Behind-the-ear hearing aids

The different types of hearing aids

Each style of hearing aid has its own pros and cons. Two important factors to consider when shopping for a hearing aid are your lifestyle and the degree of hearing loss you are experiencing. These factors, along with recommendations from your audiologist, will help you narrow down which style best suits your needs.

Behind-the-ear hearing aids

As mentioned, BTE hearing aids are the most common hearing aids. These devices traditionally have three parts. The electronic portion is worn behind the user’s ear, giving it its name. Designed as a plastic case, it contains the microphone, speaker, and battery for the device. There’s also an earmold piece, worn inside the ear and connected by a small plastic tube or wire. The custom earmold or dome holds the hearing aid inside the ear and directs sound waves into the ear canal.

In-the-ear hearing aids

In-the-ear or ITE hearing aids fit in the outer portion of the ear. This design can be made in either a full or half-shell style molded to fit the unique shape of the user’s ear. Full-shell models fit in the entire area of the external ear and are therefore larger than half-shells, which fit inside half of the external ear area. Some ITE hearing aids are large enough to include controls on the device, which is not the case for most smaller in-ear hearing aids.

In-the-canal hearing aids

ITC hearing aids are worn inside the user’s ear canal, with a smaller portion resting in the outer ear. This style is the second largest in-ear style of hearing aids, just behind ITE styles. Larger styles tend to allow for larger batteries, which provide the device with longer battery life. Some ITC hearing aids have manual volume controls which do not fit on smaller devices.

Completely-in-the-canal hearing aids

CIC hearing aids were once the smallest hearing aid style on the market, but have since been replaced by the invisible-in-the-canal model. However, CICs are still extremely discreet, with only a translucent removal handle protruding from the user’s inner ear. In some devices, the faceplate may be visible; however, these are often designed to match the user’s skin tone for maximum subtlety. Most CICs automatically adjust to the user’s environment and eliminate background noise, leaving little room or need for manual controls and buttons.

Invisible-in-the-canal hearing aids

IIC hearing aids are the smallest devices on the market today. These hearing aids fit entirely inside the user’s ear canal and are molded to have a snug, secure fit. Some audiologist offices that sell this model take a 3-D scan of the ear canal and send the data to the hearing aid manufacturer for production, while others take physical molds of the ear with impression material. Because of their extremely small size, IICs do not have many additional features that other hearing aids offer, such as Bluetooth capability and manual adjustment buttons.

The benefits of behind-the-ear hearing aids

There’s a reason BTE hearing aids tend to be a popular choice for people with hearing loss. These are just a few of the reasons people gravitate to this style.

• Equipped with the latest technology. Because BTE styles are larger than other hearing aids, they have room to contain the very latest technology and features. Many brands have telecoils and directional microphones, along with volume and setting controls. These features can be programmed by an audiologist, or, in some cases, at home by the user themselves. Most BTEs can even be connected to the user’s mobile phone via Bluetooth.
• Powered by long-lasting batteries. Larger batteries, like the ones used in BTE hearing aids, have more power and need to be changed less often. This is a huge benefit for people with dexterity issues who may struggle to change a small button battery once every few days. Newer BTE styles have rechargeable battery options are also available.
• Designed for maximum comfort. All hearing aids take some time to get used to, but many users say BTE styles are among the most comfortable to wear. This could be because the portion worn inside the ear tends to be very compact, since the bulk of the device is worn behind the ear. Even the larger portion is becoming smaller and more comfortable with technology and design advances.
• Suited for a wide range of hearing loss. BTE styles are a great choice for so many people since they can accommodate nearly any degree of hearing loss from mild to severe. They also tend to be a great option for children, whose ears are still growing and changing and therefore do not benefit from custom in-the-ear designs.

The cons of behind-the-ear hearing aids

Even with so many positive features, BTE style hearing aids are not for everyone. Consider some of the drawbacks to this particular style.

• May pick up background noise. Some users of BTE aids complain that their devices pick up on environmental and wind noise, particularly when they are outdoors in an open area. This is because the device’s microphones sit outside the ear. This can be challenging for users who work or spend a lot of time outdoors.
• Not as discreet. With the bulk of this device worn outside the ear, it is perhaps the most obvious style of hearing aid. If discretion is a key factor in your hearing aid decision, perhaps BTE is not the best choice. However, this style has been getting progressively smaller, and many brands offer a variety of skin-tone colors.
• Difficult to wear with glasses. People who wear glasses may find a BTE style to feel a bit crowding. And while it’s not impossible to wear both, people in this boat may opt for thin wire glasses frames, or a mini BTE model rather than the full version. This smaller style has thinner tubing than a traditional BTE device.
• Bulky to talk on the phone. This con is becoming less and less relevant since many BTE styles are beginning to have Bluetooth capabilities. However, if you still rely on a landline or traditional telephone to make phone calls, it may feel awkward to do so while wearing a BTE hearing aid.

How to buy a behind-the-ear hearing aid

BTE hearing aids can be purchased at certain retailers over the counter or with a prescription through an audiologist. Which route you choose to go through will impact which brands and features are available to you. Those with a long, complicated history of hearing loss may find it best to talk with a professional and get the most hands-on care. People with mild levels of hearing loss seeking extra amplification may want to try a relatively affordable OTC option.

How to buy over-the-counter behind-the-ear hearing aids

With new regulations surrounding hearing aids recently put into place by the FDA, over-the-counter options are more accessible and affordable. This allows more people to purchase hearing aids without a prescription or a doctor’s appointment. BTE style hearing aids are the most common over-the-counter devices because they require little customization and tend to have powerful amplification features.

These are some of our favorite behind-the-ear over-the-counter brands:

• The Lucid Engage and Engage Rechargeable – Lucid Engage and Engage Rechargeable can be purchased from the manufacturer’s website, on Amazon or at Best Buy.
• Jabra Enhance Select – Both the Jabra Enhance Select 100 and 200 can be purchased from the manufacturer’s website, and select Costco locations.
• Sontro – Sontro OTC hearing aids can be purchased online from Soundwave Hearing and on Amazon.
• Lexie – The Lexie B1 and B2 can be purchased from the manufacturer’s website, Best Buy, CVS, and Walmart. The Lexie Lumen can be purchased from the manufacturer’s website, Amazon, and Best Buy.

How to buy prescription behind-the-ear hearing aids

By purchasing new hearing aids through an audiologist, patients will receive more personalized care. These hearing health professionals are trained to assess your unique level of hearing loss and recommend a style and brand that will meet your needs.

1. Talk to your healthcare provider. In most cases, the first step in a patient’s journey is to talk to their general practitioner about their hearing loss. Your doctor can provide helpful information and then refer you to an audiologist for an in-depth assessment if needed.
2. Consult with an audiologist. At this appointment, your audiologist will ask about your hearing history and health. Based on these answers, they will perform a diagnostic hearing evaluation which allows them to assess your degree and type of hearing loss. These tests will provide the audiologist with the necessary information to make a diagnosis and create a treatment plan.
3. Decide on a hearing aid style. In most cases, patients work with their audiologist to choose the best hearing aid style and model. Audiologists are well-versed in the benefits and drawbacks of different hearing aids and can guide users according to their needs and lifestyle habits. Depending on the style of hearing aid you choose, your audiologist may be able to custom-design the device to fit your ear. This involves taking ear molds and sending them off to the manufacturer.
4. Attend your fitting or follow-up appointment. Once your hearing aid arrives, your audiologist will schedule a visit to have it fitted and adjusted. At this appointment, your audiologist can answer any questions you may have about your new hearing aid. They will also set up any programs and adjust the volume to fit your needs. It is also best practice for your audiologist to perform verification on your hearing aids to ensure they are functioning properly and are programmed appropriately.

These are some of our favorite behind-the-ear prescription hearing aids:

• Starkey Genesis AI
• Widex Moment
• Signia Styletto AX
• ReSound Omnia

For even more options, be sure to explore our 12 best hearing aids of 2023.

Hearing aids and insurance coverage

Many medical health insurance plans do not cover hearing health-related costs, including the cost of hearing aids. Some plans come with add-on coverage for hearing, vision, and dental. Always check with your health insurance provider to find out the specifics of your plan. Medicare does cover the costs of diagnostic testing, but not the cost of hearing aids or follow-up appointments.

The manufacturer provides warranties on your new hearing aids. The warranty length is usually determined by the hearing aid model, but could also depend on the clinic you go to. In some cases, you may have the option to extend your warranty. The warranty often covers the costs of any repairs that may be needed, whether they are done by your audiologist or by the manufacturer. Sometimes, loss coverage is included in your warranty, but you might be on the hook for a deductible. Always go over your warranty coverage with your audiologist when purchasing new hearing aids so you know what steps to take if your devices become lost or damaged. Your audiologist should provide you with a written contract outlining the terms of your warranty.

What next?

Do you think a behind-the-ear hearing aid is a good choice for you? If you’re already a patient at a hearing center, call your audiologist to schedule a visit and go over your options. Otherwise, consider purchasing an over-the-counter option and use it for a trial period. Many manufacturers have a return period that lasts anywhere between 30 to 90 days after purchase. This gives you time to wear your ear hearing aids in everyday situations and see if they are the best choice for you.