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How to buy hearing aids

How do you buy hearing aids? We’re taking a week off of our deep dive into special education metrics started in episode 10 and talking about something super specific… is it a disability rights topic? I think so. In its small way, it shows how our crazy healthcare system works for disabilities.

Buying hearing aids is also a lot trickier than you may think.

See Program Notes.

I’m your host, Steven Davis and welcome to episode 11 of Disability Democracy. This weekly podcast is about practical actions that YOU can take – to make a difference in your community. The goal of Disability Democracy is to accelerate the disability community revolution. Find out more at disabilitydemocracy.org.

According to Consumer Reports. 48 million Americans have hearing loss. And, for many of us, most of us, hearing aids aren’t covered by health insurance.

Yep, a predictable, solvable healthcare problem isn’t covered….in many cases, there is no coverage at all for a product that typically costs over $1000 – for each ear – and can range up to $2500 – EACH.

Hearing aids are so expensive that some people who need them, don’t get them or get just ONE.

I’m not going to spend my time going over all the different types of hearing aids, mostly, I’m going to talk strategy with you.

Here’s the most important thing:

Buying hearing aids is much more like buying a car or computer than buying glasses.

They aren’t just a little amplifier that you stick in your ears, they are a state-of-the-art computer that can be reprogrammed and they last 5 to 7 years.

You need to think of them as an investment that will pay off for a long time.

I wound up replacing my first pair of hearing aids after 2 years because of a healthcare savings account hiccup.

Without going into details, it made sense to upgrade them.

I’m glad I did, but I now wish I’d upgraded them “to the max”.

Let me explain.

The key number that drives hearing aid performance is number of channels.

If you’ve looked at a hearing test, you see a curve of how good (or how bad) your hearing is in each frequency – from high frequencies (my young daughter and where my hearing is worst) to low frequencies – bass drums and those super loud cars you hear shaking your windows as they drive down the street. Usually, hearing loss isn’t uniform, it is concentrated in different frequencies.

The audio channels divide that continuous curve up into frequency bins. Separate pieces that are amplified separately. The more pieces, the better the hearing aid matches your hearing loss.

My first hearing aids had 4 channels. My new ones have 12 – three times more. The top end hearing aids that I’ve seen have 20.

20 channels – what does that mean?

Now, I have growing kids, so we’re in a world of Legos now. But, if you have toddlers, or have to buy gifts for little kids, there is are big blocks called “Mega blocks”. These are super sized plastic blocks with the standard block around 6 inches long. Then, as your kids get older, you move up to “Duplos” at around 2 inch standard block, then “Legos” at around 1 inch.

More channels are kind of like moving from Megablocks to Duplos than Legos.

If you are trying to build “Hogwarts”, with lots of detail, you want Legos, if you want to build a big stack of blocks, Megablocks work fine.

Hearing detail comes from the channels.

When I really felt this when I upgraded my hearing aids.

While I like music, I am no hardcore audiophile.

When I changed from 4 channels to 12 channels, all of a sudden, I could hear a ton of extra detail… and that is when I’m listening to Johnny Cash in my car with my kids. Not Bach in a concert hall or quiet room.

The extra channels allows the hearing aids to much more closely match your actual hearing loss – that curve that they show you.

While a magnifying glass can help you see, – prescription glasses are a lot better.

More channels give you a much, much better prescription.

Going from 4 channels to 12 is three times better. Going to 20 is 5 times better… or 5 times more accurate.

And those channels are really the difference in the cost of hearing aids.

They drive the cost of the computer chip (actually a Digital Signal Processing Chip – DSP)…more channels, more power… and all of the rest of the features follow. It is not like glasses where they are actually customized, they are like a computer where all of the differences are in the power, the peripherals, and the programming.

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Consumer Reports says you should only “Buy what you need” for hearing aids.

It is essentially the advice I got when I bought my first pair…. Get the minimum.

I think it is bad advice.

Hearing is one of your five senses.

It allows you to hear your child, talk on the phone, listen to music.

No one would tell you to buy a magnifying glass if you need glasses.

Having polarizing lenses in my glasses mean I don’t need to buy (or carry) a pair of sunglasses.

They make my vision work better.

I don’t know about you, but I want my hearing not to be just “a bit better” or “better enough”. I want my hearing to be as good as possible.

So, back to those DSP chips and all of their channels.

Of course, once you move up to the higher end of DSP chips. Hearing aids with more channels, a lot of the other features wind up being included. Smarter chips have more memory and support more fancy features out of the box.

It is just the same with cars and computers.

Let’s go over a couple of what I think are the most important features.

First, an easy one. Rechargeable hearing aids are a huge win over hearing aids with batteries. First of all, at least for me, the cost difference was something like $50. Now, if you are replacing your hearing aids every year, it is kind of a wash cost-wise, but after 5 years, you’re way ahead with rechargeable batteries… and that is before the extra safety feature of having your hearing aids basically sealed up. No battery slot to open up and get dirt or water into or just mechanically fail. More reliable. More cost-effective for a five to seven year investment.

Total win for rechargeables.

Next, Bluetooth.

If you use a smart phone, Bluetooth hearing aids are an easy buy. They seem to be becoming more standard anyway. Again, not very expensive for a feature you are going to use regularly for 5 to 7 years. And Again, something like $50 to $150… a modest investment. If you don’t use a smart phone, then you don’t need Bluetooth. Pretty easy.

For the usually modest cost, Tele-coil is probably worth it. Public spaces for presentations and conferences, if we ever have them again, are often set up to with this technology that plugs you into the buildings sound system. Again, why not take advantage of everything that can help your hearing? I didn’t get this and I kind of regret it. You spend more than $20 to go to a movie, why not spend $50 to hear it better for the next 5 years?

Hearing aids are an investment in your hearing, not something to scrimp on.

Fancy computers have lots of features… and that is true of hearing aids as well. While I haven’t done a systematic market survey, if you get hearing aids with 12 or 20 channels, you are likely to get lots of other features just “thrown in”. They come standard. You’ll likely get an app for your smart phone, lots of smart programs like you might have for your stereo or sound systems. It is really the same…. And the smartest hearing aids automatically switch between these programs.

It is all pretty amazing and, just like polarizing eye glasses that protect your eyes from bright sunlight, the technology mostly takes care of itself.

It is all about investing in quality. It is all about giving yourself the best hearing you can get.

Here are three other little things that work for me… let me know how they work for you.

One. I went with the “behind the ear” hearing aids. I think overall they are more powerful and more cost-effective. Jut like the difference between a PC and a laptop, they’ve got more space to work with (even if it is hidden behind your ears).

Two. I bought silver hearing aids. No one notices them. There are a wide range of skin colored options as well as white and black. I went with silver in case I lost mine… so they’d be as easy to find as possible. I’d probably go with florescent yellow if it was an option. Even though you usually have insurance coverage with your hearing aids, who wants to deal with a missing one at getting it replaced?

Three. If you wear glasses, you may have trouble if you have heavier frames with the over-the-ear hearing aids. Not surprising. Kind of obvious once you think about it. But no one said anything. Basically, the ear pieces of your glasses can wind up sitting on your hearing aids. They gave me headaches until I switched back to much lighter eyeglass frames. Problem solved.

Four. Just a warning. Even good hearing aids aren’t perfect. I still have trouble more trouble hearing with noise in the background and my ability to hear around corners is just not good. Also, hearing aids basically have little microphones in them that point forward and backwards… I found this out while singing hymms in church. The otherwise wonderful woman who often sat behind us sang dreadfully out of tune and it was being beamed right into my ears.

By the way, You do actually need to wear your hearing aids for them to work (this shouldn’t be surprising, but there are a lot of hearing aids out there sitting in drawers). It will take a while to get used to them. My eldest sister warned me that I needed to stick with them for several weeks – no matter what. It feels weird having something sticking in your ears. It is uncomfortable. But, you’ll get used to it…. Though I still like taking them out right after dinner and being a bit deaf for a couple of hours before I go to sleep.

We have a pretty perverse healthcare system. The way it works for hearing aids is kind of insane. Hearing shouldn’t be a privilege for the wealthy. It is a terrible thing to cut corners on… but that is the system we have today.

What can you do today?

One. Well, many of us buy cars with financing or can afford low interest loans through our houses. If you can find a way to pay for really good hearing aids, do so. You, your family, your friends, and your co-workers will appreciate it – even if they don’t notice your hearing aids. Especially if they don’t notice your hearing. It is an investment that will last 5 to 7 years.

Two. Insurance companies, hearing aid manufacturers or other groups should support financing for hearing aids. I really, really don’t understand this. It is a business opportunity at the very least…. And it is a great service to people. If you can finance a car, a refrigerator, or air conditioning, you should certainly be able to finance some hearing aids.

Three. I haven’t seen refurbishment options for hearing aids. This seems like an opportunity to help those who can’t afford new hearing aids. If you know of a program out there, tell me and I’ll add it to the episode notes.

Four. Someone needs to talk to hearing aid manufacturers about marketing. It would be great (and I would think very doable) to put me in a good audio headset and let me actually hear the difference between different models and maybe even brands of hearing aids. People should know what they are missing and what they are getting with different levels and types of hearing aids.

Finally, Let’s start covering hearing aids under health insurance for everyone. 48 million Americans could benefit from better hearing. Apparently one of the reasons a lot of Veterans use their VA healthcare benefits is that the Veterans Administration DOES cover hearing aids… and they cover them very well. A great idea. A great service…and it should be there for everyone.

This episode of Disability Democracy Radio was sponsored by Not Without Us. Not Without Us is a 501c4 mutual benefit corporation. Our goal is equality for all disabled adults and kids with disabilities. You can learn more about our work at notwithoutus.org. Our strategy is built on democratic action – through this podcast and our community at disabilitydemocracy.org, providing organizing support at diydarkmoney.com, training candidates for local office at GetElected.US, endorsing candidates, or directly working on issues.

We’d like to thank Sean Moran, Meredith Mengel, for their contributions to Not Without Us. You can support Not Without Us with an annual, monthly or one-time donation at notwithoutus.org/join. If you have any questions or comments on this episode, visit disabilitydeomcracy.org – you can email us, leave a comment, or even a voice message. I’m Steven Davis and on behalf of Not Without Us, we think that democracy comes not from a vote every two years, but from the actions we can take every day.

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