Frequently Asked Questions
When you or a loved one experiences a hearing problem, it can seriously affect your ability to communicate and cause stress in your relationship. As a potential consumer of hearing health care services, the Maryland Academy of Audiology would like to help you make informed choices. The following Frequently Asked Questions (FAQs) are the ones most asked by people with hearing loss. The Links section also contains several consumer-based hearing health-care web sites.
Audiologists are the only professionals who are university trained and licensed to identify, evaluate, diagnose, and treat audiologic disorders of hearing. Audiologists may practice in Private Audiology Offices, Hospitals, Medical Practices, Universities, Public Schools, Private and Public Agencies.
All individuals with suspected hearing loss require audiological evaluation to determine the type, degree, and cause of the hearing impairment. Insurance companies and managed care organizations are realizing that efficient cost-effective hearing health care requires that primary care physicians refer patients directly to audiologists to determine whether rehabilitation or medical/surgical treatment is indicated. Insurance companies recognize that only 20% of all individuals with hearing loss require medical or surgical treatment for their hearing loss. Rehabilitation treatment consists primarily of design, selection and fitting of hearing aids and/or assistive listening devices. These services are provided directly by audiologists.
Services provided by audiologists include:
Audiologists hold a master’s, research doctoral (Ph.D.) or clinical doctoral (Au.D.) degree from an accredited university with special training in the prevention, identification, assessment, and rehabilitation of persons with hearing impairments. In Maryland, audiologists are licensed to practice audiology by the Maryland Board of Examiners. Audiologists are required to complete a full-time professional experience year and pass a demanding national comprehensive examination following completion of their master’s or doctoral program. Additionally, they are required to obtain 10 continuing education hours per year to maintain their license. By virtue of their graduate education, professional certification, and licensure, audiologists are the most qualified professionals to perform hearing tests, dispense hearing aids and assistive listening devices, provide rehabilitation services and refer patients for medical treatment.
The only precise way to determine if you have a hearing loss is to have your hearing evaluated. There are a series of simple questions you can ask yourself to confirm you are having hearing difficulties: Do you often ask people to repeat what they have said? Do you need to turn the television or radio louder than others around you? Do you have trouble hearing on the telephone? Do people seem to mumble? Do you have difficulty listening to conversation when in a restaurant or noisy listening environment? If you answer yes to one or more of these questions it may be time to have your hearing tested. Please use our Find An Audiologist section to locate a licensed audiologist in your area.
How often you get your hearing tested is variable from person to person. These are the Center for Disease Control and Prevention (CDC) guidelines for infants and babies/children:
For older children, many have hearing screenings in school and if they pass, especially in the early grades, the testing may stop once normal hearing has been established. Routine testing of older children is no recommended unless they have risk factors like chronic ear infections or are taking medications that can cause hearing loss.
For teens and young adults, having a hearing test when there is suspicion of a loss is appropriate and the Audiologist will let them and their family know if further or ongoing testing is needed.
For middle-aged and older adults, a baseline hearing screening at 40 and then again at 50 years of age is a good strategy to identify any early hearing loss. Of course, any sign of hearing deficit should be evaluated. After 50 years of age, every few years is a good plan to keep a check on hearing and then annually after 60 years of age as the incidence of hearing and balance problems start to increase significantly.
No. Hearing aids simply bring the level of loudness within a comfortable range for you. In fact, research has found that hearing aids may help preserve the ability to understand speech because they allow the sensory cells in the inner ear to stay active.
There are two ways of reducing background noise with current technology. One way is through the use of directional/dual microphone technology. These instruments often allow the patient to “turn off” the back microphone when background noise is interfering with speech. Many of the products available also offer the ability for the hearing aid to automatically select the best program for each listening environment. This way the patient doesn’t have to do anything!
The second way to improve communication in the presence of background noise is through the use of 100% digital hearing aids. The FDA has developed very stringent guidelines regarding hearing instruments that are advertised as reducing background noise. In order for a hearing aid to be advertised as reducing background noise it has to have been clinically tested and receive FDA approval. Please be aware that there are no hearing instruments available that remove all background noise. The newest hearing aid technology contains 100% digital sound processing which measures and reduces "noise-like" sound with a series of mathematical computations. If you tried hearing aids and could not adapt due to the overwhelming amplification of background noise, you will find digital hearing aids and directional/dual microphone technology a major improvement.
Most people will do best with hearing aids when they wear them during all waking hours as our ears are always “hearing”. Wearing the hearing aids helps the brain to better process sound and just like moving our muscles regularly keeps them strong and vital, keeping good sound coming into the brain helps hearing.
The life span of a hearing aid depends on many factors. In general, hearing instruments have an average life of four to six years. Care of the hearing instrument is an important factor. If hearing aids are protected from ear wax and moisture damage, they may last longer than the above estimates.
Hearing aids are fragile instruments that need daily maintenance. The majority of hearing aid problems are caused by ear wax and moisture. Hearing aids can be repaired either at your audiologist’s office or by the manufacturer. In order to insure proper operation of your hearing instrument it may be necessary for you to return to your audiologist several times per year. These visits may include cleaning and checking your hearing instrument, as well as annual hearing tests to insure the hearing aid is set appropriately for you.
Manufacturers offer warranties of generally one year to three years on new instruments, and typically six months to one year on repaired hearing aids. Many offices offer extended warranties on their new and/or repaired instruments. Talk with your audiologist about warranty options.
If you have a hearing loss in both ears the answer is yes. When sound enters both ears, it becomes louder than if you only listened out of one ear. The ability to locate where sounds are coming from is improved when both ears have amplification. It is also more natural to amplify both ears. If you need corrective lenses for your eyes, would you consider a monocle? Probably not. Your brain adjusts better when it receives information equally from both sides, especially in background noise.
Some insurance plans do cover the cost of hearing instruments, while others may cover only a partial cost or reimburse the patient for a set amount. You should always check with your particular insurance plan to see if you have coverage for hearing aids.
At present, medicare does not cover the cost of hearing aids. They do however cover some of the costs of examination. It is always best to discuss payment options with your audiologist before services are rendered.
Audiologists can test children of any age, including newborns. Newborns, infants and toddlers can be tested using non-invasive methods that either record the brain’s response to sound [Auditory Brainstem Response Audiometry (ABR)], or by introducing sounds via a probe in the ear and measuring the ear’s response to those sounds [Otoacoustic Emissions (OAEs)]. When a child is old enough to localize sounds, he/she can undergo behavioral testing in a sound booth using visual reinforcement and/or play audiometry. Children three years old and older can generally be tested much like adults.
Please see our Links section for web sites that may provide more specific information regarding your hearing and or balance problem.
Easy, you can use our Find An Audiologist section to locate an audiologist in your area via your city, zip code, area code, last name, or services offered.
Easy, use the Contact Us section and we will try to help you.
A sudden hearing loss is a medical emergency. Most people wait too long to do anything about a sudden loss thinking that it will recover on its own. Many sudden losses occur upon waking in the morning, but they can happen at any time. The first thing to do if you think the hearing in one or both ears has lessened is to try your home phone or cell phone on each ear and see if one is better than the other. There may also be some ear ringing (called tinnitus) and dizziness. If you are experiencing some or all three of these, get to a local emergency room or urgent care facility. It may be possible that early medical attention can help the hearing recover. If you had been exposed to hazardous noise (like a gun shot or firecracker going off near your ear), or something got into your ear, or you fell and hit your head but are otherwise OK, it still is a good idea to either call your primary care physician (at any time!) or go to urgent care for immediate attention. Allergies and head colds can cause a fullness feeling in the ear and sometimes this can mistaken for a sudden loss of hearing caused by something else. Viruses in the inner ear, mini-strokes, head trauma, and other causes of hearing loss can cause the loss to happen suddenly and it needs to be addressed immediately. Don’t wait…better to get it checked and have it be something simple than to “wait it out” to see if the hearing recovers.
The ears are generally self-cleaning. Most people do NOT need to do anything to clean their ears other than daily washing and shampooing/cleaning the hair. When we bathe/shower, enough water gets into the ear to help it clean it out. Just using a washcloth gently into the ear canal opening is sufficient. You do not need to use cotton swabs (Qtips) in the canal to clean it out. This can be dangerous by causing the thin skin of the canal to become torn and/or the possibility of the swab going through the eardrum. This can be bloody and painful. There are all kinds of eardrops and “ear cleaning solutions” on the market. Don’t use them unless your Audiologist or primary care physician recommends it. Some amount of wax in the ear canal is a good thing – it helps protect the ear. Over cleaning can actually do more harm. If you are concerned about ear wax build-up, make appointment to see your primary care physician and ask her or call your Audiologist to make an appointment. Both places can look into the canal and make recommendations for you.
Dizziness is never normal; it is never normal for someone to have to hold on to furniture or grab a wall to steady themselves because they are dizzy. Dizziness can be caused by many, many things: dehydration, medications, poor leg circulation, age, being sick, blood pressure problems, head trauma, etc. If you experience dizziness on a regular basis and cannot account for it, e.g., you just came off of a carnival ride (!), then you need to contact your primary care physician to have the dizziness causes checked. If you wake up in the morning and getting out of bed causes you to always feel dizzy, then this is not normal and it needs to be checked as you could get up and fall over causing more problems. If your physician prescribed some medications and told you that they may cause dizziness (as many medications do), then monitor this and let her know if there seems to be excessive dizziness. Since there are so many causes of dizziness, it is best to start with your primary care physician and from there she/he will refer you to specialists who can assess the kind of dizziness you have. Some forms of dizziness can be treated and relieved. Remember, being dizzy is not normal. It causes falls. Get it checked out!
Tinnitus is a term to describe ear noises. Sometimes the noise is a ringing or rushing sound or clicking or buzzing sound. Most people experience tinnitus at least a few times a month by hearing a high-pitched sound that suddenly comes on, lasts a few seconds or a minute and just goes away. However, there are people for whom the ear noise (tinnitus) is always there. There are many causes of tinnitus and some do have a cure, or at least in some people the tinnitus subsides or goes away. The best way to figure out what is causing your tinnitus and what to do about it is to make an appointment with an Audiologist who specializes in evaluating and treating tinnitus. The Audiologist will ask you a lot of questions about when the tinnitus started, how loud it is. what is sounds like, how aware you are of it during the day, how bothersome it is. You may be asked to fill out a questionnaire that helps get at these issues. You will also be asked about things that might be triggering the tinnitus. For example, have you started any new medications (prescribed or over-the-counter), changed your diet, had an increase in stress, whether you have been sick, just had an operation, experienced head trauma, been exposed to hazardous noise, etc. Once the Audiologist has the history, you will likely undergo a hearing test and the other tests to help the Audiologist determine your overall hearing ability. All of this information will help determine why you have the tinnitus and what, if anything, you need to do about it. If there are medical issues that need to be addressed, the Audiologist will refer you to the appropriate healthcare provider. Most cases of tinnitus are benign, that is, there is not a medical reason for it and most people can live with the tinnitus – once it is made clear it is not something that can be treated. Not everyone experiences tinnitus the same and therefore, the evaluation and subsequent treatment of the tinnitus is quite personal.
Well, that is a very complicated issue, as you might imagine and there are dozens of factors that determine what is covered (or not) by Medicare as well as all other insurance plans. Medicare, as a third-party insurance payer, just like all insurance carriers decide what to include in the coverage that is provided to the people who subscribe to their plan. The Centers for Medicare and Medicaid are federally funded (paid by tax dollars) to provide healthcare to the people who are eligible for signing up. However, Medicare is not funded by tax dollars to the point where EVERY medical or health condition can be covered in full, that is, in this case, coverage for hearing testing to determine if hearing aids would be a good treatment for someone’s hearing loss. Medicare also does not cover routine foot care and dental care and eye exams and more. No one would argue that hearing and feet and teeth and eyes (as just a few examples) aren’t important to keep healthy; there is just not enough money to pay for the coverage everyone needs under Medicare. Other private insurance companies, even the ones who have Medicare-supplement plans for purchase, also decide what to cover and what NOT to cover and it is based on many factors. These “defined benefits” are determined year over year and can change. Private insurance companies can make changes more easily than Medicare because, as a federal insurance plan the United States Congress determines how much to fund Medicare and they decide overall what health issues get covered. In the case of hearing and hearing aids, it would literally take an “act of Congress” to get these issues covered; this is something that has been looked at for many years. Some private insurance companies do indeed have hearing and hearing aids included in their “defined benefit” plans and this has been because they evaluated the available research on the benefit of treating hearing loss and the cost associated with the coverage and have decided it makes more cost-effective sense to get/keep people hearing. Insurance plans also include hearing/hearing aids as a way to encourage more people to subscribe to their plans. It is a highly complex issue and there are changes to insurance coverages every year – that is the reason there are “open seasons” – insurance companies want you to look at what they cover each year. In terms of hearing and hearing aid coverage, one must do a good deal of research to determine if selecting a plan with this kind of coverage still works for other kinds of coverage like prescriptions and heart care and diabetes care, etc., that one might need. Bottom line? Make no assumption about any plan you subscribe to with regard to hearing and hearing aid care; do your homework and ask questions to see what is covered – for any of your healthcare needs.
|Maryland Academy of Audiology
P.O. Box 8433
Parkville, MD 21234-0433
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