Types of Hearing Aids & How They Work

Types of Hearing Aids & How They Work

Like most medical devices, hearing aids aren’t always a one-size-fits-all solution to hearing issues. What works for one person may not work for another. That’s why it’s essential to find the hearing aid that’s most suited for you.  

Hearing aids vary widely and are available in different types, shapes, sizes, colors, features, and costs. With so many options, it can be confusing and overwhelming. Additionally, you can now buy FDA-regulated hearing aids found over-the-counter (OTC) at local stores and online. However, if the cost of hearing aids is a major deciding factor for you, remember there’s a distinct difference between “cheap” and "affordable" hearing aids

Before you decide, it helps to understand the different types of hearing aids available. But first, let’s go over what hearing aids are and how they work... 

What Hearing Aids Are and How They Work 

In simplest terms, hearing aids are small electronic devices worn behind or in the ear to help people with hearing loss hear better. Most work by air conduction, which means they amplify the sounds that travel from the ear canal to the inner ear, where they're processed, and then the signals go to the brain. 

Hearing aids consist of five essential parts:  

  • Microphone to pick up the sound around you 

  • Amplifier to increase the sound 

  • Microchip (signal processor) to regulate the sounds that are amplified 

  • Receiver to deliver the sound to your ear 

  • Battery unit to power the electronics 

Hearing aids may seem like simple technology, but their small size creates a significant challenge. The closer together you put the components described above, the greater the risk for feedback and poor sound quality. That means the technology needs to be better in smaller devices, which tends to steepen the price tag. 

While hearing aids are medical devices, they can’t restore natural hearing. For many people with hearing loss, hearing aids effectively boost certain frequencies so they can hear better. 

If you or a loved one has been experiencing any signs of hearing loss, it’s crucial for you to get your ears checked. About 15% of American adults have trouble hearing—that's 37.8 million people—and hearing loss increases with age. You can take our free online hearing test and see your results immediately. 

So, you’re probably wondering which hearing is best for you. Let's review the five types of hearing aids—BTE, RIC, ITE, ITC, and CIC—and how they differ.  

5 Types of Hearing Aids 

There are five main types of hearing aids. Depending on the design, they are worn either behind or in the ear.


1. Behind-the-ear (BTE) 

As the name implies, behind-the-ear hearing aids sit behind the ear, mainly out of sight. The body of the hearing aid contains the microphone, amplifier, microchip, receiver, and battery. The amplified sound travels from the body of the hearing aid and passes through thin, clear tubing into the ear canal. The control settings on BTE hearing aids are on the back of the aid, making it easy to delicately adjust the volume at a moment’s notice. If you have a dexterity problem, a BTE may be better than hearing aids that go directly into the ear canal or bowl of the ear. 

BTE hearing aids are popular because you can change and customize the tips and tubing to fit different ear sizes and shapes comfortably. These parts are inexpensive and easy to clean or replace. Behind-the-ear models usually have more space for a larger battery, so they offer a longer battery life than other types of hearing aids. Some hearing aid users dislike that this style is still visible behind their ears if they look closely. 


  • Easy-to-use controls 

  • Variety of tubing and ear tip options 

  • Replaceable parts

  • Budget-friendly 


  • Some visibility

2. Receiver-in-the-canal (RIC) 

Like BTE models, the body of the receiver-in-the-canal hearing aid rests behind the ear. The difference is that the receiver is separate from the hearing aid body and sits in the ear canal. Wired tubing connects the receiver to the hearing aid body. Because the receiver and the microphone are far apart, feedback is less of an issue at higher volumes. 

The body of RICs tend to be smaller and a bit more discreet than BTE. Like BTEs, RIC-style hearing aids have easy-to-reach controls. 

RIC hearing aids tend to have more issues from wax buildup because the receiver sits directly in your ear. Wax and moisture buildup blocks the sound and could destroy the receiver itself. On average, you'll spend $100 on receivers, which you typically need to replace at least once a year (or sooner if wax builds up too quickly). Those costs add up. 


  • Smaller, more discreet body 

  • Easy-to-use controls  

  • Can avoid feedback 


  • Wax buildup  

  • More maintenance 

  • Expensive receiver 

3. In-the-ear (ITE) 

In-the-ear hearing aids are placed in the bowl of your outer ear, and are usually custom-made from an ear mold. ITEs are available as half shell models (covering half of the bowl of the outer ear) or full shell models (covering the entire bowl). These offer more comfort if your ear size and shape are less common. Compared to other types of in-ear hearing aids (more on those below), an ITE has a larger battery that lasts longer. In addition, ITEs have bigger controls than other in-ear aids. 

ITE hearing aids take up most of your outer ear and are arguably the least discreet design. However, ITEs are usually designed to be flesh-colored, so they blend in with your skin tone. Like the other designs that fit directly into the ear, you need to clean an ITE more often thanks to wax and moisture buildup. 


  • Custom-made to fit ear  

  • Better battery life than ITC 

  • Better controls than ITC 


  • Most noticeable style 

  • Wax buildup  

  • Maintenance issues

  • Not always comfortable

4. In-the-canal (ITC) 

In-the-canal hearing aids fit in the ear canal. They’re smaller and more discreet than ITE models, but the controls won’t be as easy to use as ITEs. They will, however, be easier than CIC models (more on these below).  

ITC hearing aids can hold a slightly larger battery than other canal models, which means a longer battery life. Because these hearing aids are small and fit directly into the ear canal, wax buildup is a common problem, and maintenance can be difficult. ITC’s placement in the ear can also cause some users to feel “plugged up.” While small enough to fit in the canal, ITCs are bigger and more noticeable than CICs. 


  • More discreet than ITE

  • Better controls than CIC  

  • Better battery life than CIC 


  • Challenging to keep clean  

  • More noticeable than CIC 

  • Not always comfortable

  • May leave a "plugged up" feel

5. Completely-in-the-canal (CIC) 

CIC hearing aids sit deep in the ear canal. By design, CIC hearing aids are the smallest available and the most discreet among the models worn entirely in the ear. Similarly, you may learn of invisible-in-the-canal (IIC) hearing aids, which fit deeper in the canal and are virtually invisible. 

Because a CIC is a very small hearing aid that stays deep inside the ear, adjusting settings on the fly is much harder—if it even has controls on the hearing aid. Another trade-off for its small, nearly invisible profile is you’ll quickly run through the battery life. The smaller the device, the smaller the battery needs to fit inside; the smaller the battery, the less power it can provide. CICs are another type of hearing aid that often needs repair due to wax and moisture. 


  • Most discreet  

  • Comfortable

  • Less wind noise


  • Limited or no user controls 

  • Shorter battery life  

  • More wax buildup  

  • Harder to clean  

How to decide what is the best type 

At the end of the day, picking from the various types of hearing aids comes down to what features you prioritize first. For instance, if you want the smallest hearing aid possible, you might have to deal with a less user-friendly style, a higher price, and shorter battery life. If you’re looking for easy-to-use controls and easy-to-replace parts, you may want to choose a behind-the-ear style. It’s all about what makes the most sense for your needs and your budget. 

Analog vs. digital 

Hearing aids have come a long way since people first started using animal horns in the 1200s and ear trumpets in the 1800s. Technological advances, from vacuum tubes and circuit boards to transistors and microchips, have made hearing aids as we know them today. But what’s the difference between analog and digital hearing aids? 

Analog hearing aids aren’t that common anymore. The analogs that look most like modern hearing aids have been around since the 1960s. They work by increasing the volume of specific sound frequencies you hear. Some have microchips that allow different programs to be stored and changed based on the listening environment (e.g., noisy restaurant, music concert, quiet library, etc.), but they cannot reduce background noise the way digital aids do. 

Nowadays, most hearing aids are digital and work more like tiny computers. Digital hearing aids compensate for uneven hearing loss by converting sound waves into digital signals and boosting specific frequencies over others. You can customize this programmable technology based on your particular hearing loss, and change programs for different listening environments. Some hearing aids come already programmed for people with the most common hearing issues

Analog and digital hearing aids have similar components, such as receivers, microphones, and amplifiers. Digital hearing aids have microchips that help control the frequencies so digital hearing aids can be more finely programmed for different types of hearing loss. There is also a sound quality difference between analog and digital hearing aids. The biggest difference between the two is that digital hearing aids are capable of more complex processing of sounds and customized programming. For example, digital hearing aids can reduce background noise or feedback interference.  

Customized/clinic aids vs. OTC hearing aids

To get prescription or clinic hearing aids, you must order them through a hearing specialist, such as an audiologist. These types of hearing aids can be fit for more severe and profound hearing loss and tend to offer more sophisticated technology that makes them more expensive. However, you'll receive testing and personalized assistance in helping you find the best type of hearing aid.  

You can buy over-the-counter (OTC) hearing aids without a prescription or fitted by an audiologist, and they’re usually cheaper. OTC devices are FDA-regulated to fit mild to moderate hearing loss. You can find them locally at pharmacies like CVS, Walgreens, and Best Buy, or you can purchase them online from retailers like MDHearing. They come pre-programmed, or you can sometimes configure them yourself, typically using a smartphone app. Be sure to verify that your OTC hearing aids are FDA-registered by searching the FDA database by device name or company name.

PSAPs vs. OTC hearing aids

It’s also important to note that you mustn't confuse medical-grade hearing aids with personal sound amplification products (PSAPs) and other assistive listening devices. PSAPs merely make sounds louder and aren’t approved by the FDA for hearing loss. They’re only designed for people with normal hearing to amplify certain sounds while participating in activities like birdwatching or attending a speech. 

When searching for hearing aids, it’s vital to do your research and choose wisely. You don’t want to be stuck with a device that doesn’t work well for you, causing you to stop wearing it. Or worse, one that causes more damage to your ears. There are many consequences of untreated hearing loss, such as social withdrawal, impaired memory, increased safety risk, etc., so it’s important to take care of your ears. 

MDHearing’s FDA-Registered Hearing Aids 

MDHearing has always specialized in BTE hearing aids—they’re designed by doctors and tested by audiologists. Now, we also offer two in-the-ear options: the MDHearing NEO (our ITC model) and the MDHearing NEO XS (our CIC model), which are practically invisible. Our OTC hearing aids feature the latest digital technology, high-quality crystal-clear sound, rechargeable batteries, and a portable charging case. 

Our hearing aids are FDA-registered medical devices with a 45-day trial and a 100% money-back guarantee. We cut out the middleman and pass the savings to you, making hearing aids more affordable and accessible online. 

Order your hearing aids today and get free shipping!