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April 2009
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Hearing loss and hearing aid primer

If you’re in the age group that is just now beginning to regret listening to those loud rock concerts of your youth, you’re in good company. About one in six boomers have a hearing loss according to the Better Hearing Institute, a non-profit educational group financed by the hearing aid industry. The AARP reports that there are more people between the ages of 45-64 with hearing loss than those over age 65.

If you or someone close to you believes they may need hearing aids, your first stop should be to a physician to get a medical exam. They might refer you to an audiologist who would perform a more comprehensive evaluation. If they conclude that hearing aids are recommended, it’s especially important to become an educated consumer. We’ll tell you here what you need to know.

First, the basics
There are three types of hearing loss. Conductive hearing loss generally results from wax blockage, punctured eardrum, infection, or damage to the inner ear that prevents normal functioning of inner ear structures. Many conductive hearing problems can be improved or corrected with medical treatment. Sensorineural (“nerve”) hearing loss is most commonly caused by aging, exposure to loud noises or trauma such as a blow to the head, or damage to areas of the brain that work with the ear to interpret sound. This type of loss may be treated with a hearing aid.  Mixed hearing loss is a combination of conductive and sensorineural types and is treated accordingly. If a hearing aid is called for, two general styles of hearing aids; behind the ear (BTE) and in the ear (ITE). There are variations, advantages and disadvantages of each.

Some initial signs of hearing loss to watch for include ringing in your ears or “tinnitus”, increasing inability to hear well in groups or in areas with background noise, and frequently turning up the T.V. volume. Many people don’t even realize they are experiencing hearing loss until a family member recognized the symptoms. By the way- tinnitus can be caused by other medical conditions and medications- that’s why we recommend you check in with your physician as a first step.

Preventing hearing loss is a life-long process. The easiest way to protect your hearing is to reduce or avoid exposure to noise. Heavy machinery, loud music, engines, or even exposure to a one-time extremely intense noise can cause hearing loss. It’s most common for hearing loss due to noise to occur slowly over time as long-term exposure causes destruction of inner ear mechanics. If you live or work in a high noise area, use ear protection. Basic ear plugs used to reduce noise (say, if your sleeping partner snores) won’t protect your ears while using landscaping equipment or other high-decibel machinery.

Examples of other factors leading to or predisposing a person to hearing loss include having family members with hearing loss, taking medications that can be toxic to the ear, recurrent ear infections, and a previous history of damage to your ear drum.

Insurance doesn’t usually pay for hearing aids
Hearing aids require a prescription. Audiologists often sell hearing aids or partner with a licensed hearing aid retailer.  Unless you’re a veteran or in the case of certain states, if you’re a child under age 13, expect to pay for your own hearing aids as most insurance plans don’t cover them. Prices often range from $1,000 to $7,000 or more depending on the type of hearing loss you have and the hearing aid you select. But you might not need anything nearly so costly. In our research consumers often pay more than necessary or may be victimized by unscrupulous dealers.

Why are hearing aids so expensive?
As with many other areas of healthcare, high hearing aid prices can be attributed to monopolistic pricing and regulations that discourage competition. A hearing aid consists of a small microphone that amplifies weak sounds through a small speaker. Unlike the routine price decreases that we’ve come to expect from other electronic devices like cell phones, computers and televisions, the price of hearing aids have actually increased. Surprisingly, its own industry trade association has concluded that hearing aid manufacturers could help more people, sell many more hearing aids and make more profit if prices were reduced.

There are some hearing aid-type devices that like reading glasses, don’t require a prescription and offer benefit at substantial savings. These devices are made by companies including Maxisound, Nexear and Songbird. Prices for these types of aids range from $80 to $500 each. They can generally only be purchased online, but all are sold with money-back guarantees. So for mild to moderate hearing loss, they’re worth a try and may be a good bet for your money. (VidaCura carries Nexear brand products, Click here to see them.)

Here’s an interesting tidbit that can help you understand the hearing aid industry better. A study conducted and reported on in a recent issue of the American Journal of Audiology concluded that these over-the-counter type hearing aids “don’t work well and could potentially damage a persons hearing”. The kicker is that study was funded by the Oticon Foundation, manufacturer for Oticon brand hearing aids. We suspect the eyeglass industry said many of these same things about reading glasses when they first began to be sold over the counter.

Be a smart shopper
Following a principle you’ll hear us frequently refer to; you will get the best care if you do your research and ask the right questions. It’s especially important for hearing aids since in addition to dealing with your hearing, it’s also likely you’re spending your own money. When the results of your exam indicate that you might benefit from a hearing aid, consider the following factors: Hearing aids are sold (“dispensed”) by licensed audiologists and by retailers who have relationships with audiologists. That opens the door wide to potential kickbacks, and referral fees in exchange for recommending higher priced models. This can result in your paying prices higher than you should.

Five important rules to follow when shopping for a hearing aid:

  1. Rather than relying on the yellow pages, ask friends and family for recommendations as to where they’ve purchased hearing aids.
  2. Beware of suspect advertising claims such as “Thousands of dollars off” a digital hearing aid, “25 people needed to participate in hearing study”, “buy one get one free” and “We offer Medicare discounts”. Unfortunately, all are common gimmicks
  3. Keep the medical recommendation from your medical practitioner or audiologist separate from their brand, model and style recommendations. Rather, ask what features and specifications they recommend in a hearing aid for you. Then, shop based on your own price, service and style preferences.
  4. Insist on at least a thirty day trial period. Some dealers may charge a 5-20% service fee on returns. If you are a Costco member, the hearing aids they sell fall under their standard “if you’re ever dissatisfied for any reason, we’ll take it back” policy.
  5. Some dealers charge a fee for creating the custom molds into which the electronics of the hearing aid goes so that it fits properly in your ear. Others don’t.

One final thought… If hearing aids can help you hear better, please consider them. The stigma associated with wearing a hearing aid is largely gone. Well-known celebrities who have been helped by hearing aids include President Bill Clinton, actors Lou Ferrigno and Richard Thomas, and U.S. Army General Norman Schwarzkopf. These days, it’s so common to see people with earpieces plugged into one ear, who knows whether they’re talking on the phone or just improving their hearing.

Larry Berk and Delaney La Rosa, RN,  are a husband and wife team; healthcare and insurance professionals with over 25 years of combined experience. Larry is the President of VidaCura, Inc. Delaney spent several years’ performing healthcare fraud investigations and is a registered nurse in Connecticut. This article also appears in The Hartford Courant‘s online edition of CTWatchdog

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