What are hearing aids, and how do they actually work?
A modern hearing aid is a small computer worn in or around your ear. It listens to the sounds around you and adjusts them for your hearing, giving more help to the pitches you struggle with while keeping loud sounds comfortable.
What is inside a hearing aid?
Despite how small they are, hearing aids bring several parts together in one device. Here is what each one does.
- 1Microphones. Pick up the sounds around you. Multiple microphones can also support directional processing, which helps the device give more emphasis to sound from particular directions.
- 2Processor. The small computer inside the hearing aid analyses incoming sound and applies the settings programmed for your hearing.
- 3Amplification. The hearing aid applies the amount of amplification needed at different pitches and sound levels.
- 4Receiver. The tiny speaker that delivers the processed sound into your ear.
- 5Battery. Powers the device. Depending on the model, this may be rechargeable or replaceable.
- 6Wireless technology. Allows compatible hearing aids to connect with phones, televisions, remote microphones and other devices.
Sound enters through the microphones, the processor adjusts it using your programmed settings, and the receiver delivers the result into your ear.
What happens when sound enters the hearing aid?
- 1 The microphones pick up the room
Speech, music and the other sounds around you enter the hearing aid.
- 2 The processor analyses the sound
It assesses characteristics such as pitch, level and the listening environment.
- 3 Your programmed settings are applied
Different parts of the sound receive different amounts of help according to your hearing needs.
- 4 Other processing is applied
Depending on the model, features such as directional microphones, noise management and feedback control may also be used.
- 5 The sound reaches your ear
The receiver delivers the processed signal into the ear.
Hearing aids do not just make everything louder
This is one of the biggest misconceptions about hearing aids. If someone hears low pitches reasonably well but struggles with higher pitches, simply turning every sound up could make low sounds uncomfortable without adequately helping the frequencies they are missing.
A properly programmed hearing aid can apply different amounts of amplification across frequencies and sound levels. Soft sounds may receive more help while louder sounds are kept within a comfortable range.
That is a fundamental difference between a fitted hearing aid and a basic sound amplifier.
What can hearing aids actually help you hear?
Hearing aids will not sound the same for everyone, but for many people they make a real difference in everyday situations.
Conversations at home
Voices can become clearer, particularly the softer consonant sounds that often fade with high-pitch hearing loss.
Television
Speech can be easier to follow without turning the volume up for everyone else. Some models can stream the TV audio directly.
Restaurants and cafés
Directional and noise-management features can favour speech and make background sound less intrusive.
Family gatherings
Two hearing aids can help you follow voices coming from different directions.
Phone calls
Compatible hearing aids can stream calls directly into both ears.
Outdoors
Awareness of everyday sounds such as birds, vehicles, indicators and people approaching can improve.
What hearing aids cannot do
Being honest about the limits matters as much as the benefits.
- They do not restore normal hearing. A hearing aid compensates for hearing loss. It does not reverse damage inside the ear.
- They cannot remove every unwanted sound. Background noise is still sound. Modern aids can manage it, but a busy room will not fall silent.
- They cannot guarantee perfect speech understanding. How clearly you understand speech also depends on the type and severity of your hearing loss.
- Adjustment takes time. Sounds you have not heard properly for years can seem very noticeable at first while your brain adjusts.
Your audiogram is the starting point
A simplified example only. Real audiograms and real fittings are more detailed.
An audiogram is the chart produced by a hearing test. It shows the quietest sounds you could hear at different pitches.
Low pitches appear toward the left and high pitches toward the right. Hearing level runs vertically. Results further down the chart mean the sound had to be louder before you could hear it.
How that becomes hearing-aid settings
Your hearing test gives the audiologist a starting point for programming the hearing aids. Frequencies where you need more help can receive more amplification, while frequencies you already hear relatively well may need much less.
- relatively good low-pitch hearing, so little help may be needed there
- moderate loss in the middle pitches, so more amplification may be used
- greater high-pitch loss, so still more help may be required within safe and useful limits
Two people can buy the exact same hearing aid and leave with very different programming, because their hearing is different.
The main hearing aid styles
Despite all the abbreviations, most hearing aids fall into two practical families: designs with a component behind the ear, and custom designs that sit entirely inside the ear.
RIC and RIE devices technically belong to the behind-the-ear family, but they are usually discussed separately because the receiver sits inside the ear canal rather than inside the case behind the ear.
Receiver-in-canal RIC / RIE
One of the most common modern designs. A small body sits behind the ear while a thin wire connects to a receiver inside the ear canal. RIC devices are popular because they can be discreet while still supporting a wide range of features and fitting options.
- small and discreet
- rechargeable options are common
- broad choice of technology and connectivity
- open fittings can feel less blocked
- receiver options can add flexibility if hearing needs change
- part of the device remains behind the ear
- the receiver is exposed to earwax and moisture
- domes and wax filters need routine maintenance
Behind-the-ear BTE
The main electronics sit behind the ear and sound travels through tubing or an earmould. BTE hearing aids are robust and can accommodate a very broad range of hearing needs.
- robust design
- useful where more amplification is required
- larger controls can be easier to handle
- custom earmould options
- generally more visible than a small RIC
- earmoulds can feel fuller in the ear
- tubing and earmoulds require maintenance
Custom in-ear hearing aids
Custom hearing aids are shaped to the wearer's ear. The main difference between ITE, ITC, CIC and IIC styles is how much of the device sits inside the ear canal.
- ITE
In-the-ear
Sits mainly in the outer ear. Usually easier to handle than very small canal devices and can accommodate more controls and hardware.
- ITC
In-the-canal
Sits partly inside the canal. A middle ground between handling and discretion.
- CIC
Completely-in-canal
Sits further inside the canal and is designed to be less visible. Smaller size may reduce room for controls, battery capacity or some wireless hardware.
- IIC
Invisible-in-canal
Fits deepest inside the canal and is designed for maximum discretion. Suitability depends on the ear canal, hearing loss and the particular product.
Smaller does not mean better. The right style depends on your hearing, ear anatomy, dexterity, comfort, connectivity needs and how discreet you want the device to be.
Which style might suit you?
| Style | Usually chosen for | Handling | Main trade-off |
|---|---|---|---|
| RIC / RIE | Discreet all-rounder | Generally easy | Receiver requires wax and moisture care |
| BTE | Robustness and power | Often easiest | More visible |
| ITE / ITC | Nothing behind the ear | Generally manageable | More visible in the ear |
| CIC / IIC | Maximum discretion | More fiddly | Fewer features on some models |
These are general differences, not fixed rules. Size, features and suitable hearing-loss range vary between individual models and fittings.
What do modern hearing aids actually do?
Manufacturers use hundreds of names for their technology, but most features are trying to solve a handful of practical problems.
Make speech easier to follow
Directional microphones, speech processing and remote microphones can help emphasise useful speech, particularly when sound comes from different directions or from a distance.
Make noise less intrusive
Noise-management systems analyse the sound environment and try to reduce distracting background sounds while preserving useful speech. They manage noise. They do not make a busy room silent.
Keep sound comfortable
Hearing aids use compression, so soft sounds can receive more help while very loud sounds are kept within a comfortable range rather than simply getting louder.
Adapt automatically
Many hearing aids can recognise when you move between quiet rooms, the car, cafés and outdoor settings, and adjust their processing to suit.
Connect with other devices
Depending on the model, hearing aids can connect to a phone, television, remote microphone or hearing loop, and some support newer standards such as Bluetooth LE Audio or Auracast.
Tinnitus support
Some hearing aids include tinnitus-management sound programs that may help some people manage the perception of tinnitus. They are not a cure.
What does an "AI hearing aid" actually mean?
In hearing aids, AI usually refers to machine-learning or neural-network systems used to analyse sound and make processing decisions. It does not mean the hearing aid understands a conversation in the way a person does.
-
Recognising environments
Identifying patterns associated with speech, noise, music, wind and other sound scenes.
-
Separating speech from competing sound
Some newer processors use trained neural networks to help distinguish speech patterns from background sound.
-
Personalising settings
Some systems can use wearer preferences or previous adjustments to help personalise operation.
-
Improving automatic decisions
AI can help determine which processing approach to use as the sound environment changes.
"AI" on its own does not tell you whether one hearing aid will be better for you. What matters is whether the technology improves the situations where you actually struggle. Read our honest guide to AI in hearing aids.
Choosing what suits you
Rechargeable or disposable?
Rechargeable
Advantages- Charge overnight, with no tiny batteries to change
- Convenient day to day for many people
- Charging cases are easy to travel with
- Needs regular access to charging
- Battery servicing may be required over time
Disposable batteries
Advantages- Swap the battery and keep going straight away
- Useful where charging is difficult
- Batteries need replacing regularly
- Small batteries can be fiddly with reduced dexterity
- Keep button batteries away from children and pets
One hearing aid or two?
If you have aidable hearing loss in both ears, two hearing aids are commonly recommended. Hearing with both ears can help with sound localisation, balanced hearing and conversations where sound comes from different directions.
But two aids are not automatically right for everyone. Some people have hearing loss in only one ear or a pattern of hearing loss that needs a different approach. The decision should follow the hearing assessment.
How much should technology level matter?
Different technology levels of the same hearing aid can look almost identical. Most of the difference is in the processing inside.
Higher levels may provide more sophisticated processing for difficult situations such as restaurants, groups, changing environments, wind and speech from different directions.
That does not mean everyone needs the highest level. Someone who spends most of their time in quiet conversations may get less value from premium noise-processing features than someone regularly navigating busy groups and restaurants.
Choose the level around the environments you actually spend time in.
Why the fitting matters as much as the hearing aid
Even an excellent hearing aid can perform poorly if it is not fitted properly.
The device is only one part of the result. Its settings need to reflect your hearing thresholds, comfortable listening levels, ear acoustics, listening environments and preferences.
The first settings are a starting point. Fine-tuning may be needed after you have worn the hearing aids in your actual life.
- 1 Hearing test
Your hearing is measured across a range of pitches.
- 2 Starting prescription
The results become the initial settings for the hearing aids.
- 3 Hearing aid programmed
The device is set up to that prescription and to your ear.
- 4 Real-world use
You wear them in your own life: home, conversations, the car and noisy rooms.
- 5 Fine-tuning
Settings are adjusted based on how they actually sound for you.
- 6 Ongoing adjustments
As your hearing or preferences change, the aids can be reprogrammed.
This is why comparing hearing aids only by brand, chip or feature count misses a large part of what determines whether you are happy with them.
What do new hearing aids sound like?
For some people the first reaction to hearing aids is not simply that everything sounds better. It can be a set of surprises:
"Why can I suddenly hear paper rustling?"
"Why are my footsteps so noticeable?"
"Why does my own voice sound different?"
If your brain has spent years receiving less sound, everyday noises can initially seem unusually noticeable when they return. Many people adapt as they wear their hearing aids, but genuinely uncomfortable sound should not simply be tolerated. It can often be adjusted.
Signs it may be worth getting your hearing tested
You may want to have your hearing checked if you regularly:
- ask people to repeat themselves
- feel that other people mumble
- turn the television up higher than others prefer
- struggle to follow conversations in restaurants or groups
- hear that someone is talking but cannot make out the words
- find phone conversations difficult
- rely more on watching faces and lip movements
- find social situations tiring because listening is hard
A hearing test is the way to find out whether hearing loss is present and what type of help may be appropriate. You can start with a quick online hearing check.
When hearing changes should be checked medically first
Some hearing problems need medical assessment before hearing aids are considered
Sudden hearing loss is an emergency. If your hearing suddenly drops, particularly in one ear, seek urgent medical care.
Also seek medical advice for hearing changes associated with:
- significant dizziness
- ear pain
- facial weakness or numbness
- a recent head injury
- a sudden change following very loud noise
- fluid, pus or blood from the ear
- persistent or significantly changed tinnitus in one ear
How much do hearing aids cost in Australia?
Hearing aid prices vary considerably according to technology level, style, manufacturer, included services, warranty and aftercare.
When comparing prices, check whether the price includes:
- professional programming
- fitting
- follow-up adjustments
- warranty
- servicing
- accessories where applicable
- a trial or return period
- loss or damage cover where offered
A low advertised device price and a fully fitted package are not always the same thing. See current TellyHear hearing aid prices.
Can hearing aids be subsidised in Australia?
Some Australians can receive subsidised hearing services and devices through the Australian Government Hearing Services Program. Eligibility depends on your circumstances.
Other possible sources of support may include the NDIS for eligible participants, private health insurance and Department of Veterans' Affairs arrangements where applicable. Medicare itself does not generally pay for hearing aids.
Eligibility rules can change, so we keep the detail on a dedicated page. See our hearing aid funding guide.
Questions worth asking before you buy
About your hearing
- What type of hearing loss do I have?
- Which situations cause me the most difficulty?
About the device and fitting
- Why does this style and technology level suit me?
- Will it work with my phone?
- Who programs it, and are follow-up adjustments included?
About the purchase
- What exactly is included in the price?
- How long is the warranty, and is there a trial or return period?
Hearing aid terms, in plain English
- Audiogram
- The chart from a hearing test, showing the quietest sounds you could hear at different pitches.
- Frequency
- The pitch of a sound, measured in hertz (Hz).
- Gain
- How much amplification the hearing aid provides.
- Receiver
- The tiny speaker that delivers sound into the ear.
- RIC / RIE
- A hearing aid with the body behind the ear and the receiver inside the ear canal.
- BTE
- A hearing aid worn behind the ear, with sound carried through tubing or an earmould.
- ITE
- A custom hearing aid that sits inside the outer ear.
- CIC
- A small custom hearing aid that sits mostly inside the ear canal.
- IIC
- A very small custom hearing aid fitted deep inside the canal.
- Directional microphones
- Microphones that let the hearing aid emphasise sound from particular directions.
- Noise reduction
- Processing that aims to make certain unwanted sounds less intrusive.
- Telecoil
- A component in some hearing aids that can pick up compatible hearing-loop systems.
- Bluetooth
- Wireless technology used to connect compatible hearing aids with phones and other devices.
- Auracast
- A newer Bluetooth broadcast system that some hearing aids can use to receive audio from supported transmitters.
- Tinnitus
- The perception of sound such as ringing or buzzing when there is no external sound.
Common questions about hearing aids
Will hearing aids restore my hearing to normal?
No. They compensate for hearing loss by giving your hearing better access to sound, but they do not reverse it.
Do hearing aids make everything louder?
No. They apply different amounts of amplification at different pitches and sound levels, based on your hearing.
Will they remove background noise?
No hearing aid removes all noise. Noise-management features can make it less intrusive while keeping speech clearer.
Do I need two hearing aids?
If both ears have aidable hearing loss, two are commonly recommended, but it is an individual clinical decision.
Are smaller hearing aids better?
Not necessarily. Smaller can be more discreet, but it may involve trade-offs in handling, battery life and features.
Can hearing aids connect to my phone?
Many can, but compatibility varies by hearing aid and phone, so check the specific model.
Can I watch TV through my hearing aids?
Often yes, using a compatible TV streaming accessory or built-in streaming, depending on the model.
Can hearing aids help tinnitus?
Some include tinnitus-management programs that may help you manage the perception of it. They are not a cure.
How long do hearing aids last?
It varies with the device, wear, moisture, servicing and whether your hearing changes. Many people replace them after several years.
Will my hearing aids need adjusting later?
Often, yes. Hearing and preferences change, and hearing aids can usually be reprogrammed.
Are expensive hearing aids always better?
No. Higher levels can help in difficult environments, but the most expensive option is not automatically the most appropriate for you.
Start with your hearing, not a brand
You do not need to know whether you want Phonak, Oticon, Signia or anything else. The useful starting point is understanding your hearing and the situations where you are struggling.
If you already have an audiogram, send it through and we can help explain what it means and narrow down the styles and technology that make sense for you.
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