Get your hearing tested and find the right hearing aid with a structured guide. Covers recognizing hearing loss signs, scheduling an audiogram, understanding test results, choosing hearing aids, adjusting to new devices, and ongoing hearing care.
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Recognize Signs of Hearing Loss
Assess whether you have common hearing loss symptoms
Key signs: frequently asking people to repeat themselves, difficulty following conversations in noisy environments (restaurants, parties), turning the TV volume higher than others prefer, feeling that people mumble, missing doorbells or phone rings, tinnitus (ringing or buzzing in ears), and difficulty hearing on the phone. Hearing loss develops gradually, so many people do not notice until it is moderate. If family or friends have commented on your hearing, take that feedback seriously. The average person waits 7-10 years from noticing hearing difficulty to seeking treatment.
Understand who is at risk for hearing loss
Age-related hearing loss (presbycusis) affects one-third of adults aged 65-74 and nearly half of those over 75. Other risk factors: noise exposure (concerts, machinery, headphones above 85 decibels), family history, certain medications (aspirin in high doses, some chemotherapy drugs, certain antibiotics), diabetes (doubles hearing loss risk), and cardiovascular disease. Noise-induced hearing loss is increasingly common in younger adults from earbuds and headphones. The WHO estimates 1.1 billion young adults are at risk from unsafe listening practices.
Get a Hearing Test
Schedule a comprehensive audiological evaluation with an audiologist
An audiologist (Au.D. or Ph.D. in audiology) performs the most thorough hearing evaluation. The test includes pure tone audiometry (you wear headphones and respond to beeps at different frequencies and volumes), speech recognition testing (repeating words at various volumes), and tympanometry (testing middle ear function). The full evaluation takes 30-60 minutes. Cost: 75-250 USD, often covered by insurance with a referral. Find an audiologist through the American Academy of Audiology directory (audiology.org) or ask your primary care doctor for a referral.
Understand your audiogram results
An audiogram is a graph showing the softest sounds you can hear at each frequency (pitch). The vertical axis shows volume in decibels (dB): 0-25 dB is normal hearing, 26-40 dB is mild loss, 41-55 dB is moderate, 56-70 dB is moderately severe, 71-90 dB is severe, and 91+ dB is profound. The horizontal axis shows frequency from low pitch (250 Hz) to high pitch (8000 Hz). Most age-related hearing loss affects high frequencies first (4000-8000 Hz), causing difficulty hearing consonant sounds (s, f, th, sh) that are critical for understanding speech.
Discuss treatment options with your audiologist based on results
Mild hearing loss: monitoring with annual re-testing, or hearing aids if speech understanding is affected. Moderate to severe loss: hearing aids are strongly recommended. Severe to profound loss: powerful hearing aids or cochlear implant evaluation. OTC hearing aids (available without prescription since 2022) are appropriate for perceived mild to moderate hearing loss in adults. Prescription hearing aids from an audiologist include professional fitting, adjustment, and follow-up care. Your audiologist will recommend specific devices based on your audiogram, lifestyle, and budget.
Choose the Right Hearing Aid
Select a hearing aid style based on your hearing loss degree and preferences
Behind-the-ear (BTE): fits behind the ear with a tube to the ear canal. Best for all levels of hearing loss. Most visible but most powerful. Receiver-in-canal (RIC): small behind-the-ear unit with a thin wire to a speaker in the ear canal. Most popular style (60% of fittings). Good for mild to severe loss. In-the-ear (ITE) and completely-in-canal (CIC): custom-molded to fit in the ear canal. Less visible but smaller batteries and less powerful. Best for mild to moderate loss. Your audiologist recommends styles based on your audiogram and dexterity.
Compare prescription hearing aids vs. OTC options based on your needs
OTC hearing aids (Jabra Enhance, Sony CRE-C10, Lexie B2: 500-1,000 USD per pair) are self-fitted using an app and appropriate for mild to moderate hearing loss. Prescription hearing aids (Phonak, Oticon, Starkey, ReSound: 2,000-7,000 USD per pair) include professional audiological fitting, real-ear measurements, multiple adjustment visits, and ongoing support. Insurance coverage varies: Medicare does not cover hearing aids, but many Medicare Advantage plans do. Federal employees (FEHB) and some private plans cover 500-3,000 USD per pair.
Essential features to look for in modern hearing aids
Bluetooth connectivity: streams phone calls, music, and TV audio directly to hearing aids. Most modern aids connect to smartphones via an app. Rechargeable batteries: eliminates tiny button batteries that need changing every 3-7 days. A full charge lasts 16-24 hours. Directional microphones: focus on the speaker in front of you while reducing background noise. Noise reduction: automatically reduces environmental noise in loud settings. Telecoil: picks up audio from hearing loop systems in theaters, churches, and public buildings. Discuss which features matter most for your lifestyle.
Adjust to Wearing Hearing Aids
Wear hearing aids for 2-4 hours per day in the first week, increasing gradually
Your brain needs time to readjust to sounds it has not heard clearly in years. Start by wearing hearing aids in quiet environments (home, one-on-one conversations) for 2-4 hours per day. In week 2, increase to 6-8 hours and add moderately noisy environments. By week 3-4, wear them all waking hours including restaurants and group conversations. Your own voice will sound strange at first (hollow or too loud). This normalizes within 1-2 weeks. Most audiologists schedule a follow-up fitting at 2 weeks and again at 4-6 weeks.
Attend follow-up appointments for fine-tuning within the first month
The initial fitting is a starting point. Real-world experience reveals adjustments needed: certain frequencies too loud or too soft, feedback (whistling) in specific situations, or difficulty in particular environments. Your audiologist fine-tunes the programming based on your feedback. Most manufacturers include 2-4 follow-up adjustments in the fitting fee. Be specific about situations where hearing is still difficult (restaurant background noise, TV, phone calls) so the audiologist can make targeted adjustments. Full adjustment to new hearing aids takes 1-3 months.
Practice listening exercises to retrain your brain to process sound
Auditory rehabilitation accelerates adjustment. Exercises: read along while listening to an audiobook (matches visual and auditory input), practice conversations in progressively noisier environments, listen to podcasts and TV with closed captions to check comprehension, and make phone calls (many people find phone listening most challenging). The LACE (Listening and Communication Enhancement) program (online, 50-100 USD) provides structured auditory training exercises. Your brain's ability to process sound through hearing aids improves measurably over the first 3-6 months.
Ongoing Hearing Care
Schedule annual hearing tests to monitor any changes
Hearing loss typically progresses 1-2 dB per year with age-related loss. Annual testing detects changes early so hearing aid programming can be adjusted. If hearing drops significantly between annual tests, see your audiologist sooner. Some conditions cause sudden hearing loss (within 72 hours), which is a medical emergency requiring immediate treatment (oral steroids) for the best chance of recovery. Annual visits also include hearing aid maintenance: professional cleaning, receiver and tubing replacement, and firmware updates.
Protect your remaining hearing from further noise damage
Wear earplugs or noise-canceling headphones in loud environments: concerts (100-120 dB), power tools (90-110 dB), lawn mowers (85-95 dB), and sporting events (95-110 dB). Custom earplugs from an audiologist (100-200 USD) provide better fit and sound quality than foam plugs. Follow the 60/60 rule for headphone use: no more than 60% volume for no more than 60 minutes at a time. Noise-induced hearing loss is 100% preventable and irreversible once it occurs. Protecting remaining hearing is especially important for people already wearing hearing aids. This guide is informational only, not medical advice.
Frequently Asked Questions
How do I know if I need a hearing test?
Get a hearing test if: you frequently ask people to repeat themselves, you have difficulty hearing in noisy environments, others say your TV is too loud, you have trouble hearing on the phone, you have ringing in your ears (tinnitus), you struggle to follow group conversations, or family members have expressed concern about your hearing. Adults over 50 should get a baseline hearing test even without symptoms. Adults with noise exposure history should test earlier. A hearing test is quick, painless, and provides objective data about your hearing ability.
How much do hearing aids cost?
OTC hearing aids: 200-1,000 USD per pair (no professional fitting). Prescription hearing aids: 2,000-7,000 USD per pair (includes professional fitting, programming, and follow-up visits). Mid-range prescription aids with Bluetooth and rechargeable batteries: 3,000-4,500 USD per pair. Medicare does not cover hearing aids, but many Medicare Advantage plans cover 500-3,000 USD per pair. Some insurance plans cover partial costs. Financing options are available through most audiology practices. Hearing aids typically last 5-7 years before needing replacement.
Are OTC hearing aids as good as prescription ones?
For mild to moderate hearing loss, quality OTC hearing aids (Jabra Enhance, Sony CRE-C10) provide meaningful benefit at a fraction of the cost. However, they lack professional fitting, real-ear measurements (which verify the device matches your specific audiogram), and personalized adjustments. Prescription hearing aids offer more sophisticated algorithms, better noise reduction, and ongoing professional support. For moderate to severe hearing loss, prescription aids with professional fitting produce significantly better outcomes. An audiological evaluation first determines which option is appropriate for your hearing loss.
How long does it take to adjust to hearing aids?
Initial adjustment: 1-2 weeks for sounds to stop seeming too loud or unusual. Full adaptation: 1-3 months for your brain to relearn how to process amplified sound. Speech understanding in noisy environments continues to improve for 3-6 months as your brain develops new auditory processing pathways. Wearing hearing aids consistently (all waking hours) accelerates adjustment. People who wear aids only occasionally never fully adapt. The most common reason for hearing aid dissatisfaction is insufficient wear time during the adjustment period.