You were recently in a noisy restaurant. A friend started telling you a story. You smiled and nodded along, but you actually had a hard time hearing what they were saying. 
 
It’s common for a person’s hearing to decline as they get older.¹ In fact, about a third of older adults have some kind of hearing loss.²  One reason is because as you age, your inner ear can lose cells that pick up sound. And nerves that carry sound to your brain may get weaker.³ Age-related hearing loss happens little by little, which is why the signs and symptoms can be hard to notice.⁴  

When you have trouble hearing, you might avoid social situations where it’s hard to hear. That isolation can affect your mental health.⁵ Untreated hearing loss is also linked to greater risk of falls, trouble concentrating, and even dementia.⁵ 

The good news: There are treatments that can help, including hearing aids. Here’s where to start and who to see if you’re concerned about your hearing.

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When to see a hearing specialist 

Your first step is to get your hearing tested. Not sure it it’s time to see a doctor? Here are some signs and symptoms that may mean your hearing needs help:^{5, 6} 

• You can’t hear someone if they’re out of sight.  
• You can’t hear what people say in noisier settings. 
• You often ask people to repeat themselves. 
• You have tinnitus (ringing in your ears). 
• You have trouble understanding people on the phone. 
• You raise the volume on the radio or television so high that others say it’s too loud. 

Keep in mind, though, that these symptoms could also be signs of other medical issues. For example, not being steady on your feet could be a sign of heart or blood flow issues.⁷  

To get started, schedule an appointment with your Optum primary care physician (PCP). Your PCP may be able to help you figure out the root cause of your hearing issues. They’ll want to rule out an infection or earwax buildup.  
 
Or they may send you to an Optum specialist, such as an ear, nose and throat doctor.⁸ Your doctor might also refer you to an audiologist. That’s a type of provider who can assess hearing issues by using specialized tests. They can also offer solutions for hearing loss.⁹ 

What to expect during a hearing evaluation 

An audiologist will do a comprehensive hearing evaluation. During the test, they will:¹⁰ 

• Ask about your medical history and hearing problems.  
   
• Look inside your ear canal with a tool called an otoscope. This is to make sure you don’t have too much wax or some other issue that would get in the way of a hearing evaluation.  
   
• Do several tests to find out if you have hearing loss. If you do, the audiologist will tell you what type you have. You’ll also find out the extent of your hearing loss and if it’s in one ear or both. 
   
• Offer remedies if you have hearing loss. This can include hearing aids and practical strategies to hear better. 

Looking for a doctor who really listens to you? Check out Optum Care’s network of primary care providers and specialists. Find an Optum doctor. 

What to do if you need hearing aids 

These small electronic devices make some sounds louder and can make it easier to hear. You can get them in two ways: 

With a prescription: An audiologist or hearing aid specialist prescribes hearing aids.⁹ They’ll also fit and adjust them. You have some choices for types of hearing aids. These include:¹¹ 

• Behind-the-ear (BTE): These hook over the top of the ear and rest behind the ear. 
• Completely-in-the-canal (CIC) or mini CIC: These are molded to fit inside your ear canal. 
• In-the-canal (ITC): These are custom-molded and fit partly inside the ear canal. 
• In-the-ear (ITE): These are custom-made in two ways: One fills most of the bowl-shaped area of your outer ear (full shell); the other fills only the lower part (half shell). 
• Receiver-in-canal (RIC) or receiver-in-the-ear (RITE): These are similar to BTEs, with the speaker or receiver sitting in the ear canal.  

Over the counter (OTC): You can also buy OTC hearing aids online or in your local pharmacy. You don’t need a prescription. They are mainly for people who have perceived mild to moderate hearing loss.¹² You fit them yourself. 
 
“OTC hearing aids can make amplification more affordable,” says Nancy Swayze, MD. She’s a geriatrician with Optum in Worcester, Massachusetts. “But it’s best to have a have a hearing test with an audiologist to assess the type of loss and if OTC hearing aids can help.”  

They may help if you only have trouble hearing in loud places, for example.¹² 

One note: Original Medicare doesn't cover hearing aids or the exam to get them.¹³ But some Medicare Advantage Plans may. Talk to your Optum doctor about whether that might be the case for you. 

And no need to feel embarrassed about getting hearing aids. Hearing tech has come a long way, and many hearing aids are now so small that they’re hard to spot in an ear.  

Bottom line: If you’re having trouble hearing, your Optum doctor is ready to listen to your concerns. They are your partner in care, and can help you find the doctors and specialists you need to hear better. 

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