More than five years ago, I wrote about my journey acquiring my first hearing aid. With a new insurance plan with hearing benefits, I thought it was time to take another look and see where the latest aids can help me with my high frequency hearing loss and tinnitus.
Now there are three components of your hearing that will motivate you to get an aid. First, you have some kind of hearing loss (as I said, for me it is the higher frequencies, which is typical for older folks) and you want to hear things better. Second, the type of sounds you “hear” with your Tinnitus, and whether you want these masked with an aid or some combination of audio processing and masker. Tinnitus can vary by time of day, whether you have gotten enough sleep, or by stress levels. If this describes you, then ideally you want to be able to adjust the masking technology according to give you the greatest comfort. Part of the issue here is that you may not want to become a DIY audiologist or software engineer.
Finally, how the aids interact with each other to place you in a sonic environment so you can understand what is going on around you. Given that I am completely deaf in one ear and that I need only one aid, this isn’t relevant for me.
If you haven’t read my original blog post when I first bought my aid, now would be a good time to go do that to remind yourself of that process.
But buying the first aid may seen easy when you consider a complicated journey to upgrade your aid. This is because the hearing aid medical industrial complex is just that — complicated. And while there are professionals that can be helpful, you have to first know the right questions to ask, second know what the aids can and cannot do, and have a great deal of patience being the hearing-deprived patient. Oh, and be prepared to spend lots of time and money when you do get your aid.
You would think that already having an aid would mean that you have already dealt with these issues. But you would be wrong. The replacement market is truly a different ball game. This is because being human, our hearing changes as we age. And the aid technology marches on, which means your beforetime knowledge is outdated. And that you now have a standard — your existing aid — to compare things with introduces new complexities.
There is one other factor, that you can now purchase aids over the counter. That is fine if you have a simple hearing loss, don’t have to muck around with the frequency controls, and don’t have a lot of Tinnitus. Yes, no and no for me. So this wasn’t an option. The OTC aids generally cost less, but don’t include much in the way of hand-holding and servicing. This is not like buying a blender: instructions and personal demonstrations are essential to their operations. You might not like the initial fit of the instrument, or be confounded with its numerous settings.
The OTC aids don’t really give you the best price comparison either. When you buy an aid from an audiologist, you are actually paying for a service contract for a period of time and this contract may or may not cover all problems or has exceptions (like water damage).
As I mentioned previously, for the past five plus years I have been using one of the Starkey models. I was generally happy with it. I made an appointment with a different audiologist than the one I had been seeing for the Starkey, just to see how the two approach solving my problems. I give the new audiologist, a woman whom I will call B, props in thoroughness, and knowledge, and service. She spent nearly two hours on my first visit, and wanted to schedule several follow up visits. She told me that I am her first Tinnitus patient who is not a new hearing aid user. We will get to why that matters shortly.
B has worn aids since childhood, a perspective of which I liked. She had some very fancy gear to test your aid’s programming, which I liked as well. Think about the device that an optometrist uses to determine if your glasses prescription matches the actual optics. She puts every aid she sells through this device, to ensure it is programmed properly.
Why is this important? Modern hearing aids are more software than hardware and can be programmed in one of three ways: At the factory when they are assembled and make use of various automatic sound processing features (to soften noisy environments, to enhance the frequencies used in human speech, to change the microphone coverage area to the sides or in front of you, and other things).
But one piece of programming is very important to me, and that includes figuring out the Tinnitus masking sounds, which can be tricky to deal with. Everyone has different “ringing” sounds as part of their Tinnitus affliction, some relatively simple sounds (such as I have) and some that vary in terms of frequency, period, and loudness. The aids do some counter-programming — meaning they produce their own sounds — to try to keep your attention away from the tinnitus, at least that is the working theory of the moment.
Second, the audiologist has the ability to change some of its programming that affects its audio processing and also set up pre-set conditions that you can access with the buttons on the aid or on its smartphone app. I mentioned to B that one night my wife accidentally slammed a cabinet door — the sound of which, amplified by my new aid, almost made me jump. She told me that she could program the “door slam sound” (yes, this is a thing) to soften it up.
Yes, there is an app for that, and the different vendors do a varying job on their apps. The app — the third piece in this puzzle — is what you fiddle with yourself (assuming you have a smartphone and that you want to do this). Each aid manufacturer has different models with varying features — which you may or may not need. Tinnitus masking generally is included in the higher end (and pricier) products, just my luck.
One of the things that I will be doing over the next week or so is to try them out in different sonic environments and see if one of them is worth the cost of the new aid, or I can still get by with the old aid with a few simple adjustments.
So B recommended that I check out the Resound models. She likes their app, which has a lot of controls, as you can see from the screenshots. This was very obvious when I compared it to the app that controls my old Starkey aid, which doesn’t have as many Tinnitus pre-set controls either available to the audiologist or on the app itself.
I should mention one other complicating factor. My old aid had regular batteries that needed replacement every week or so. But most of the newer aids have rechargeable batteries that last about a day on a charge and probably need complete replacement every three years. I don’t mind the non-rechargeable kind but you may feel otherwise.
Then there is the matter of insurance. My insurance plan covers $2000 per aid, but this is a deceptive situation, as some audiologists don’t take insurance (such as B) because they don’t want to bother with the reimbursement. But she is very upfront about the services she provides to make sure your aids are the right choice for you, and includes several visits the first year you buy an aid from her.
The insurance issue is a vexing one. For years, my plans had no coverage, so it was easier. There are three problems: first, as you say, limited reimbursement on part of the costs, which still leaves them expensive. Second, a general lack of transparency about pricing. Each audiologist can set prices independent of others, which as I mentioned bundles in a certain level of service. This makes it hard to shop around. Selling OTC aids was supposed to make things more transparent, but it hasn’t.
So let’s take a step back here. The issue for the aids is what problem are you trying to solve. For example, I would like better Bluetooth fidelity (especially when I am outside, which renders my old aid almost useless), better control over the masker, and more options in general for the smartphone app. Not all aids deliver all of these features. And sometimes you don’t know what is important until you try out the aid and hear it for yourself. Or see the app’s controls and decide whether you want to spend your day fiddling with them.
After spending a few days with my new Resound aid, I decided I would stick with the tried and true Starkey. Much as I would like the latest and greatest tech, I just couldn’t justify the extra bucks. Perhaps when it finally bites the dust that will force my decision, but by then there will be something even more techy.