Hearing Loss FAQ
Get answers to common questions about hearing loss
Understanding hearing loss
How can I tell if I have a hearing loss?
Some warning signs include:
- Asking people to repeat themselves
- Missing large parts of conversations when there is a lot of background noise
- Difficulty hearing on the telephone
- Finding it hard to understand dialogue at the movies or the theater
- Complaining that people around you are mumbling when they speak
- Inability to hear common sounds like doorbells or alarm clocks
If you think you have a hearing loss, get your hearing tested. Online hearing screenings can be an easy first step. Learn more.
What causes hearing loss?
Many factors can contribute to or cause hearing loss. Age, genetics, and damage to the ear are among the most common causes of hearing loss. Chronic exposure to loud noises, like listening to loud music, can lead to damage inside your ear, while exposure to explosive noises, such as firearms, can cause immediate and permanent hearing loss. Certain ototoxic medications can result in hearing loss, ringing in the ear, or balance disorders. Other factors, such as excessive earwax or fluid, can temporarily reduce how well your ears conduct sounds.
This Healthy Hearing article provides in depth information about hearing loss symptoms, causes, treatment and prevention.
What type of hearing loss do I have? Is it treatable?
Only a hearing health professional can diagnose you, so a medical assessment is a good idea. Treatment is available for many types and degrees of hearing loss.
Sensorineural is most common type of hearing loss caused by inner ear damage or disruptions from the nerves in your inner ear to your brain. Hearing aids and other hearing enhancement devices generally help with this type of hearing loss. American Speech Language Hearing Association, ASHA
Conductive hearing loss happens when sounds cannot make it through your outer and middle ear. Medicine and surgery can often help. ASHA
Mixed hearing loss is a combination of sensorineural and conductive hearing loss. Addressing the conductive component—say, treating an ear infection—is usually the first recommended treatment.
Auditory Processing Disorder (APD) can have symptoms similar to hearing loss, but is a condition where the brain doesn’t properly translate sounds. People with APD often “hear” sounds differently. While it’s often associated with childhood, APD affects people of all ages. There is no cure, but treatment and specific strategies are available. Healthyhearing.com
Presbycusis refers to slow, age-related hearing loss, usually in both ears. The loss can happen so gradually, you might not notice it. Presbycusis can be caused by changes in your ears or the nerve pathways to your brain, or both. Cedars Sinai
Late-deafened refers to folks who learned speech first before losing most or all of their hearing later in life either suddenly or gradually. Sometimes technologies can help. Late deafened adults are more likely to use captions rather than ASL. In addition to HLAA-WA, you may find useful resources at ALDA.org, the Association of Late Deafened Adults.
I have a ringing, whooshing sound in my ears — do I have tinnitus? Is this a type of hearing loss?
If you hear ringing, buzzing, clicking, roaring or other noises that others don’t hear, you may have tinnitus.
Tinnitus is different from hearing loss, but hearing loss often comes with it. As many as 20% of people experience tinnitus, and it is especially common in older adults. The condition can come and go, or remain persistent and ranges from annoying to debilitating and even disabling. Tinnitus is usually caused by an underlying condition, such as exposure to loud noises like concerts or gunshots, an ear injury, or a problem with the circulatory system. For many people, tinnitus improves with treatment of the underlying cause or with other treatments that reduce or mask the noise, making tinnitus less noticeable.
The Mayo Clinic is a good source of tinnitus information, and Web MD talks about tinnitus treatment. For tinnitus coping strategies, watch Dr. Neil Bauman at a recent HLAA-Whatcom County meeting.
Working with a hearing health professional
What’s the difference between an audiologist and a hearing aid specialist?
Audiologists and hearing aid specialists are hearing health professionals and both are licensed to sell hearing aids in Washington State. Both are trained to test hearing and fit and adjust hearing aids.
Audiologists have a master’s or doctoral degree in audiology. They are certified by the American Speech Language Hearing Association (ASHA). They are trained to interpret test results from a medical perspective and to use advanced testing to determine the need for further medical treatment.
Hearing aid specialists are trained to recognize problems that require referral to an audiologist or medical doctor. They are are licensed by their state and can service hearing aids. In order to be certified, they must attend continuing education courses and successfully pass a national examination.
How do I find a good hearing health professional?
There are many factors that should determine who you choose to be your hearing health professional. This is an important relationship and can mean the difference between simply living with or thriving with hearing loss. We encourage people to ask friends or HLAA-WA members for personal recommendations. It is a good idea to be prepared with questions that can help determine if a potential hearing health professional is a good fit.
For more information
- Check out our Working with hearing health professional page for more information.
- Read How to Find a Good Audiologist on Hearing Tracker
- Visit the Washington State Academy of Audiology to search for a local audiologist.
- Healthy Hearing provides information on Washington State hearing aid specialists and audiologists. You can search by city.
- The American Speech Language Hearing Association (ASHA), the certifying body for audiologists, can also provide certified audiologists in your area.
What should I look for in an hearing health professional?
It is extremely important that your relationship with your hearing health provider works for you. It is OK to interview potential providers so that you find the one who meets your needs.
We recommend finding someone who:
- asks questions about your lifestyle and needs and is an active listener
- you can talk with openly and honestly
- has a patient-centric approach to care — meaning that your specific needs drive care decisions and outcomes
- is open to family member coming to appointments — this is usually a good sign that they are open to listening and collaborating
- carries multiple brands of hearing devices
Because your device will need to be adjusted, and your hearing should be regularly checked, try to find a provider who is close to your home or office and with available appointment times.
Check out our Working with a hearing loss professional page for more insights.
Talking about hearing loss
How do I tell people that I have a hearing loss?
How you acknowledge your hearing loss is up to you; the most important thing is to develop language that you are comfortable with and will use. Some people say, “I am hard of hearing,” while others say, “I have a hearing loss,” or “I’m partially deaf.” You can also simply say, “I’m having difficulty hearing you, let’s move a more quite place,” or “If you look at me when you are talking, I can better understand what you are saying.”
However you describe your hearing loss, it’s OK to talk about it. In fact, it’s helpful. The more you practice, the easier it becomes. You also help normalize hearing loss for others.
Download this helpful guide: Hearing Loss Conversation Kit
How can my family and friends help me deal with my hearing loss?
Great question! The first step is to be open about your hearing loss and, if you are comfortable, share the feelings surrounding your diagnosis. You may be surprised that your family and friends are not at all surprised by the diagnosis. The people we speak with often are usually aware of the increased difficulty we have hearing.
The good news is that there are many techniques that hearing people can practice to improve communications and help you hear better. We suggest sharing our Help for Family and Friends page with your loved ones. You can also share the communication tips on that page with anyone and everyone that you communicate with, be it colleagues, a lawyer, your mechanic, teachers, your doctor or pharmacist – anyone you want to make sure you understand.
I’ve been offered a sign language interpreter as an accommodation. This isn’t helpful — what do I do?
We strongly encourage you to say that you have a hearing loss, that ASL will not be helpful, and that you need captions and/or an assistive listening system, like a hearing loop, and whatever else you need. You can use the American With Disabilities Act (ADA) to remind a venue they need to provide communication access. Get more information on how to ask for hearing help.
At HLAA-WA, we try to help people understand the differences between the needs of hard-of-hearing people and the needs of people who are Deaf. These two communities are different, though they both support accessibility and disability rights. People with hearing loss generally don’t use sign language, and instead, they rely on residual hearing and technologies to hear.
Hearing aids and components
Which hearing aids are the best?
As with many things, it depends.
An audiologist will recommend one or more models based on your type of hearing loss, the severity, your lifestyle and work, and cost. There is no simple way in advance to tell which hearing aid is best for a person — what might be appropriate for one person may not be appropriate for another. This is why some hearing aids that are sold through mail order catalogs or on-line may be ineffective or even harmful.
Unfortunately, many people look for the cheapest option. When price is the main deciding factor, sometimes people choose an option that isn’t effective, and the hearing aid often ends up in a drawer unused. Get fitted properly and don’t let price be your sole consideration. Get in touch with one of our members who can share with you their experience of getting hearing aids, read others’ experiences with hearing aids, and join us for a HOPE meeting.
If you hearing loss is mild, you can also consider an over-the-counter hearing aid. These new OTCs are often cheaper than prescription hearing aids. You can read more about OTCs on HLAA’s website.
What is a telecoil, and why do I want it in my hearing instrument?
The term hearing instrument refers to hearing aids, cochlear implants, and bone conduction devices.
A telecoil, also known as a t-coil, is an important connectivity component to have in your hearing instrument; it can improve sound quality in specific situations. Telecoils connect your hearing instrument to telephones, devices like personal amplifiers, and to assistive listening systems (ALS) like hearing loops. When coupled with an ALS, telecoils in decrease background noise and increase clarity.
Telecoils are available in many hearing aids and are built into most cochlear implants and bone conduction devices. Telecoils are also available in some personal amplifiers, earbuds, and headphones.
Be sure to ask your hearing health provider about telecoils and ensure that they program the telecoil and show you how to use it.
What are cochlear implants and bone conduction devices?
A cochlear implant is an electronic device designed to bypass the external and middle ear and excite the auditory nerve directly. It is implanted in the inner ear or cochlea. By stimulating auditory nerve fibers, patterns of nerve activity occur which the brain interprets as sound. Cochlear implants are the hearing solution for people with severe to profound hearing loss in.
Cochlear implant FAQLearn more
American Cochlear Implant Alliance (acialliance.org)
Bone conduction devices gently vibrate the bone behind the ear to send sound directly to the cochlea. Bone conduction devices are different than a cochlear implant. This is because the inner ear moves the bone conduction vibrations the same way a healthy ear moves sound waves. These devices work best for people who have one inner ear that functions normally, and conductive or complete hearing loss in the other ear.
Insurance and returns
Are hearing aids covered by insurance?
Despite hearing loss being one of the most common medical problems in the general population, most insurance carriers do not cover hearing aids.
Unfortunately, Medicare does not currently cover hearing aids. Medicare does pay for cochlear implants if the recipient meets certain requirements. Most Medicare Advantage plans — offered by private insurers and known as Medicare Part C — include some coverage of hearing aids. HLAA is actively working with Congress to pass legislation that will include hearing health and aids under Medicare.
Beginning January 1, 2024, hearing aids will be covered by most private insurance plans in Washington State.
In 2023, HLAA-WA and other hearing advocates championed the passage of Senate Bill 5338 and House Bill 1222, which expand hearing aid coverage to many more children and adults in our state. Senate Bill 5338 requires some group health plans and all school and state employee health plans to cover hearing care and hearing aids at no less than $3,000 per ear every 36 months.
Ask your insurance company, employer, or audiologist about your hearing aid coverage.
Children and adults on Washington State Medicaid receive hearing health care, including single and bilateral hearing aids. Cochlear implants and bone-anchored hearing aids are covered for people age 20 and under. Some exclusions or limitations may apply. In 2018, HLAA-WA led the advocacy effort to restore hearing aid coverage for adults on state Medicaid. Dozens of senior and disability advocacy groups joined us and share in the victory.
My hearing aid was super expensive, but it doesn’t really work right. What do I do?
Getting hearing aids is not like getting glasses; your hearing is not perfectly restored the moment you put them on. It helps to have the right expectations. Getting hearing aids to perform optimally can take time and device adjustments by your audiologist. It is not unusual for hearing aids to initially hurt, fall out, squeal, or not help you in situations where you really need them.
Whatever the reason for your frustration, please don’t keep your hearing aids in a drawer instead of your ears. Instead, we encourage you to…
- Wear your hearing aids a few hours a day and keep a journal that lists the problems you are having
- Follow up with your audiologist and explain your concerns
- Ask your Audiologist to do a Real Ear Measure. Learn more in this article or watch this video)
- Visit our Hearing Aids 101 page for troubleshooting
- Join a HOPE support group virtual meeting and ask questions
- Ask us for a hearing loss mentor who can help you one on one
Sometimes the solution is as simple as a new ear mold, an adjustment, coaching and training, telecoil activation or programming. Remember, too, that your hearing may change over time, and new technology comes into the market every year that might work better for you. In other words, don’t give up!
You might find this article interesting : What to Expect When You Get Your Hearing Aids.
Can I return my hearing aids?
In Washington State, you have 30 days from purchase to return your hearing aids for reasonable cause, provided you meet the provisions of Washington State law and your hearing aids are in their original condition. Ask your hearing health care provider about their return policy, which may give you additional protection. It is important to try the hearing devices in different environments within your return window to make sure that they are helping you hear in different situations.
- Download this consumer rights brochure from the Washington State Board of Hearing and Speech
- If you have a complaint about your hearing health provider and/or feel that they are not complying with your legal right to return your hearing aids, use the Washington State Department of Health complaint process.
Other hearing issues
Where can I get information on acoustic neuromas?
An acoustic neuroma is a growth – a benign tumor – on the auditory nerve. As it grows larger, it impinges on the nerve conduction and hearing is lost permanently. Some tumors grow very slowly and others grow rapidly. Learn more from the Acoustic Neuroma Association (ANA)or contact the Seattle Acoustic Neuroma Group.
ANAUSA offers a free patient kit along with a complimentary temporary membership. The kit includes information about support groups, a peer mentor program, patient booklets and more.
What is Ménière disease?
Ménière disease is a disorder of the inner ear that causes episodes of vertigo, tinnitus, a feeling of fullness or pressure in the ear, and fluctuating hearing loss. A typical attack of Ménière disease may be preceded by fullness or aching in one or both ears. Hearing fluctuation or tinnitus (ringing or sounds in the ears) may also precede an attack. A Meniere’s episode generally involves severe vertigo (spinning), imbalance, nausea, and vomiting. The average attack lasts two to four hours. After a severe attack, most people find that they are extremely exhausted and must sleep for several hours.
The cause of Ménière disease is unknown; but possible contributors are stress, excessive salt intake, and occasionally, endocrine problems, such as low thyroid function, abnormal sugar metabolism, or an inability to handle fats, high cholesterol and/or triglycerides.
- Learn more about this condition from University of Washington Medicine.
- Robert Hall and Laura Cohen of the HLAA-California Peninsula Chapter lead an online support group for people with Ménière’s. The leaders, who also have Ménière’s, focus on managing symptoms and finding ways to not let it take over your life. For more information, including how to join the Zoom support meetings, email firstname.lastname@example.org.
How does exposure to noise affect hearing? When should I protect my ears?
Exposure to noise is damaging to hearing. The longer you are exposed, and the closer you are to the source of loud noise, the more damaging it is. Avoiding noisy situations is the best prevention. If you can’t avoid the noise, use adequate hearing protection.
Any exposure to noise above 105 decibels (dB) can have an immediate damaging effect. There is no way to restore life to dead nerve endings; the damage is permanent. Bring hearing protection devices like earplugs, earmuffs, and/or headphones with you. Keep them in your car, pockets, or other easy to access place.
Maximum exposure before damage occurs:
8 hours @ 90dB
4 hours @95dB
2 hours @100dB
1 hour @105dB
Loud noises and corresponding decibel (dB) rates
- Shotgun blast 140
- Jet Takeoff 130
- Rock concerts 120
- Electric blender 90
- Baby screaming 80
- Vacuum cleaner 75
- Normal conversation 60
- Quiet library 50
- Whisper 30
Why do my ears plug up when I am on an airplane?
The middle ear is an air pocket that is vulnerable to changes in air pressure. Normally, each time you swallow, a small bubble of air enters your middle ear through the Eustachian tube. This process keeps air pressure on both sides of the ear drum about equal. If, and when, the air pressure is not equal, the ear feels blocked.
Altitude changes require the Eustachian tube to open frequently and widely enough to equalize the changes in pressure. If you chew gum or let mints melt in your mouth, you will swallow more often, thus activating the muscle. Yawning is an even stronger activator of that muscle. During air travel avoid sleeping during descent, because you may not be swallowing often enough to keep up with the pressure changes.
Children are especially vulnerable because their Eustachian tubes are narrower than adults. Babies cannot intentionally equalize or pop their ears, but may do so if they are sucking on a bottle or pacifier. Feed your baby, keep him/her in a sitting position, and do not allow him/her to sleep during descent when the pressure changes are the worst.
Colds, sinus infections, and allergy attacks exaggerate air pressure problems, so it is best to postpone an airplane trip. Also, if you have recently undergone ear surgery, consult your surgeon on how soon you may safely fly.
Let us know
Based on your experiences, what other questions and answers would be helpful to others on their hearing loss journey? It’s fine to just send the question, even if you don’t have the answer. Please email us at email@example.com. Thank you!
You can find much more information on these HLAA-WA pages below.
Hearing Aids 101
There are many hearing aid models and even more features — understanding your options and potential trade-offs will help you get the right device for your needs
Working with an Audiologist
Having a patient-centric hearing health provider, is essential to living well with hearing loss — this is a partnership that can last your entire hearing loss journey.
Help for Buying Hearing Aids
Several Washington State and national organizations provide free or lower-cost hearing hearing aids and cochlear implants for people with qualifying incomes