I recently went through the process of upgrading my bone anchored hearing aid and learned a lot about how that procedure works. Even though I did my research, surprises came up. I wanted to share my experience. 

So, first, I have a confession. I received my first bone anchored hearing aid almost nine years ago and I did not go back to an audiologist until this year. This is probably not the best plan, but there were a lot of contributing factors.

One reason I did not follow up with an audiologist since I received my first device is that my previous audiologist did not provide much guidance. In general, I don’t feel we connected well. She did not seem to be a huge fan of bone anchored devices and tried to steer me toward CROS aids. CROS aids were not the right fit for me or my lifestyle (I have tiny ear canals, chronically tuck my hair behind my ears, and hate the feel of things in my ears). I felt my audiologist gave me the most basic time and information and sent me on my way without any plans or structure for the future.

Another reason I waited so long was definitely finances. I spent a lot of time talking to my insurance about how they covered bone anchored hearing aids. I kept getting conflicting information on what the device fell under for insurance coverage and what the insurance paid. In general, bone anchored hearing aids aren’t common and often just don’t fit standard structures. My insurance told me at the time that they would cover the first device with my outpatient surgery benefits since I needed surgery to install the post. They said that upgraded devices would be covered under my hearing aid benefits, which at the time were that $2,000 maximum would be paid by the insurance company. As bone anchored hearing aids cost around $5,000, I was worried about affording the remaining $3,000+ cost for an upgrade. This turned out to either be incorrect information or very different in 2024 from 2015.

Most people do an upgrade after 5 years, which fell in 2020 for me. Obviously, that was a time period when non necessary doctor appointments were postponed. I also had to spend significant time getting in to see an audiologist when I was ready. It took months to get in. I started the process in January and had a several month wait for the first available appointment, only to have that appointment canceled because the audiologist left. Then, I was rescheduled with the wrong kind of audiologist and had to be rescheduled again, so it took more than 7 months just to get an appointment. I don’t know if all audiologist offices are as backed up as mine, but I was rather appalled by the challenge of just getting an appointment.

Lastly, I had waited so long for an upgrade because my aid was really working fine. It seems bone anchored aids are mostly hardy equipment. I had really had no trouble with it. I took good care of it, putting it in a dry chamber each night and keeping it clean. My audiologist said it was the best condition aid she had seen for its age. 

However, even though the long break between upgrades was ok for my life, I learned it probably wasn’t the best plan. 

Oticon, the brand of my bone anchored aid, provides a warranty the first two years you have the aid. After that, you can purchase an extended warranty for $400. If your aid is damaged you can mail it to Oticon and pay the $400, and they mail you a replacement back. This works as long as you have an aid to mail in (even an aid in pieces is sufficient). I took advantage of this at 3.5 years when I knocked my aid to the pavement, and the attachment shattered. Once the aid is seven years old, you can no longer get your aid repaired or do a warranty claim. Since I now know it takes months to get into an audiologist and 2-3 months to do the upgrade process, the idea of having an aid that can’t be sent in for repairs is stressful. When I did a warranty claim, I didn’t have an aid for a week. If I had broken my 9 year old aid, I could have been aidless for months. I wouldn’t recommend taking that risk.

I also found out that most US insurance, mine included, doesn’t cover bone anchored hearing aids under hearing aid benefits but rather under durable medical equipment. My insurance, and probably most, covers durable medical equipment way better than hearing aids. I had a very expensive health year this year and met my maximum out of pocket expenses. That was part of why I went into the audiologist this year as I didn’t have to worry about copays anymore. I found that my insurance paid completely for my upgraded device since I had met my deductible and paid my maximum out of pocket.

The upgrade process summarized:

• I contacted my audiologist office to make an appointment. For me, this was a multi month wait.
• I had to have an appointment with both an ear, nose, and throat surgeon’s physician assistant as well as an audiologist. The ENT PA just looked at my abutment post and confirmed all was good. 
• The audiologist did a hearing test, a hearing in noise test, and walked me through my options for my device upgrade. She was thorough and helpful, going in depth on options. We decided what to order and she started the paperwork process. Before leaving, the audiologist recommended scheduling the appointment for programming the new device 3 months later.
• I completed and submitted paperwork to the hearing aid company, Oticon.
• Oticon contacted my insurance and worked out the coverage. Once it was all confirmed, Oticon notified me that my insurance approved it and what my cost would be.
• Oticon shipped the new device to my home.
• I downloaded the new app, read the instructions booklets, and charged my remote mic accessory to prepare for the audiology appointment.
• I brought the device with me to an audiology appointment.  The audiologist programmed it by having me essentially do a hearing test with hearing beeps on the device. She also went through linking it to my phone, using the accessories, and using the app. By the time I left, I felt very comfortable with all my new technology. 
• My audiologist did give me a recommended schedule for follow-ups. She said I do not need a hearing test every year. She recommended every three years or so to have my hearing checked. She also said I should have a follow-up before my hearing aid warranty expires just to make sure everything is working great before a repair would cost me money. Lastly, the audiologist recommended coming in at least every three years for firmware upgrades to keep functionality current in this time of constant technological updates.

I am very excited about my new device and its functionality. I will get more in-depth on my review of the device in an upcoming blog post. My only disappointment has been that my new bone anchored hearing aid only streams directly from an Apple phone. I am an Android user, so I have to use an accessory device to stream music or calls from my phone to my aid. When ordering the aid, an accessory is included. I had opted for the accessory called an edumic that is a remote microphone that connects my hearing aid to venue sound systems via a telecoil and hearing loop. I had thought I could stream directly from my phone. My audiologist and I had called the hearing aid company to confirm that I should get the edumic as my accessory when ordering the aid, and they had concurred without explaining the Android issue. However, when we went to set up streaming with the new aid it did not work. We called up Oticon and they explained the Apple vs Android difference at that call. Hearing my frustration and disappointment at being unable to stream, Oticon mailed me a complimentary connectclip accessory so that I could stream my phone to my hearing aid via that device. In general, this was a step down as my previous bone anchored hearing aid had one accessory device that could both link to a hearing loop and allow my phone to stream. Now I need two different accessories (edumic and connectclip) for those tasks. I did very much appreciate Oticon sending me the device I needed for free.

So far, my favorite part of the new device is the amazing feedback cancelation. I am excited to have a remote microphone to help me hear my conversational partner in challenging locations like out at a restaurant. I also love knowing I have a spare aid in case something happens to my primary device. In general, the new device is excellent, and I am very grateful I was able to upgrade.