Hearing Aids

Before your hearing aid consultation, you will need:

• An audiologic (hearing) evaluation performed within the last year with our team. If you have a more recent audiogram through another center, we are happy to review it to see if we would recommend repeating the test with us.
• Medical clearance by your primary care provider (PCP) or an ear, nose, and throat (ENT) physician
• If you are prone to wax accumulation, please arrange to have your ears cleaned by your PCP or ENT. The ear canal must be clear of ear wax when we take an impression of the ear for custom fit hearing aids or earmolds as well as prior to evaluation of your hearing.

After the hearing test appointment, you will typically have a minimum of 3 appointments, including:

• Hearing aid selection appointment (90 minutes) to discuss what type of hearing aid best fits your needs, to take impressions of your ears, and to place the hearing aid order
• Hearing aid fitting appointment (90 minutes) to fit your hearing aids and teach you how to use and care for them.
• Hearing aid check appointment, approximately 2 to 3 weeks following the fitting, to check on your progress and make any necessary adjustments. Additional appointments may be added if needed.
  • Adult patients (45 minutes)
  • Pediatric patients (90 minutes) one follow-up appointment

This process typically takes approximately 8 weeks.

• The fee for the first appointment—the hearing aid selection—is $150 and is not refundable.
• The fee for the hearing aid fitting and dispensing is $600. This is the professional service fee, which includes the fitting and dispensing procedure as well as the hearing aid check appointments during the 30-day trial period.
• Prices for hearing aids range from $700 to $3,100 per device depending upon the technology level.

All hearing aids come with a 30-day trial period. After you are fitted with the hearing aids, you will have 30 days to decide whether you would like to keep or return them. If you choose to return your hearing aids during the trial period, you will be refunded for the cost of the hearing aids only. The professional service fee ($600) is not refundable.

All new hearing aids carry a minimum 2-year warranty from the manufacturer. There are two parts to this warranty:

• Repairs, which relates to any issues that come up with the normal use of the instrument
• Loss and damage, which relate to the loss of the device or damage outside of typical use (for example, the family dog chewed it). There is a $300 processing fee per device for a replacement under the loss and damage clause.

You can purchase an extended warranty for $150 per device before the original warranty expires.

At the selection appointment, you will make 3 significant decisions about the type of hearing aids you want:

• Hearing aid physical style
• Hearing aid circuitry
• One ear or two

Hearing aid styles

The style of the hearing aid that is most appropriate for you depends upon the size of your ear, your hearing test results, and your preference. Your audiologist will demonstrate the styles that are appropriate for your hearing loss and ear size. The four basic styles are:

• Behind-the-ear (BTE), either slim tube/receiver in the canal or standard configuration
• In-the-ear (ITE)
• In-the-canal (ITC)
• Completely-in-the-canal (CIC)

Hearing aid circuitry

Most hearing aids dispensed at Dartmouth Hitchcock Medical Center contain digital circuitry. The various levels of technology can be ordered in any of the four hearing aid styles. The hearing aid circuitry that is most appropriate for you depends upon your listening demands, your hearing test results, and your budget. Your audiologist will recommend a circuit to meet your needs.

There are 5 broad levels of digital circuitry (pricing is per hearing aid):

• Entry ($700)
• Basic ($900)
• Standard ($1,500)
• Mid ($2,100)
• High ($3,000)

Manufacturers

We currently dispense hearing aids made by Phonak, Oticon, Starkey, and ReSound.

One ear or two

The benefits of using both ears include localization, convenience, and a balanced quality of sound. The latter is important when trying to hear speech when background noise is present.

Improved hearing

You should be able to hear voices at a more comfortable loudness (for example, you will be able to turn the television volume down) and listen with less stress and strain; however, you may still have some problems understanding certain words in some situations.

Hearing aids cannot restore normal hearing. When a hearing loss occurs, in addition to losing volume, the damaged ear introduces some distortion into the sounds you hear. While making speech sounds louder via a hearing aid will be helpful to gain audibility, any distortion caused by the hearing loss will keep sound from being crystal clear.

It is important to note that each person’s hearing loss is different; therefore, the perceived hearing improvement will depend on your individual loss, amount of distortion, and communication situations.

You and your environment will sound different at first

While using the hearing aids, your voice may sound different to you because it is now being amplified. The more you wear your hearing aids, the quicker your own voice will start to sound normal to you again.

Sounds in your environment that you’ve probably become used to hearing at a quieter level will become noticeable again. At first, they may sound annoying because you haven’t heard them normally in a while. These sounds may include the refrigerator motor running, tires on the car while driving, or heels clicking on the floor while walking. In a short time, your brain will start to notice them less and less, until they are moved into the background where they belong.

Improved but still somewhat limited benefit in background noise

The ability to understand someone talking in a background of noise is more difficult when hearing loss is present. Hearing aids do help some in this situation, but it depends on how loud the background noise is compared to the speaker’s voice. Some features in hearing aids, such as directional microphones and advanced speech processing circuits, may help speech understanding in groups or noisy situations.

Special attachments, known as assistive listening devices (ALDs) can help provide good hearing in noisy environments if you are motivated to use them. Ask your audiologist for more information about these devices.

Success with the right outlook and strategy

Hearing aids are not a cure for all hearing problems. But, when combined with other important strategies (such as looking at the speaker’s face, reducing or avoiding background noise and reverberation, and asking others to face you when talking to you), hearing aids can help to improve your hearing and quality of life.

Having healthy expectations and patience during the adjustment period will allow a smooth transition into hearing aid use.

Hearing aid servicing and repairs are offered by appointment. Alternatively, you may drop your hearing aids off with our receptionist. You’ll be asked to complete a form at drop-off. Some hearing instruments may be serviced in-house while others will need to be sent to the manufacturer for repair. For more information, see "Hearing aid repair services," below.

• Some health insurance companies do not cover hearing aids or appointments associated with hearing aids. Others do but may list these benefits under “Durable Medical Equipment.” Medicare does not cover hearing aids, but Medicaid may cover them if you meet certain eligibility criteria.
• Federal and state funding and employment services are available through Vocational Rehabilitation. These services are designed to help deaf/hard-of-hearing individuals who need amplification to obtain or maintain employment. Please contact the state agency directly to see if funding is available. Please note that currently, we are not a participating clinic with the Vermont Vocational Rehabilitation hearing aid financial aid program.
• Other supports and agencies that may contribute to funding for hearing aids such as the Rotary or Lions Clubs or the Veterans Administration (for U.S. veterans who qualify).
• We offer a refurbished hearing aid program based on income requirements. For more information, please ask your audiologist for an application or contact the Lebanon Hearing Instrument Specialist team.
• Consider using Care Credit to pay out-of-pocket expenses not covered by medical insurance. Patients can apply by calling Patient Financial Services at 603-650-5999 or toll-free at 866-272-1958. Ask for information regarding Care Credit.

The Hearing Aids Basics (DOCX) instructions provide information to help you get started in using and caring for your new hearing instruments. For more information regarding your specific device, please refer to the manufacturer's manual.