Age-Related Hearing Loss: When to Get Testing and Treatment?

Hearing loss isn't just about struggling to hear the TV or missing parts of conversations. It's about staying connected to the people and activities that make life meaningful. The trouble is, age-related hearing loss happens so gradually that most people don't realize they're losing their hearing until it's already affecting their relationships, their independence, and their quality of life.

Here's what makes this especially frustrating: people wait an average of five to 10 years between first noticing hearing problems and actually doing something about it. During those years, they're missing important conversations with family, feeling left out at social gatherings, and dealing with the exhaustion that comes from straining to hear.

The good news? Getting your hearing tested is straightforward, treatment options are better than ever, and taking action early makes a real difference. This guide will help you understand when to get tested, what to expect, and how to get the care you need.

What Is Age-Related Hearing Loss?

Age-related hearing loss—also called presbycusis—is the gradual loss of hearing in both ears that happens as we get older. It's not a sudden change. It creeps up slowly, which is why many people don't notice it at first.

Approximately one in three people in the U.S. between ages 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. It's one of the most common conditions affecting older adults.

How It Happens

Several changes in your ears can lead to hearing loss as you age. The tiny hair cells in your inner ear that detect sound gradually wear down and don't regenerate. The nerve pathways between your ears and brain can deteriorate. The structures in your middle ear may stiffen, and blood flow to the ear decreases.

These changes are a normal part of aging, but other factors can speed them up. Long-term exposure to loud noise, certain medications, smoking, high blood pressure, and diabetes all play a role in how quickly hearing loss progresses.

Why It Matters

Hearing loss affects more than just your ability to hear. Research shows it's linked to social isolation, depression, and even cognitive decline. When you can't hear well, you might start avoiding social situations, missing important health information from your doctor, or feeling unsafe because you can't hear alarms or approaching vehicles.

Having trouble hearing can make it hard to understand and follow your doctor's advice, respond to warnings, and hear phones, doorbells, and smoke alarms. It can also make it difficult to enjoy talking with family and friends, leading to feelings of isolation.

Signs You Might Have Hearing Loss

Because hearing loss happens gradually, you might not notice the changes yourself. Often, family members notice first. Here are the common signs to watch for.

Difficulty Understanding Speech

You can hear people talking but can't make out what they're saying. Conversations are especially hard in noisy places like restaurants. You constantly ask people to repeat themselves, and phone conversations feel frustrating. Many people with age-related hearing loss find that speech becomes difficult to understand, particularly when there is background noise.

Trouble with Certain Sounds

High-pitched sounds are typically harder to hear, including women's and children's voices, birds chirping, or your phone ringing. Soft sounds disappear entirely. Words that include "s" and "th" sounds seem muffled.

Behavioral Changes

You turn up the TV or radio volume more than others find comfortable. You avoid social gatherings because conversation is exhausting. You feel anxious about not being able to hear, and you withdraw from activities you used to enjoy. The volume settings on electronic devices can be a useful gauge in the onset of hearing loss—if you find yourself consistently turning up the volume, something might be amiss.

Physical Signs

Other symptoms include ringing in your ears (a condition called tinnitus), feeling like your ears are plugged, or experiencing dizziness and balance problems.

If you're experiencing any of these signs, it's time to get your hearing checked. Don't wait—the sooner you address hearing loss, the better your outcomes.

When to Get Your Hearing Tested

The short answer: you should get your hearing checked regularly as you age, even if you think your hearing is fine. Routine tests can help catch changes early, often before they interfere with daily life.

Recommended Testing Schedule

Ages 18-40: Get a baseline hearing test at least once, ideally in your mid-20s. This gives you a reference point for the future. Have your hearing tested every 3-5 years if you're in overall good health and not experiencing any symptoms.

Ages 40-50: Continue testing every 3-5 years if you're not experiencing any problems.

Ages 50-60: Increase testing frequency to every 3 years as age-related changes become more common.

Age 60 and older: Get your hearing tested annually, regardless of whether you're experiencing symptoms. You should have a baseline test at least by age 65, as most insurance covers routine hearing screenings.

Any age: Get tested immediately if you notice sudden hearing changes, ringing in your ears, pain, or other concerning symptoms. Sudden hearing loss requires prompt medical attention.

Who Needs More Frequent Testing

Some people should get their hearing tested more often. Anyone regularly exposed to loud noise at work—like construction, manufacturing, or music—should have annual hearing tests. People who use loud equipment like lawn mowers, power tools, or motorcycles need more frequent checks.

You'll also want more regular testing if you already have hearing loss, take medications that can damage hearing (certain chemotherapy drugs or high doses of aspirin), have a family history of hearing loss, or have conditions like high blood pressure or diabetes.

Why Early Testing Matters

Most people wait years before addressing their hearing loss, but early intervention makes a real difference. The longer you wait, the harder it becomes to adjust to hearing aids, the more likely you are to experience social isolation and depression, the greater your risk of cognitive decline, and the more difficult it is to maintain speech understanding skills.

Getting tested early—before you think you need it—establishes a baseline and catches changes before they significantly impact your life.

What Happens During a Hearing Test

If you've never had a hearing test as an adult, you might be wondering what to expect. The good news: it's painless, straightforward, and usually takes about 30 minutes.

Where to Get Tested

You have several options. Your primary care doctor's office can do basic screenings. An audiologist is a specialist in hearing who can perform comprehensive testing. An ear, nose, and throat (ENT) doctor can evaluate medical causes of hearing loss. Some hearing aid centers also offer free screenings.

Most insurance plans, including Medicare, cover routine hearing screenings.

The Testing Process

Physical Examination

First, your provider will examine your ears using an otoscope—a lighted magnifying tool. They're checking for earwax buildup that might be blocking sound, fluid in the ear, damage to the eardrum, and signs of infection or other problems.

Hearing Tests

The main test is called an audiogram. You'll wear headphones in a quiet room and listen to tones at different volumes and pitches, played one ear at a time. You'll signal when you hear each sound by raising your hand, pushing a button, or saying you hear it.

Some tests also include speech testing, where you'll hear simple words at different levels of loudness and repeat what you hear. Some words will be spoken over noise to see how well you can understand speech in realistic conditions.

Understanding Your Results

Your results show which ear is affected more, what type of hearing loss you have (conductive, sensorineural, or mixed), how severe your hearing loss is, and which frequencies you struggle with most.

Hearing loss is measured in decibels (dB). When someone whispers in your ear, that's 30 decibels. Normal speech is 60 decibels. Shouting in your ear starts at 80 decibels. Here's what the levels mean:

• 0-25 dB: Normal hearing
• 26-40 dB: Mild hearing loss
• 41-55 dB: Moderate hearing loss
• 56-70 dB: Moderately severe hearing loss
• 71-90 dB: Severe hearing loss
• 91+ dB: Profound hearing loss

Types of Hearing Loss and What They Mean

Understanding what kind of hearing loss you have helps determine the best treatment.

Conductive Hearing Loss

This happens when sound can't travel from your outer or middle ear to your inner ear. Common causes include earwax buildup, fluid in the middle ear, ear infections, and damage to the eardrum or ear bones.

The good news? Conductive hearing loss can often be treated or even reversed with medical care or surgery. Removal of earwax is curative for hearing loss caused by cerumen impaction.

Sensorineural Hearing Loss

This is the most common type in older adults. It happens when there's damage to the inner ear or the nerves that connect your ear to your brain. This is true age-related hearing loss, also known as presbycusis.

What you need to know: Sensorineural hearing loss is permanent and cannot be cured, but it can be managed effectively with hearing aids or other devices. The goal of treatment is to improve your communication and function, and prevent future problems associated with hearing-related disability.

Mixed Hearing Loss

Some people have both conductive and sensorineural hearing loss at the same time. Treatment addresses each component separately.

Treatment Options for Age-Related Hearing Loss

There's no cure for age-related hearing loss, but several treatments can dramatically improve your hearing and quality of life. Treatment depends on the severity of your hearing loss, so some options will work better for you than others.

Hearing Aids

Hearing aids are the most common treatment for mild to moderate hearing loss. They're electronic devices that make sounds louder. Today's hearing aids are more advanced than ever—smaller, more comfortable, and with features like Bluetooth connectivity and noise cancellation.

Over-the-Counter Hearing Aids

Since 2022, a new category of hearing aids for adults was established by the U.S. Food and Drug Administration. These devices can be purchased over the counter from retail or online outlets without seeing a healthcare professional or getting a hearing test.

Over-the-counter hearing aids work well for adults with mild to moderate hearing loss who can hear some speech but find soft sounds hard to hear, have trouble hearing in groups or noisy places, and don't have severe or profound hearing loss.

Prescription Hearing Aids

If you've tried an over-the-counter hearing aid without success or have trouble hearing loud sounds, you should consult a hearing health professional, because your hearing loss may be more severe. Prescription hearing aids are programmed by an audiologist to match your specific hearing loss pattern.

Hearing aids increase your ease of hearing and can reduce levels of stress and fatigue. They let you rejoin conversations and more fully enjoy your favorite activities.

Cochlear Implants

For people with severe to profound hearing loss who don't benefit from hearing aids, cochlear implants can be life-changing. These small electronic devices are surgically implanted in the inner ear and help provide a sense of sound to people who are profoundly deaf or severely hard of hearing.

Assistive Listening Devices

Beyond hearing aids, other devices can help you function better day-to-day. These include amplified telephones, TV listening systems, personal amplifiers for conversations, alert systems for doorbells and smoke alarms, and captioned phones.

Communication Strategies and Support

Treatment isn't just about devices. Many people benefit from auditory rehabilitation, education about alternative communication techniques, and use of assistive listening devices. Some people learn lip-reading skills, which can help them understand conversations better. Support groups connect you with others facing similar challenges.

Does Insurance Cover Hearing Loss Treatment?

Coverage for hearing loss varies significantly by insurance plan, which is why having an advocate who understands your specific benefits can make such a difference.

Medicare Coverage

Medicare Part B covers diagnostic hearing tests ordered by a doctor and hearing tests to determine if you need a hearing aid. However, traditional Medicare generally does not cover hearing aids or exams for fitting hearing aids.

Medicare does cover cochlear implants when they're medically necessary for severe to profound hearing loss that doesn't improve with hearing aids.

Medicare Advantage Plans

Many Medicare Advantage plans offer additional hearing benefits beyond what traditional Medicare covers, including coverage for hearing aids. If you have a Medicare Advantage plan, check your specific benefits—coverage varies widely by plan.

Private Insurance

Some private insurance plans cover hearing aids, but many don't. Coverage varies dramatically. Some plans cover one hearing aid every few years, while others cover a percentage of the cost up to a certain dollar amount.

Out-of-Pocket Costs

Here's what you might pay without insurance coverage:

• Over-the-counter hearing aids: $500-$1,500 per pair
• Prescription hearing aids: $1,000-$6,000 per ear
• Cochlear implants: $30,000-$50,000 per ear (often covered by Medicare when medically necessary)

Many hearing aid providers offer payment plans to make the cost more manageable. Some nonprofit organizations also provide financial assistance for hearing aids.

Living Well with Hearing Loss

Getting treatment is just the first step. Here's how to protect your remaining hearing and adapt to changes.

Protect Your Hearing

You can protect yourself from noise-induced hearing loss by avoiding loud noises, reducing the amount of time you're exposed to loud sounds, and protecting your ears with earplugs or protective earmuffs when you can't avoid noise.

Keep the volume of earbuds and headsets at a safe level. Limit time in noisy environments. Wear ear protection when using loud equipment like lawn mowers or power tools, or when attending concerts or sporting events.

Manage Related Health Conditions

Control your blood sugar if you have diabetes, since diabetes is associated with hearing loss. Manage your blood pressure and avoid smoking. Regular exercise helps maintain good blood flow to your ears and can support overall ear health.

Communicate Effectively

Let people know you have hearing loss so they can help. Ask them to face you when speaking so you can see their lips and facial expressions. Request written information when possible for important details. Choose quieter environments for important conversations whenever you can.

Stay Connected

Don't let hearing loss isolate you. A decrease in hearing can separate someone from the world around them, making it more difficult to communicate, process information, and participate in group activities. Continue participating in activities you enjoy, use assistive devices when they help, and consider joining a support group for people with hearing loss.

How a Solace Advocate Can Help

Dealing with hearing loss involves more than just getting a test. You need to schedule appointments, understand your results, figure out insurance coverage, compare treatment options, and coordinate with multiple providers. That's where a Solace advocate makes all the difference.

Navigate the Testing Process

Your advocate helps you schedule hearing tests with in-network providers, so you're not paying more than necessary. They prepare questions for your appointments to make sure you get all the information you need. They ensure all necessary tests are ordered and help you understand your test results and what they mean for your care.

Understand Your Coverage

One of the most confusing parts of addressing hearing loss is figuring out what your insurance covers. Your advocate determines exactly what your insurance covers for hearing tests and hearing aids. They find providers who accept your insurance and help you avoid surprise bills.

If you have Medicare, they can identify Medicare Advantage plans with hearing benefits if you're eligible to switch during open enrollment. If you need financial help, they connect you with assistance programs and nonprofits that provide support for hearing aids.

Coordinate Your Care

Hearing loss doesn't happen in isolation. Your advocate ensures your primary care physician, audiologist, and any specialists are all communicating. They track follow-up appointments and retesting schedules so nothing falls through the cracks.

They make sure hearing loss is properly documented in your medical records, which can be important for insurance claims and disability applications. If you have related conditions like diabetes or high blood pressure, they coordinate care across all your providers.

Support Treatment Decisions

Your advocate helps you understand the pros and cons of different hearing aid options. They prepare questions for audiologists and ENT doctors, so you feel confident in your appointments. They review your treatment plan to ensure it makes sense for your lifestyle and daily needs.

If treatment isn't working as expected, they follow up and help you get adjustments or try different approaches. They stay with you through the entire process, from that first hearing test to finding the right treatment and making sure it's working for you.

You don't have to figure this out alone. Your Solace advocate handles the logistics so you can focus on your hearing health and staying connected to the people and activities you love.

Frequently Asked Questions

Can age-related hearing loss be reversed?

No, sensorineural hearing loss—the most common type of age-related hearing loss—is permanent and cannot be reversed. Scientists don't yet know how to prevent age-related hearing loss, and it's not a reversible condition. However, it can be effectively managed with hearing aids and other treatments that significantly improve your quality of life. Some types of conductive hearing loss can be treated medically or surgically.

How long does it take to adjust to hearing aids?

Most people need 2-3 months to fully adjust to hearing aids. Your brain has to relearn how to process sounds you haven't heard in years. Wearing your hearing aids consistently—even when it feels uncomfortable at first—and working with your audiologist to fine-tune them helps the adjustment go more smoothly. Today's hearing aids are a good blend of medical and physical technology, allowing you to customize your hearing for different environments.

Will my hearing loss get worse over time?

Age-related hearing loss typically progresses gradually. Research shows an approximate 1 dB per year increase among adults age 50 years or older. Regular hearing tests help monitor changes so your treatment can be adjusted as needed. Protecting your ears from loud noise and managing related health conditions can help slow progression.

Are expensive hearing aids better than over-the-counter options?

Not necessarily. Over-the-counter hearing aids work well for many people with mild to moderate hearing loss and cost significantly less than prescription devices. However, prescription hearing aids offer more customization, professional programming, and ongoing adjustments, which some people need for their specific type and degree of hearing loss. An audiologist can help you determine what's best for your situation.

Does Medicare cover hearing aids?

Traditional Medicare (Parts A and B) does not cover hearing aids or exams for fitting hearing aids. However, many Medicare Advantage plans do offer hearing aid coverage, with benefits varying by plan. Some plans cover hearing aids partially or fully, while others offer allowances every few years. A Solace advocate can help you understand your specific coverage and find options that work within your plan or connect you with financial assistance programs if needed.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.

Related Reading

• Will Medicare Pay for Hearing Aid Repairs?
• Understanding Medicare's Preventive Service Coverage
• How to Make the Most of Your Doctor's Appointment
• Elderly Home Care: Benefits, Costs, and How to Choose the Right Care
• The Importance of Health Advocacy

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