Select a hearing aid provider

01/20/2015 in article

If you are a veteran, your first step should be to determine whether you are eligible to get your aids at your nearest Veterans Affairs facility. For everyone else, our suggested choice is a medical office headed by an otolaryngologist (an ear, nose, and throat physician) who employs an audiologist to fit and dispense hearing aids.

About one in five survey respondents got their hearing aids from a doctor's office. They gave those hearing-aid providers higher marks on their thoroughness in evaluating hearing loss than did respondents who went to other types of providers. Another plus: An ear doctor can rule out medical conditions such as a tumor or bacterial infection in the ear that might be affecting your hearing. He can also clear your ears of wax so that you're ready for your hearing test.

Medicare will cover the medical exam and an audiologist's test if ordered by a physician. Some private Medicare Advantage plans might cover part of the hearing-aid cost. People with other types of private insurance should check with their carriers because coverage might vary.

If you can't find a conveniently located doctor's office that dispenses aids, an independent hearing-aid provider is a reasonable alternative, our survey found. Thirty percent of respondents got their aids from that type of provider, which is usually staffed by non-M.D. hearing professionals. We consider it important to have some choice of brands, and independent providers generally carry two to four different ones. (The Food and Drug Administration requires patients to have a physician's exam before acquiring a hearing aid but lets adults who don't want one sign a waiver.)

Name-brand stores such as Beltone and Miracle-Ear, used by 18 percent of survey respondents, handle their own brand. (The remainder of survey respondents went to clinics in civilian hospitals or at big-box retailers such as Walmart and Costco. We didn't have enough responses to evaluate them.)

The professionals you might encounter at independent hearing-aid providers could fall into two categories: audiologists and hearing-aid specialists (also called hearing-instrument specialists). Name-brand stores more often use the latter.

Both types of professionals can evaluate your hearing and fit your hearing aids. But their training varies significantly. Newly minted audiologists must have a doctoral degree (generally the Au.D.), pass national and sometimes state tests, and have more than 1,000 hours of clinical training. Hearing-aid specialists generally have from six months to two years of supervised training or a two-year college degree and in most states must pass licensing tests. They can also seek national certification.

You might not necessarily know when you walk in the door which professional you are dealing with. Our shoppers occasionally encountered two or three types working at the same office. Our survey respondents had a difficult time even making distinctions among professionals; 87 percent said they'd visited audiologists, though many had gone to vendors known in the industry to be staffed primarily with hearing-aid specialists.

Does it matter whether the office is staffed by an audiologist or a hearing-aid specialist? Audiologists have broader training and, unlike hearing-aid specialists, can treat auditory conditions that might be better addressed without hearing aids, such as balance problems.

But both types of professionals made mistakes in fitting the aids purchased by our 12 shoppers. Audiologists made fewer serious fitting errors than did hearing-aid specialists, but in about two-thirds of all of the fittings, patients ended up with incorrect amplification.

In the sections that follow, we provide advice on how to increase your chances of getting a good hearing-aid fitting, regardless of which type of hearing-aid provider you choose.

Consider practical things, too, in your choice of provider. Check with your state to make sure the professionals' licenses are current, and with the Better Business Bureau or state attorney general's office for complaints.

Make sure the location and office hours are convenient. Ask whether the office does walk-in repairs rather than requiring you to make an appointment. Ask about hearing-rehabilitation services or support groups for after you get your hearing aids. Experts we interviewed said that those elements might be important for your long-term satisfaction with your aids.

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