds
Needs regular maintenance and care, which can be cumbersome for some
Can be expensive, with high-end models costing several thousand dollars, and usually not covered by insurance
Some users may feel self-conscious wearing them due to the stigma associated with hearing loss

What is a hearing aid?

A hearing aid is a compact electronic device designed to be worn in or behind the ear. It amplifies certain sounds, enabling individuals with hearing loss to better engage in conversations and participate actively in everyday activities. This device enhances auditory perception in both quiet and loud environments.

Generally, a hearing aid comprises three main components: a microphone, an amplifier, and a speaker. The microphone captures sound and transforms it into digital signals. These signals are then boosted by the amplifier and delivered to the ear via the speaker, improving the wearer’s hearing capability. ( 4 )

How do hearing aids work?

Hearing aids work by capturing and amplifying sound. When sound enters the hearing aid, it’s picked up by the microphone, which converts the sound waves into digital signals. These signals are then processed by the hearing aid’s amplifier, increasing their power and clarity based on the user’s hearing loss, listening needs, and the sounds around them. Finally, the amplified signals are converted into sound waves and delivered to the ears through speakers. This process helps to enhance speech understanding and reduce the effort required to listen. ( 4 )

Benefits of hearing aids

Hearing aids significantly improve the auditory and overall life quality of individuals with hearing loss. ( 5 ) They enhance the ability to hear everyday sounds, such as the doorbell, telephone, and speaking, which might otherwise go unnoticed. Users often experience greater control over their lives and can enjoy a broader range of activities, from social gatherings to cultural events. Moreover, hearing aids can help prevent the social, psychological, and cognitive decline often associated with untreated hearing loss. ( 6 )

Untreated hearing loss often leads to brain fatigue. ( 7 ) Rachael Cook, AuD, an audiologist at Applied Hearing Solutions and content creator for the Dr. Cliff, AuD YouTube channel, told us, “It takes a lot of cognitive resources and brain power to constantly fill in the missing information caused by hearing loss—it’s draining. A lot of the social withdrawal we see with hearing loss is due to an overwhelming feeling of fatigue. They just start to withdraw from hobbies, activities, and things they’ve always loved to do, and they can’t really pinpoint why. The use of hearing aids allows us to free up those cognitive resources and brain power for other things in our lives. Hearing aids can help people remain engaged with their families, workplace, and communities.”

Types of hearing aids

Hearing aids are now available in two categories: over-the-counter (OTC) or by prescription.

OTC hearing aids

OTC hearing aids are designed for adults with mild to moderate hearing loss. These devices became available due to a regulatory category created by the FDA in 2022 to make hearing aids more accessible and affordable. ( 8 ) OTC hearing aids can be purchased directly from stores or online without a medical exam, prescription, or fitting by an audiologist. They are typically less expensive than prescription hearing aids. They are often seen as an entry-level option for those who have noticed hearing difficulties but are not ready or able to invest in professional-grade devices.

Prescription/professional hearing aids

Prescription or professional hearing aids are recommended and fitted by audiologists or hearing care professionals. These devices are intended for individuals with mild to profound hearing loss and are tailored to the specific needs and preferences of the user.

Prescription hearing aids involve a comprehensive hearing test, and the devices are programmed based on the audiogram results to precisely amplify sounds where the user has hearing deficits. They usually come with more advanced features. While prescription hearing aids are more expensive, they offer greater customization, potentially leading to better hearing outcomes for more severe or complicated types of hearing loss.

Dr. Cook recommends all people experiencing hearing loss at least get an audiogram before moving forward with hearing aids because it’s very difficult for someone to accurately identify their degree of hearing loss.

Styles of hearing aids

Hearing aids come in various styles to accommodate different aesthetic preferences and hearing requirements. The primary types include behind-the-ear (BTE), receiver-in-canal (RIC), in-the-ear (ITE), in-the-canal (ITC), and completely-in-the-canal (CIC) models. Each type offers unique features suited to different degrees of hearing loss and user needs. ( 4 )

BTE-style hearing aids

BTE models feature a durable casing behind the ear, with sound transmitted through a clear tube to an earmold inside the ear. This robust design is often chosen for its versatility, which makes it suitable for almost all types of hearing loss, from mild to profound. Because of their larger size, BTE hearing aids are easier to handle and maintain, making them ideal for children and older adults.

RIC-style hearing aids

RIC (or mini BTE) hearing aids are similar to traditional BTE models but are smaller because the receiver is placed directly in the ear canal and connected to the main device by a thin wire. This design reduces the size of the part behind the ear and minimizes the occlusion effect in the ear canal, providing a more natural sound quality. RIC models are particularly beneficial for individuals with mild to severe hearing loss who seek a discreet design but require powerful amplification.

ITE-style hearing aids

ITE aids are made to fit within the outer portion of the ear canal, making them less conspicuous than BTE models. They are easier to manipulate and include additional features, such as volume controls built directly into the device. These are suitable for mild to severe hearing loss and are favored by those who prefer a balance between discretion and functionality.

ITC- and CIC-style hearing aids

ITC and CIC hearing aids are smaller than ITEs and are designed to fit partly or completely within the ear canal, making them almost invisible. CIC models are the smallest and most discreet options, best for adults with mild to moderate hearing loss who prioritize aesthetics and extended use. Their smaller size gives them some limitations, though, because there’s not often room for advanced features like Bluetooth connectivity or directional microphones. Battery life may also be shorter due to the smaller size of their batteries.

How much do hearing aids cost?

The cost of hearing aids varies widely, depending on the type, technology, and features. Basic OTC models can start at as little as $100 per pair. Most cost between $1,000 to $3,000 per pair, while advanced models equipped with the latest technology, such as AI, can cost $7,000 per pair or more.

Many factors influence the price, including the warranty, customer service, and additional fees for fittings or adjustments. Unfortunately, most insurance plans, including Medicare , do not cover the cost of hearing aids, which can make affordability a significant concern for many users. ( 9 )

How to choose a hearing aid

Choosing the right hearing aid involves assessing various factors to ensure it meets your specific hearing needs and lifestyle preferences. Here are key considerations to keep in mind when selecting a hearing aid:

  • Severity of hearing loss: Select a hearing aid designed to treat your degree of hearing loss, which can range from mild to profound. OTC hearing aids are suitable for most mild to moderate hearing loss cases. Those with severe or profound hearing loss should consult a professional for a prescription hearing aid. ( 10 )
  • Lifestyle needs: Consider how your daily activities might affect your choice. Active individuals might need more durable, water-resistant models with advanced features. Also, consider how many hours a day you’re active and ensure the battery life will accommodate that.
  • Budget: Factor in the initial cost and potential expenses for maintenance, repairs, and follow-up care. Some suppliers offer maintenance and care packages for an additional monthly or one-time fee.
  • Style/aesthetics: Consider how visible and comfortable the hearing aid is. Some users prefer an invisible hearing aid that’s as discrete as possible.
  • Ease of use: Ensure the device is easy to handle, especially if you have dexterity issues. Small hearing aids can be difficult for older adults to use.
  • Trial periods and warranties: Check if the manufacturer offers a trial period to test the hearing aids and ensure they fit your needs and what warranty coverage is included for repairs or loss.
  • Features: Technological advancements are equipping today’s hearing aids with many features. Even many OTC models contain many desirable advanced features. Consider which of the following features are important to you when making your selection:
    • Directional microphones: Enhances sound from a specific direction, improving the ability to hear in noisy environments.
    • Noise reduction: Automatically reduces background noise, making it easier to hear conversations clearly.
    • Feedback suppression: Prevents whistling sounds that can occur when the hearing aid picks up its own output.
    • Rechargeable batteries: Eliminates the need for frequent battery replacements, offering convenience and cost savings.
    • Wireless connectivity: Allows the hearing aid to connect with smartphones, TVs, and other devices, enabling direct streaming of audio, connection to apps, and hands-free calling.
    • Telecoil: Picks sound up through the electromagnetic field rather than the microphone, which is useful in public venues equipped with induction loop systems.
    • Data logging: Records usage and preference settings can help audiologists fine-tune the hearing aids.
    • Wind noise reduction: This feature reduces the sound of wind blowing across the hearing aid’s microphone to improve outdoor audio clarity.
    • Tinnitus masking: Emits a compensating noise to distract the user from tinnitus sounds.
    • Frequency lowering/shifting: Converts higher frequencies, where hearing is poor, to lower ones, where hearing is better, enhancing speech clarity.
    • Speech enhancement: Focuses on amplifying speech frequencies to improve understanding, especially in noisy environments.
    • Automatic environmental adaptation: Adjusts settings automatically based on the acoustic environment.
    • Geotagging: Uses GPS data to adjust settings automatically based on location-specific listening environments previously tagged.
    • Binaural processing: Allows two hearing aids to communicate and process sound together, mimicking natural binaural hearing.
    • Artificial intelligence (AI): Learns from the user’s preferences in different listening environments.
    • Fall detection: This includes sensors that detect falls and alert emergency contacts.

FAQs

What type of hearing aid is most popular?

The most popular type of hearing aid is the behind-the-ear (BTE) style. BTE hearing aids are favored for their versatility and suitability for almost all types of hearing loss. They feature a case behind the ear with a tube that directs sound into an earmold fitted inside the ear canal. Their popularity stems from their comfortable design, ease of handling, and adaptability to various auditory needs, including severe and profound hearing loss.

How many hours a day should you wear hearing aids?

It’s generally recommended to wear hearing aids during all waking hours, except when participating in activities that could damage them, like swimming or showering. Hearing aids consistently help users adjust to them more quickly and improve overall auditory experiences and speech understanding. ( 11 )

How can I choose the right hearing aid?

Choosing the right hearing aid involves several considerations:

  • Decide between OTC and prescription: Those with common mild to moderate hearing loss will likely do well with an OTC option, while those with more complicated or severe cases of hearing loss should consult an audiologist for a hearing test and professional fitting.
  • Consider your lifestyle: Assess how your daily activities might influence your choice of features, such as water resistance or directional microphones.
  • Set a budget: Determine how much you’re willing to spend, considering both initial costs and long-term maintenance.
  • Evaluate features: Decide which features are essential for your hearing needs, such as wireless connectivity or noise reduction.
  • Check trial periods and warranties: Trial periods allow you to try models before committing fully. Also, ensure there’s adequate after-sale support and warranty coverage.
How long do hearing aids last?

Typically, hearing aids last between three and seven years. This lifespan can vary depending on the type of hearing aid, the care and maintenance it receives, and how much wear and tear it undergoes daily. ( 12 )

How do you clean your hearing aids?

Cleaning your hearing aids regularly is crucial for maintaining performance and longevity. It’s a simple process involving these steps:

  • Daily wiping: Use a clean, dry cloth to gently wipe the hearing aid’s surface daily to remove earwax, dust, and moisture.
  • Wax removal: Use a soft-bristled brush or a specialized wax pick to remove any earwax from the nooks and crannies, especially around the microphone ports and sound tubes. Wax guards generally need to be replaced regularly.
  • Drying: Use a drying container or dehumidifier overnight to remove accumulated moisture during the day, especially in a humid climate.

Our experts

Dr. Raj Dasgupta, MD, FACP, FCCP, FAASM

Quadruple-board certified in pulmonary, sleep, internal, and critical care medicine. An active clinical researcher, Dr. Raj is currently an Associate Professor of Clinical Medicine at the University of California, Riverside School of Medicine, and the Associate Program Director of Internal Medicine Residency at Huntington Health, an affiliate of Cedars Sinai.

Krista Manning

Krista Manning is an accomplished medical copy editor and fact-checker who stands out in the pharmaceutical, health, and wellness domains. With a meticulous eye for detail and a command of medical language, Krista ensures the accuracy and clarity of content. Beyond her professional expertise, Krista is an advocate for mental health awareness. Recognizing the crucial intersection of psychological and physical well-being, she actively contributes to projects that promote mental health awareness within the healthcare narrative. Krista’s commitment extends beyond the pages she edits, emphasizing the holistic nature of health communication.

Lauren Sherman, MS

Lauren Sherman, MS

Fortune Recommends Writer

About Author

Lauren Sherman brings a blend of academic rigor and practical application to her role as a health content expert. With a Master’s degree in Human Genetics from the University of Colorado Anschutz Medical Center, Lauren combines deep scientific knowledge with real-world experience gained at National Jewish Health and Children’s Hospital Colorado. She specializes in creating authoritative and engaging content tailored to aging adults, drawing on her extensive research into products and strategies that enhance the quality of life for this demographic. Her work is informed by personal experience, having navigated the aging process with her own parents, and is underpinned by a commitment to providing actionable insights for her readers. Lauren’s contributions can be found on renowned platforms such as NCOA.org, HelpGuide.org, and MarketWatch.com, where she addresses complex health topics with clarity and compassion.

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