Hearing Aid Basics

Medically Reviewed by Jabeen Begum, MD on March 15, 2024
15 min read

Hearing aids are small devices that go in or behind your ear. These electronic gadgets make certain sounds louder so that you can hear better if you have hearing loss.

Hearing loss can have a big impact on your life, from your work to your relationships and emotional well-being. Hearing aids can make a big difference, especially if you pick the right ones and get help adjusting to them.

Hearing aid vs. cochlear implant

A cochlear implant is also an electronic device. Part of it sits behind your ear. But it also has a part implanted under your skin. A hearing aid works by making sounds louder so that your ear can pick them up. Cochlear implants skip past the damaged part of your ear and work directly on your auditory nerves. The process of hearing with a cochlear implant is different.

Hearing aids may help you hear better when it's quiet and when it's noisy. Here are the basic parts and how they work:

A microphone. This picks up sound around you. 

An amplifier. This makes the sound louder. 

A receiver. This sends the sounds into your ear.

Not everyone with hearing loss can benefit from hearing aids. But only 1 in 5 people who could have improvement wear them. Most of the time, they're for people who have damage to their inner ear or the nerve that links the ear with the brain. These are some of the things that can cause damage: 

  • Disease
  • Aging
  • Loud noises
  • Medications
  • Trauma to the head or ear
  • Ear wax buildup
  • Poor nutrition
  • Viral infections

Hearing loss caused by problems with the ear canal, eardrum, or middle ear is called conductive hearing loss. Usually, surgery or other medical help can make it better. But those options aren't right for everyone. Some people are born without an external ear or ear canal, which means they can't use a typical hearing aid. 

Do hearing aids help tinnitus?

Tinnitus is the medical name for ringing in your ears. Most people who get it also have underlying hearing loss. Hearing aids can help with tinnitus in a few ways: 

Masking. By making other sounds louder, they mask or cover the noise of tinnitus.

Stimulation. When noise outside your head is louder, your brain gets more auditory stimulation. 

Communication. When you can understand others more easily and participate in conversations, you may find your tinnitus less frustrating and socially isolating. 

If you think you might need hearing aids, there are several things to consider. 

Before you buy hearing aids

See your doctor. Your regular doctor can make sure you don't have an infection or earwax buildup causing your hearing loss. 

Get a hearing test. If your doctor says your hearing loss is permanent rather than temporary, the next step is to get a test. You'll need to see an audiologist for that. If you don't know one, ask your doctor for a recommendation.

Try before you buy. Ask whether you can have a trial period with your hearing aid. 

Think ahead. You might need a device that can adjust as your hearing gets worse over the next few years. Ask about increased capacity. 

Check the warranty. Make sure you know what's covered and what isn't.

Understand their limits. Get information on what hearing aids can--and can't--do, so that you're not fooled by misleading claims. 

Budget. The cost of hearing aids varies, and there are add-ons that can increase the price. Make sure you know what you're getting, and learn about options you might have to offset the cost.  

Prescription hearing aids

You'll need to see a health care provider to get prescription hearing aids. 

If you have asymmetric hearing loss--meaning the condition is worse in one ear--or any other concerning finding, then you'll see an ear, nose, and throat doctor (ENT). You can also start with an ENT, but that isn't typical.

If you don't already know an ENT, ask your regular doctor to send you to one. 

If you have hearing loss in both ears, it's probably best to wear two hearing aids.

Over-the-counter hearing aids

If you're 18 or older, you can buy hearing aids in a store or online without seeing an audiologist or an ENT. Over-the-counter, or OTC, hearing aids are meant to help people whose hearing loss is mild to moderate. They may be the right choice if your hearing trouble is limited to certain situations.

Although you don't have to see a medical professional to get OTC devices, you may not be able to measure your hearing loss on your own. An audiologist can find out how much help you need and guide you through your choices.

Another option is to have your hearing tested by a professional and get a copy of your results. You can use that information to buy your hearing aids online or in a store.

The FDA regulates OTC hearing aids. There are two types. "Self-fitting" hearing aids are those you can program to your specific needs. You'll use an app or a website to make adjustments. If your device is not self-fitting, it will have a volume control and a few simple settings.

Pros and cons of over-the-counter hearing aids

Being able to buy hearing aids without a prescription is fairly new, so all the advantages and disadvantages aren't clear yet. 

Among the pros: 

Price. The least expensive OTC hearing aids cost hundreds of dollars. Prescription hearing aids can run four times as much.

Convenience. You can buy your hearing aids and start using them the same day.

Among the cons: 

You have to self-diagnose. You may not be the best judge of your hearing loss and how much help you need.

Research. You'll need to do a lot of homework to learn about the different types of OTC hearing aids, their features, warranties, and prices before you make a decision.

Hearing care professionals have expressed concerns. First, a medical problem that needs attention could be causing a hearing loss. Another worry among audiologists is that, given full control of their devices, users will turn up the volume too high, which can damage your hearing.

If you get prescription hearing aids, the cost will range between $1,000 and $4,000. That total price includes the devices, fitting, maintenance, and helping you deal with problems that come up. In some cases, your total price might include replacing your hearing aid batteries. 

Over-the-counter hearing aids are generally less expensive. Because they're meant for people with less-severe hearing loss, you don't need as much professional expertise to get things right. OTC hearing aids can cost as little as $99 and as much as $6,000. It all depends on the device and level of service you choose. 

Why do they cost so much? Hearing aids are small but complex electronic devices that contain advanced hardware and software. Manufacturers have made large investments in improving the technology, and hearing aids now can be customized more for your needs. 

Most private insurance doesn't cover the cost of hearing aids for adults, though you might have coverage for hearing tests and other evaluations. Check with your insurer. Medicare doesn't cover the cost of hearing aids or tests, nor do most Medicare supplement plans. Medicare Part B offers some coverage of hearing tests if your doctor ordered them. If you have Medicare Advantage, you may have some coverage for tests and hearing aids. For information about Medicare, you can call 1-800-633-4227.

If you're an adult with Medicaid, your coverage depends on your state's program. For more information, go to Medicaid.gov.

Private insurance may cover more hearing services for children. For those who are eligible, up to age 21, Medicaid covers tests and treatment of hearing loss, which can include hearing aids. Your child also might be covered under your state's program. 

 How to lower hearing aids cost

If you're a veteran of the U.S. armed forces, you may be eligible for free hearing tests, hearing aids, and replacement batteries.

Warehouse shopping clubs sell hearing aids. If you have a membership, check the prices there to see if they're lower than other outlets. 

Some companies run promotions around the holidays. You may be able to find a deal if you watch for sales. If you find the brand you like on sale at one store, you may be able to get another store to match that price. And some stores offer payment plans.

Some nonprofit organizations help with hearing aids cost. Your audiologist may know of programs. The National Institute on Deafness and Other Communication Disorders has an information clearinghouse that can answer questions about financial assistance. The Hearing Industries Association has an online guide to finding financial assistance.


The right device for you depends on:

  • The type of hearing loss you have and how serious it is
  • Your age
  • How well you can manage small devices
  • Your lifestyle
  • Cost

There are two main types of hearing aids:

Analog hearing aids

These devices convert sound waves into electrical signals and then make them louder. They amplify all sounds the same way, though some may have settings you can store and switch between (quiet environments and loud environments, for instance). They're usually less expensive and have simple volume controls.They're not very common. 

Digital hearing aids

This type converts sound waves into numerical codes similar to computer codes, then amplifies them. The code includes information about the direction of a sound and its pitch or volume. That makes it easier to adjust the sound to what you need, whether you’re in a restaurant, a quiet room, or a stadium. Most will adjust automatically. Although this type costs more than an analog hearing aid, the results are much better. They’re also smaller and more powerful.

There also are different styles of hearing aids. They differ in size, placement in or on the ear, and how well they make sound louder:

In-the-canal hearing aids

These hearing aids fit inside your ear and are hard to see. An in-the-canal (ITC) hearing aid fits your specific ear canal and can help with mild to moderately severe hearing loss. But because of their size, they can be harder to adjust and remove. This style isn't ideal for children or adults who might have problems with very small devices. They're also prone to getting clogged by earwax. An invisible-in-canal (IIC) aid is nearly impossible for others to see. You may put it in every day, or it may be a device you wear for several months at a time.

Completely-in-the-canal hearing aids (CIC) and Mini CIC

CIC and mini CIC are molded to fit inside your ear canal. These are the very smallest and least noticeable types. They're designed for those with mild to moderate hearing loss. They're less likely than some other types to pick up wind noise when you're outside. They may lack some features, such as volume control, that other devices have. The batteries are very small and can be hard to handle, and they also have a shorter life and need replacing more often. Like in-the-canal hearing aids, these can get plugged by earwax.

In-the-ear (ITE) hearing aids

Thesehearing aids fit completely inside your outer ear. They have a hard plastic case that holds the electronics. They're best for people with mild to severe hearing loss, but they don't work as well for children whose ears are still growing. They're larger and more visible than in-the-canal types, but they also have more controls than smaller devices. The hearing aid itself and its batteries may be easier to handle because they're larger. They may pick up more wind noise than smaller devices when you're outside. They also are prone to clogging with earwax.

Behind-the-ear (BTE) hearing aids

These hearing aids sit in a hard plastic case behind your ear. A plastic ear mold fits inside the outer ear and directs sound to the ear. They're typically the largest and most visible hearing aids, though new, smaller ones are coming on the market. A different type, called a Mini BTE, fits entirely behind your ear, with a narrow tube that goes into your ear canal. This helps keep earwax from building up and makes sure your own voice sounds clear. Behind-the-ear hearing aids work for almost any type of hearing loss. These have directional microphones and can give you greater sound amplification. They also may come with rechargeable batteries. You may hear more wind noise than you would with other styles.

Receiver-in-canal (RIC) and receiver-in-the-ear (RITE) hearing aids

These styles both have a behind-the-ear component that connects to a receiver in the ear or ear canal with a tiny wire. They're smaller than other behind-the-ear hearing aids. They allow low-frequency sounds to enter the ear naturally and high-frequency sounds to be amplified through the hearing aid. RIC and RITE may be a good choice for people with mild to profound hearing loss. They may come with more control options and usually have directional microphones. The batteries might be rechargeable. You'll have to watch for earwax clogging the speaker.

Open fit hearing aids

This type is similar to BTE, RIC, and RITE. It has an open dome in your ear, which keeps the ear canal clear. You'll hear low-frequency sounds naturally, through your ear, and high-frequency sounds will be amplified. It might make sense if your hearing loss is mostly at the high frequencies. It can make your own voice sound better to you. But it's more visible than some other styles and can be hard to put in, because it's not as customized to fit you.

Bone conduction hearing aids

Implantable hearing aids work differently than regular hearing aids. One type is anchored to the bone behind your ear, and it's called a bone-anchored hearing aid (BAHA). This device is surgically attached to the bone behind your ear and sends sound vibrations straight to your inner ear via your skull. BAHA might be the right choice if you have a middle ear problem or hearing loss only in one hear. But because surgery is required, you'll have to weigh the pros and cons.

Middle ear implant

This device is also called an MEI. It's attached to a bone in your middle ear, and it moves those bones directly in response to sound. It can help people who have sensorineural hearing loss, which is caused by damage to your inner ear.

Waterproof hearing aids

Electronic devices are rated for how well their design keeps out elements that might damage them, like dust and water. This is called Ingress Protection, and the number is the IP rating. The first number represents how well it keeps out solids, like dust. The second number represents how well it keeps out liquids. You can ask an audiologist about IP ratings or find them in the device's manual. The best score on the first measure is 6, which means total protection. Most hearing aids are rated 8 on the second score, which makes them water-resistant but not waterproof. That means it can survive being submerged in water, but only briefly. A company called Phonak says its Audéo Life hearing aids have protection that "goes beyond IP68." These are sometimes referred to as "waterproof," but the hearing aid's rating is still IP68, and the company qualifies its use of the term waterproof.

Bluetooth hearing aids

If your hearing aids are Bluetooth-enabled, you'll be able to manage the control from an app on your smartphone or tablet. You also can stream audio from smart devices--including TVs--straight to your hearing aids.

Hearing aid features

Be sure to ask if the device you choose has special features you want. Not all hearing aids have the same ones. 

Directional microphones. These help you respond better to sound coming from a specific direction and tune out background noise. 

A direct audio input. This allows you to plug in a remote microphone or FM listening system. You can also connect directly to a TV or other device.

Noise reduction. Most hearing aids offer some level of noise reduction, which filters out background sounds. 

Rechargeable batteries. Maintenance is easier if you can recharge your hearing aid batteries instead of replacing them regularly. 

Telecoils. This is a type of technology that works with certain telephones and the sound systems in some public places like churches and theaters. If your hearing aid has telecoils, you'll be able to hear better on the phone and when you visit places that are equipped with compatible sound systems.

Variable programming. If your hearing aids have this feature, you can create certain settings for different environments, for instance, one for conversation at home and another for a place with a lot of background noise. Then you can choose the setting that works best in a particular situation. 

Remote controls. This lets you adjust your hearing aid using a remote or an app on your phone instead of having to fiddle with the hearing aid itself. 

Synchronization. If you use two hearing aids, you can adjust both at the same time -- for instance, the volume -- if they are synchronized.




Your hearing aid can't make your hearing what it used to be. But as you use it, you'll become more aware of sounds and where they are coming from.

When you first get your hearing aids, be patient. It may take some time to get used to them. In most states, you're allowed a trial period after you buy a device. Then, if yours don't work out for you, you may get a partial refund and be able try a different type that works better for you. Also ask about warranty coverage.

It may help to start wearing your hearing aids in quiet areas and to keep a diary about how you feel. Wear them around family members or close friends at first and ask for their support as you adjust. Some areas may have support groups for people who are just starting to use hearing aids.

Test them out in different situations to see how they perform--indoors, outdoors, quiet places, louder environments. 

If you have questions or concerns, go for a follow-up visit. Adjustments and help getting your hearing aids working for you may be included in the price you paid.

Take time to learn how your hearing aids work and insist on a good fit. You want to avoid problems such as:

  • Discomfort
  • Echo-like sounds from your voice
  • Feedback or a whistling sound
  • Background noise
  • Buzzing when you use a cellphone

Here are some solutions to possible problems:

Discomfort. It's not unusual to find your hearing aid uncomfortable at first. Your audiologist can give you tips on how long to wear it while you're adjusting.

Echo. If your voice carries an echo or sounds too loud to you, that's not unusual. Your audiologist might be able to make adjustments that will help. Most people get used to this and it becomes less noticeable over time.

Feedback. This may mean your hearing aid is clogged, doesn't fit right, or isn't working well. Your audiologist can help. 

Background noise. Your audiologist may be able to make adjustments to reduce this. 

Buzzing. Sometimes cell phones and hearing aids have radio frequency interference, which causes a buzz.The best way to avoid this is to take your cell phone with you when shopping for hearing aids. 

Your hearing aids will last much longer if you take good care of them. Some tips to keep in mind:

  • Keep them away from heat and moisture.
  • Don't use hair care products, including hair spray, while wearing your hearing aids.
  • Clean them as directed. Earwax can damage your hearing aids.
  • Turn off your devices when you are not using them.
  • Replace dead batteries right away.
  • Keep your hearing aids and batteries away from small children and pets. They can be lethal if swallowed.

Hearing aid batteries may last from several days to a couple of weeks. Battery life depends on the battery type, hearing aid power requirements, and how often you use it.

In general, hearing aids can last for 3 to 6 years. You may need a new one sooner if your hearing loss gets worse. Behind-the-ear hearing aids give you more flexibility because they can be programmed for a wider range of hearing loss.

Digital hearing aids get stronger and better every few years as computer technology improves. This often prompts people to upgrade their devices. 

Hearing aid cleaning kits

You can buy a kit that will help you keep your hearing aid clean. These usually come with: 

  • Loops or picks to clear wax
  • Brushes
  • Gadgets to blow debris out of molds or tubing 

The manufacturer of your hearing aids should provide instructions for keeping them clean. Follow those directions to make sure you don't void the warranty on your devices.

If you think you might need hearing aids, you're not alone. Experts estimate about 29 million adults in the U.S. would benefit from them. Hearing aids come in a variety of types and styles, and you can buy them over the counter now. Start with a visit to your doctor, and then an audiologist. They'll figure out the cause and degree of your hearing loss, and help you decide what hearing aids might be best for you. 

What are the best three hearing aids?

Several factors go into choosing a hearing aid. Some are better for certain types of hearing loss than others. You might want to choose the least-visible model. Your budget may affect your choices. The "best" choice is different for every individual. 

What is the average cost of a good hearing aid?

Now that you can buy hearing aids over the counter, many lower-priced models are available. Prescription hearing aids can cost as much as $4,000. Some well-rated OTC pairs cost as little as $100.