Hearing aid assistance in northern CO/online alternatives?

October 29, 2016 12:48 PM

My uncle is looking for a new provider to service his hearing aids. The only, new-in-town one in his area (northern CO), is "incompetent" and wants to sell him a (prohibitively expensive) new pair. Alternatively, he is also interested in an online, $50 pair with "good reviews", which can be programmed individually?? Any suggestions/thoughts about local providers or cheaper hearing aides would be very much appreciated. TIA!
posted by warm_planet to Health & Fitness (3 answers total)

Hearing aids are unfortunately very expensive and the market is really confusing. I'm going to tell you a bit about how hearing aid pricing works, and the differences between what's online and what you'll get at an audiologist, and you can decide what works for you.

At an audiologist, you'll get a comprehensive diagnostic evaluation and they will fit you with a hearing aid and program the hearing aid output to your hearing loss. They then should verify the output of the hearing aid using real-ear responses, where they actually put a small microphone in your ear canal and make sure that the hearing aid is putting out sound at levels/frequencies that is appropriate for your hearing loss. A lot of good evidence suggests this is worth doing and people have better outcomes with a properly fit and verified hearing aid.

The trouble is that this hearing aid will then come with three or four 'technology levels.' It is the same hearing aid, same computer chip, but buying more expensive levels allows you to 'unlock' premium features, which are generally more algorithms which are reported to help, for example, hearing in noise. Many audiologists will try to sell their patients these more expensive levels. Most of the features have not been shown to have real benefit for people.

What I do with most of my patients is I fit them with the least expensive technology level of a hearing aid, but take the time to program it appropriately and verify the output. I rarely sell my patient a higher level hearing aid unless they are adamant that they want it.

Most audiologists are still bundling their costs - so when you pay $6000 or whatever, you are paying for their services, the hearing aid itself, and then usually follow-up services for a year. The follow-up services are actually critical because most people need some amount of ongoing adjustments, especially in the first year.

Online hearing aids work two ways. The first is sometimes it is an actual hearing aid (approved by the FDA), and you send in a copy of your audiogram (hearing test results) and the company fits the hearing aid to what's called a 'first fit' - sort of an automatic calculation of a probable good fit based on the audiogram. Then they mail it back. They probably aren't bad, but they are not verified and no adjustments are made to the hearing aid based on patient feedback or actual in-situ measurements.

The other online hearing aid model is actually Personal Sound Amplification Products (PSAPs), and are not FDA approved. These are usually just over the counter, fit for some generalized, common hearing loss, without much at all in the way of individual programming.

The average cost of a pair of hearing aids is about $4,600. The cost of the actual hearing aid to the audiologist is probably about $1200-1400. The rest is for the diagnostic services, the fitting, and the year of follow-up care. Online hearing aids that are not verified are usually in the $500 range (like Audicus). PSAPs are what are down in the $50 range. It's a big range. It's confusing for people. There is no universal best answer. I am biased because I feel that proper fitting and verification is important.

A lot of people like Costco hearing aids, if he has a Costco. They sell the same hearing aids you'd get at an audiologist, but the chip is 'flipped', so you can only have follow-up care at Costco. I tell people it's fine to go to Costco, but you should ask if they are doing real-ear measures first.

The other option is if your uncle is near Greeley, UNC has a great audiology program with a clinic, and they can fit your uncle for a much cheaper price than he'd pay at an audiologist. Of course it's a student clinic, so things will be slower, but everything is supervised by faculty. Here's their website.
posted by Lutoslawski at 1:10 PM on October 29, 2016 [18 favorites]

One nice thing about Costco is that you can get their hearing aids adjusted at any Costco. Most private audiologists include adjustments, but only from their office.

If your uncle happens to be a veteran, and near a VA hospital, he should definitely look into what's available to him there. My father's are free through the VA.

There's a big difference between audiologists and hearing aid dispensers. Dispensers in general (not Costco's) have a fairly bad (and well-deserved, in my experience) reputation. Audiologists are a much better way to go.
posted by still_wears_a_hat at 2:23 PM on October 29, 2016 [1 favorite]

It's true, good and really effective hearing aids cost a lot of money that a lot of folks can't afford. The type that seems to be in your uncle's comfort/financial zone would be the PSAPs that Lutoslawski described above.

The problem with these types of hearing aids is that they tend to amplify all sound equally - so if he's sitting alone in a quiet living room watching tv, or having dinner with one or two people in a quiet dining room, they might help him a lot (depending on the specifics of his hearing loss), but add a noisy fan in the window or music playing in the background, or add a few people to the mix, and the signal-to-noise ratio goes down and they become a lot less effective. Trying to hear the server in a typical restaurant or clerk in a grocery store is harder yet.

This is not to discourage him from trying the lower cost aids, just my thoughts about having reasonable expectations. Hearing loss is hard and can be very isolating. I hope you and your uncle find a good solution!
posted by cilla at 7:24 PM on October 29, 2016