Hearing loss affects one in seven Australians, and three out of four people over 70. Hearing aids won't restore hearing, but in conjunction with training and rehabilitation can help. But for those not eligible for government assistance, that comes at a price, with hearing aids costing as much as $12,000 a pair. This makes hearing aids one of the most expensive 'things' people will buy, so making the right decision is important.
1. Get a hearing screening
Many people start with a hearing screening. This is a short and simple test, which covers any or all of the following:
- Lifestyle questions about situations where you may have trouble hearing.
- A tone test of different frequencies – the most common form of hearing loss involves high frequencies, or high-pitched sounds.
- Your ability to distinguish between similar-sounding words.
- Your ability to hear words or numbers above a background noise, which could be white noise, a repetitive beat or situational noise (chatter, cheering, traffic etc).
Audiology clinics offer these for free, and they take only a few minutes. You can also do them online – google 'free hearing test' and use headphones (rather than the device speaker) for the best results.
2. See a doctor
If the screening suggests you may have a problem, it's time to see your doctor. They can check your ears for wax build up, and do a general health check-up to make sure your hearing loss isn't due to illness.
3. See an audiologist
Then you should consult an audiologist at a hearing aid clinic, or one that your doctor recommends, for a comprehensive diagnostic hearing test.
Some clinics offer tests free to everyone, some free to eligible people under the hearing services program, and some may charge you, but waive the charge if you decide to buy hearing aids from them.
At this point, consider getting someone to come with you. You may be provided with a lot of information and/or decisions to make, and it's useful to get another perspective.
There are nine major hearing aid clinic brands (with more than 20 stores), and hundreds of independent stores, or stores part of smaller chains. Then there's the behemoth Australian Hearing, with over 500 permanent or visiting centres, supplying one-third of all government-subsidised hearing aids.
New disruptor on the block is Specsavers Audiology, which at the time of writing has 56 outlets, with more rapidly rolling out. Even bulk goods supplier Costco provides audiology services and hearing aids.
So which one should you choose?
While price is important, remember that you're not just buying a product – you're entering into a service relationship. Confidence, trust and rapport with your audiologist are also important, as are more practical issues such as location, opening hours and ease of getting appointments.
At your consultation, your hearing services provider should:
- do an audiogram and explain the results
- explain the benefits and limitations of different types of hearing aids, if aids are recommended
- give you a detailed quote
- agree to a free trial period of at least 30 days
- outline a plan for how to get the best from your new hearing aid and make arrangements for a follow-up visit.
Audiology and hearing aid clinics in Australia
We contacted major brands of hearing aid clinics in Australia – those with access to more than 20 outlets – to find out what they offered in terms of screening and assessments, free trials and satisfaction guarantee and after care.
A free trial can help you discover if you like the feel of the hearing aid – if you're trying a new style, for example.
But a generous satisfaction guarantee can make a big difference to your hearing aid experience. All the clinics we contacted offered at least 30 days, but some up to 90 days. There is an argument that if you're not happy in 30 days, you won't be happy in 60 or 90, which may well be true.
However, the extra time may come in useful if you're busy, or have to travel a long way to a clinic, and have to fit in a few appointments within that period. It will also give you a chance to try them in lots of different situations – a big wedding or a party on day 35 could be good testing ground.
The main brands available in Australia are:
- Signia (Siemens)
- Sonic Innovations
There is no one 'best brand' for hearing aids. That's not to say they're all the same – different brands will focus on different aspects of hearing, so sometimes one brand may suit your needs better than another.
Nina Quinn, CEO of the Neurosensory chain of clinics, says, "In 80% of cases, the brand doesn't matter. Every brand has a suitable product in its range. What is really important is selecting the right product for the individual and far more importantly, the programming of those devices. A device is only as good as the way it is programmed. However, in approximately 20% of cases, certain brands will better meet niche requirements."
Our consumer counterparts in the US surveyed almost 20,000 of its members who wear hearing aids, asking them to rate their overall satisfaction with the aid, as well as various features such as ease of changing batteries, ease of cleaning and fit/comfort.
It isn't about the brand of hearing aid, it's about how the hearing aid is programmed
All the brands listed above scored between 65 and 68% for overall satisfaction. Their statistics boffins worked out that a difference of less than four percentage points between any two products meant they were not noticeably different, implying all these brands were rated about the same.
However, this doesn't take different levels of technology within each brand into account, nor how well the aid is programmed for the individual – a poorly programmed top-of-the-line product won't be as good as a well-programmed basic model, and that's regardless of which brand's involved. This importance of individual tailoring is why CHOICE doesn't test hearing aids.
Some outlets have their own brand of product – for example, Costco has Kirkland, while Specsavers has Advance – which are locked to the supplier. If you move to an area where there's no local Costco or Specsavers, you won't be able to get them serviced.
In 2020 we surveyed 470 CHOICE members about their experiences with hearing air brands to find out which ones hold up best over time.
The top performers
Most reliable brands: Signia, Oticon, Phonak.
Brands with the highest owner satisfaction: Signia, Oticon, Phonak.
Looking at an eight-year purchase period, the most popular hearing aid brands among the respondents were Phonak (20%), Signia (17%) and Oticon (15%).
In general, all performed similarly in terms of reliability as well as user satisfaction. The differences in scores were not statistically significant.
The majority of respondents (75%) had a Behind The Ear (BTE) hearing aid – much more popular than Receiver In The Ear (RITE) at 12% and In The Ear (ITE) at 11%.
Hearing aids appear to be a relatively unreliable category with an overall reliability score of 59%. Of those who bought their hearing aids in the last eight years:
- 37% have never experienced problems with their hearing aids
- 25% complained that conversations were not filtered properly through their hearing aid
- 13% noted that their hearing aids had a low battery life
- 13% felt their hearing aids were hard to clean or accumulated too much ear wax
- owners of ITE hearing aids were the most likely to complain that conversations were not filtered properly (41%; BTE at 24%; and RITE at 20%)
- 43% of hearing aid owners had contacted the brand for service support. Nearly half (46%) of them did so due to a major failure.
While we didn't ask respondents about the cost of their hearing aids, there were a number of mentions that the hearing aids were expensive.
With a high incidence of problems reported, there were a lot of comments on getting the hearing aids repaired, readjusted or replaced.
A number of hearing aid owners like the Bluetooth connectivity so they can answer calls or listen to music from their phone.
It also appears that owners were more likely to contact the hearing aid retailer or audiologist for repair and service, instead of directly dealing with the manufacturer.
|Signia (Siemens) (85)
Sample sizes in brackets. Differences of 8% or more are significantly different.
Sample sizes in brackets.
There are several options available in terms of the physical form of the hearing aid and your hearing services provider will help you decide which is the most suitable for your condition and lifestyle.
Going invisible – Lyric and other options
For many people, a discreet hearing aid is important – they don't want others to notice they have a hearing aid. However, some argue that a noticeable hearing aid isn't necessarily a bad thing – if others notice you have hearing aids they can modify the way they interact with you accordingly (speaking clearly, not speaking from behind you, not thinking you're ignoring them and so on).
Invisible in canal (IIC) models are almost invisible – they have a small stick (handle) that pokes out of your canal so you can insert and remove the aid.
Phonak Lyric hearing aids are smaller and worn deeper in the canal than typical IIC models, making them truly invisible. They stay in place 24/7, even while showering, and they're disposable so you don't need to change the battery – aids last for around 2–3 months before being replaced with the help of your audiologist.
You pay for them on a subscription basis, rather than a one-off cost, and you can reckon on $2000–2800 per ear, per year. While it works out to be more expensive than other hearing aids, the invisibility and set-and-forget convenience may make it worthwhile for some. Another advantage is that you automatically get the newest technology as it's upgraded.
But some people might not like the feeling of something permanently in their ear.
They're generally available on a trial basis, so you can see if it suits you before committing to the program.
Some features can make life with hearing aids even better, but some may not be worth the money.
Batteries in hearing aids are small and fiddly, and notoriously difficult to change when people have limited dexterity (such as arthritis) and/or poor vision. And you need to change them often. With rechargeable batteries you simply place the device on a charger each night, and they'll be ready in the morning. At this stage only BTE or RIC devices are rechargeable.
Your smartphone can be used as a 'remote control' for your hearing aids, allowing you to switch between listening programs, adjust volume and so on. Your phone can also transmit sound directly to your hearing aids – useful not only for phone calls, but music, podcasts, audiobooks and videos too.
Omnidirectional microphones pick up sound 180 degrees around each ear, so if you're wearing two hearing aids, it will be 360 degrees. Directional microphones face front and back, and if you're in a noisy environment you can switch off the back one so you can hear speech in front of you. More advanced hearing aids have automatic switching, so they detect the noise level and switch between different microphone modes. Adaptive microphones focus on speech, whether it's behind you (in a car, say) or in front of you.
Telecoil or t-coil
Used in conjunction with a hearing or induction loop fitted in some public places (such as auditoriums, airports, places of worship, theatres), a telecoil in your hearing aid switches off the microphones and allows you to hear speeches, announcements and so on picked up by the hearing loop – without all the background noise. If you want this feature, it needs to be installed and/or activated by your audiologist.
Many hearing aids will play a low level white noise to mask the sound of tinnitus.
Hearing aids made with titanium are smaller than those made with plastic. However, they're more expensive, and the smaller size may or may not make much difference to you.
Wind noise reduction
This feature is found on more advanced hearing aids, and if wind is blowing across one hearing aid it reduces amplification of low frequency noise. It's a useful feature if you spend a lot of time in the outdoors, hiking or playing golf, for example.
Hearing aids range in technological capability from simple amplification in quiet situations to highly sophisticated sound processing that separates speech from background noise in complex environments.
Each brand carries one or more series with a range of models at different levels of technology within each series. The names of technology levels may vary, and just to confuse things, terms like 'basic' and 'essential' can mean different levels in different clinics. Descriptors like bronze, silver, gold, platinum and diamond may also be used.
The series/models included here as examples are among the most popular – they're not necessarily recommended as being the best.
We've also provided a price range for each technology level. Note that prices are indicative only and will depend on where you buy, whether service is included and if there are any additional features, such as rechargeable batteries, titanium casing, TV connectors, remote controls and so on.
We haven't included the Costco and Specsavers brands, but they're substantially cheaper than label brands – their respective premium models cost $1899 and $3495 per pair, compared to $6000–8000 or more for mainstream brands.
Is lifestyle really the best criterion for hearing aid level?
For each level, we've listed examples of hearing aids that may help in particular lifestyle situations, but they'll also help in less challenging situations. So hearing aids that will help you at small social gatherings will also help with one-on-one conversations at home, or when talking with a few people while visiting friends and family.
The key is to be properly assessed so you understand your hearing loss and know what devices may be able to provide the best benefit.
It's commonly followed in the industry that the more 'active' your lifestyle, the more advanced – and more expensive – the hearing aid should be.
But not everyone agrees with this practice, such as audiologist Grant Collins, president of the Independent Audiologists Australia and principal of the Clarity Hearing + Balance chain in Queensland.
He says, "More often than not it isn't lifestyle which determines what technology level you would benefit from. It's more functional elements, such as the severity of hearing loss, configuration of hearing loss, speech discrimination, hearing in background noise, dexterity and eyesight, cognitive capacity, and outdoors vs indoors lifestyle, to name but a few things."
As an example, Collins explains, "If you have a severe to profound hearing loss with no functional hearing in the high frequencies, your ability to be able to understand speech is going to be limited – so it doesn't matter how much you spend and what features you have.
"On the other hand, you could have a mild to moderate hearing loss with excellent speech discrimination and auditory processing, and could have just as good an outcome with a cheap personal amplifier as a premium hearing aid – no matter what your lifestyle.
"The key is to be properly assessed so you understand your hearing loss and know what devices may be able to provide the best benefit."
Christo Fourie of Value Hearing agrees, adding that while ability to distinguish speech in noise is one of the most important determinants of which hearing aid technology is right for you, it's often overlooked in testing.
"Instead, it's just assumed that everyone has 'average' difficulty [hearing] in noise. This leads to hearing aids being selected based on this assumption that you're 'average', and you're offered hearing aids based on your lifestyle, activity level and age," he says.
Are premium hearing aids actually much better?
The higher end hearing aids add very little – if any – benefit over the more basic models for most people, according to Grant Collins. He says they start most people with the entry level or basic model, which is free for eligible people.
However, Christo Fourie says, "Hearing aids are priced based on the features they have. More expensive hearing aids have lots of features, but can also clean up the speech from noise better."
Start basic and upgrade if necessary
Rather than plunge in at the most expensive end of the market, take advantage of the free trial period offered by hearing aid retailers, starting with a more basic model and upgrading if it's not up to the task. Having then tried a higher level aid, you can decide whether the difference, if any, is worth the extra cost.
Much of the technological capability in higher end hearing aids is due to software, rather than the hardware – so the programming, rather than the physical aid itself. With Unitron hearing aids, you can buy a base model and pay your audiologist to 'unlock' or enable enhanced capabilities if you decide you need them.
Give them a chance to work
Unlike glasses which correct vision impairment, hearing aids won't restore your hearing to 'normal'. It will take you and your brain time to get used to them – and, where devices are capable of learning from your behaviour, for them to get used to you!
It may be frustrating at first, and possibly disappointing if you were hoping to have your hearing back to 'normal'. It can take a few weeks – possibly up to 12 weeks – for your brain to adapt to the new sounds it's getting. That's why it's important when you first get them to wear them often and test them out in challenging situations.
Hearing aids range in price from around $2000 a pair, up to $10,000, and sometimes more when extra gadgets are included. If you're no longer working, that's a significant financial hit, and given that hearing aids only last around five years, an expense you'll likely experience again.
Many people are eligible for government assistance with hearing aids
Many people are eligible for government assistance with hearing aids, either through the Office of Hearing Services or the National Disability Insurance Scheme. The tax offset for medical expenses is unfortunately being phased out, with 2018–19 the last year it's claimable.
Office of Hearing Services – Hearing Services Program
Hearing aids aren't covered by Medicare, but the Australian Government's hearing services program helps people on low incomes most likely to struggle with hearing aid costs. Eligible people, including children, Indigenous Australians, most pensioners, part-pensioners, veterans and some other groups, are entitled to a free hearing assessment, hearing rehabilitation and hearing aids or assistive listening devices.
Around 80% of hearing aids sold in Australia are fully or partially subsidised under this program.
Most of the free devices are basic, but they often have features such as automatic directional microphones, noise reduction, multichannel function, telecoils, wireless connectivity and basic remote controls.
If you're after aids with higher-technology features, you'll have to pay your provider the difference between the cost of these 'top-up' aids and that of appropriate aids that could be fitted free.
Private health insurance
Many health insurance extras policies will contribute to the cost of hearing aids, and depending on the policy, up to $1600 per person. In fact we've found some policies which cost less than the hearing aid rebate.
Shopping around for a good deal
If you don't have health insurance and aren't eligible for government assistance, you can still save on hearing aids by shopping around.
If an audiologist recommends a certain hearing aid for you, get online and look at prices. Just make sure you're comparing apples with apples – you need the exact model name, and keep in mind any extras included, such as charging station, titanium, remote controls, batteries. Some retailers have a price-matching guarantee, so if you see it cheaper elsewhere, try to bargain.
It's not always clear what the price includes, and many audiologists argue you're not just buying a device, you're buying a service. This includes the services of a highly qualified health professional, such as testing, education, rehabilitation and ongoing service and support for the life of the device – as well as the device itself.
Some retailers, such as Clarity Hearing + Balance, aim to help consumers by making their pricing transparent and displaying prices online, and they unbundle the cost of the device from the cost of professional services as much as possible. So experienced users, for example, may choose to buy the device without any included service, and then pay extra for service if it's needed. This ends up being substantially cheaper than buying a device which includes service, and if the service isn't needed you shouldn't be paying for it. On the other hand, new users, or people with complex needs who may need to make numerous visits for testing and adjustment, can buy service packages of various levels.
Get the technology level right
Don't be talked into buying something more expensive than you need. If in doubt, start with cheaper technology, make use of the satisfaction guarantee/free trial period and only upgrade if you feel it's necessary.
Stock images: Getty, unless otherwise stated.