New to hearing aids and looking for advice

I had a hearing test five years ago and one about a month ago. Hearing loss is mild to moderate. The audiologist in my ENT’s office is who we met with. Charging $4800 for top line Starkey, 4 year warranty, services for life of the aid. I have more questions to ask and just reading posts on the forum have been helpful. Also going to Costco next week for hearing test and see what they have to say and pricing. As a first time HA user, am I better to go with an audiologist or to Costco?

Your post sounds like my wife’s experience. She started with expensive Starkey aids and ended up with Costco KS9 aids. She is very happy and saved a bunch of money.

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Welcome. My bias is Costco. Doesn’t sound like you have anything tricky about your loss, but it’s not posted so can’t really say. Costco will for sure be cheaper ($1500-$3000 per pair) and if you purchase with a Costco credit card will come with a total of a 5 year warranty. You’d have 180 days to make up your mind if you wanted to return. If you were really wowed by the audiologist and the money isn’t an issue, that’s an ok way to go, but without knowing more I’d whole heartedly recommend Costco.

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Money is always an issue! No insurance coverage. I also have ringing in my ears and that has been longer than the five years. Thank you for your thoughts.

Consumer Reports rated Costco as the best hearing aid retailer based on a survey of about 16,000 subscribers. I would ask to try the Kirkland Signature KS9 aid that sells at $1500 a pair. It is a premium level hearing aid essentially equivalent to the M90 Marvel but with a 312 battery, no tinnitus masking, and no telcoil. There is no charge for the initial exam or unlimited number of follow up visits. Off the shelf fittings are included in the price.

It would be helpful if you filled in your most recent audiogram data. See the “My Audiogram” link at the top of the page on the right. It lets others here know what you are dealing with for a loss.

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Many of us with hearing loss have the ringing in the ears or tinnitus effect. What you are most likely to find is that with hearing aids the background noise will be increased due to recovery of the sounds you are not hearing, and the tinnitus effect is essentially masked.

I did just complete the audiogram - thank you - I didn’t even see that at the top of the page.

That is a fairly modest loss. You should do well with the KS9 and open fittings with little risk of feedback issues. I would ask to try both the NAL-NL2 and DSL v5 prescription formulas. The DSL v5 would likely give you better recovery of the high frequencies. The simulated insertion gain is shown below.

Here is what the NAL-NL2 prescription curves look like. They are very different and it will probably sound very different to you. Which one is better really can only be determined by you and your ears. The main difference between the two methods is that NAL-NL2 uses more compression. Compression is when loud sounds are NOT amplified as much as soft sounds. The curves in this graph show the amplification for all three levels. The loud amplification is the light colour curve at the bottom, the normal is the heavier curve in the middle, and the soft sounds is the lighter curve at the top. In comparison the DSL v5 curves are all pretty much in the same place which means soft, medium, and loud sounds are almost equally amplified.

One of my personal theories about hearing aids is that users, especially new ones, put too much emphasis on the brand, model, and the bells and whistles count, and overlook the impact of the prescription formula. My view is that the prescription formula has much more of an impact on the “sound” of the hearing aid.

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Thank you. I think I will have to read a few times to fully understand and also look up what this all means. I’m sorry, but I am REALLY new to all of this. I personally don’t care about the bells & whistles myself but would just like to hear as normally as I can. Being able to hear people clearly at home, at the office and make out what people close to me are saying in a conversation when out in a louder environment is what I am after. Not having to crank up the tv as well. I can hear fine on the phone.

So within the hearing aids, there are different prescriptions?

Yes, most manufacturers will have a proprietary prescription formula which they claim is optimized to their particular hearing aid. It may have a couple of levels, like new user or experienced. In addition there are industry standard prescriptions offered like NAL-NL2, DSL v5, NAL-NL1 (which older and mainly replaced with the NL2), and often one called 1/3 gain. The 1/3 gain one is the most basic and has no compression. It, as it suggests just adds back in 1/3 of the loss you have at each frequency. This would be the oldest method, but some like it.

One advantage of the industry standard ones is that the next step after using the computer to set the prescription formula, they (at least Costco does) measure the actual sound level in your ear canal to verify that it is at the target set by the prescription formula. Then it is adjusted to achieve what it should be. This is called a real ear measurement or REM. At least in Canada at Costco they can do REM to the industry standards, but not to the manufacturer proprietary one. So there is some advantage in the fitting process to use one of the industry standards.

From what I understand, Costcos here use REM as well but will find out. When I go there for the hearing test, will they then recommend aids at that point?

Yes, everyone here reports that Costco consistently uses REM both in Canada and the US. The normal process is to do the full hearing evaluation at the first appointment. They will discuss options with you for aids, but I can tell you now that their KS9 (Phonak Marvel) aids are the best buy from what they have. They do not operate on commission, so should not be pushy at all with aids. Some people that go to get tested are trying to find validation that they don’t need aids. Sounds like you are convinced you need aids and are willing. If you decide on the KS9 (or other brand) they order them and they are fitted with the REM on your next visit when the aids are received.

Most new hearing aids including the KS9 have multiple programs that can be set for different situations. On the first fitting I would ask to have two programs used to test the different between NAL-NL2 and DSL v5. And to have one program set for each, and the REM done independently for each of these two programs. You can easily switch between the programs and see which one works best for you in all the different situations you have. Then make your next appointment for adjustments. At that appointment you can tell them which prescription you prefer and if there is any fine tuning you want them to do.

The one issue with Costco is that the wait time for a prescription can be long, so it is a good idea to always make the next appointment, and then if everything is good and you don’t need it then you can cancel.

I definitely don’t think I will get a hearing test that tells me otherwise but a free 2nd test certainly doesn’t hurt. In reading both on this forum and other reviews of Costco, time seems to be an issue and good to hear I can make that next appointment ahead of time. Thank you again for all the information.

And I don’t know that I am convinced that I need them but am curious to see how I hear with them. I know I do not have severe loss by any means.

I think you are in the happy zone for loss. You should hear a distinct improvement with minimal adverse effects.

Since you’ve been reading a lot on this forum, hopefully you are well aware of the adjustment period. Everything is going to sound too loud to you for at least a couple of weeks.

Here is your right ear loss on a speech banana chart. You are most likely missing the speech sounds of letters that are above the ear loss curve.

Your biggest deficit is in and around the 2k range , a very important frequency range for understanding speech. Aids should make a very noticeable improvement for you

Thank you. Where would I go to do those same charts or that type of information?

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