Whether you’ve just noticed changes in your hearing or you’re researching hearing aids for the first time, you probably have questions. Below, Dr. Tracy Hayden answers the 26 questions Billings patients ask most — covering hearing tests, costs, hearing aid technology, insurance, tinnitus, and more.
Audiology & Hearing Care Questions
What does an audiologist do, and how is that different from an ENT?
An audiologist is a doctoral-level healthcare professional who specializes in diagnosing and treating hearing loss and balance disorders. In Billings, an audiologist like Dr. Tracy Hayden at Big Sky Audiology performs comprehensive hearing evaluations, fits and programs hearing aids, treats tinnitus, and assesses balance problems. An ENT (ear, nose, and throat physician) is a medical doctor who handles surgical and medical conditions of the head and neck. When hearing loss is confirmed, most ENTs refer patients to an audiologist for hearing aid fitting and long-term hearing care.
How do I know if I need a hearing test?
The most common signs you should schedule a hearing test in Billings include frequently asking people to repeat themselves, struggling to follow conversations in noisy places like restaurants, turning the TV up louder than others prefer, missing high-pitched sounds like birds or doorbells, and hearing ringing or buzzing in your ears (tinnitus). Adults over 60, people who work around loud machinery, and anyone with a family history of hearing loss should have a baseline hearing evaluation every one to two years, even without obvious symptoms.
What happens during a hearing test at Big Sky Audiology in Billings?
A comprehensive hearing evaluation at Big Sky Audiology in Billings typically takes 60 to 90 minutes. Your audiologist will begin with a health history and lifestyle discussion, then examine your ear canals with an otoscope to check for wax buildup or other issues. Next comes a series of audiometric tests — you’ll wear headphones and respond to tones at different pitches and volumes, and repeat back words to measure speech understanding. Results are plotted on an audiogram, reviewed with you in detail, and used to guide personalized treatment recommendations.
Cost & Insurance Questions
How much does a hearing test cost, and what insurance does Big Sky Audiology accept?
A comprehensive diagnostic hearing evaluation is $150 if you pay for it yourself, and a hearing screening costs less. We work with most insurance plans, including Medicare, the VA, workers’ compensation and PacificSource, but we do not accept Medicaid. You do not need a doctor’s referral to book a hearing evaluation. If your plan is GEHA, Aetna, Blue Cross Blue Shield or Humana, you may have a hearing aid benefit you can use here through TruHearing. Original Medicare does not pay for hearing aids. We also offer 12-month financing at 0% interest through CareCredit. Testing for dizziness and balance, called VNG, does need a referral from your doctor. Call us at 406-656-2003 with questions about your own plan.
How much do hearing aids cost in Billings, MT?
In Billings, the cost of prescription hearing aids typically ranges from about $2,000 to $7,000 per pair, depending on technology level, features, and the services bundled into the price. The national average for a pair of professionally fit hearing aids is around $4,700. This usually includes the hearing evaluation, fitting, programming, follow-up visits, and adjustments over time. Entry-level devices handle basic listening environments, while premium aids offer advanced features like Bluetooth streaming, rechargeable batteries, and AI-powered sound processing. Financing options are often available.
Does Medicare cover hearing aids in Montana?
Original Medicare (Parts A and B) does not cover hearing aids or routine hearing aid fittings in Montana. However, many Medicare Advantage (Part C) plans do offer hearing benefits — some include an annual allowance toward hearing aid costs or discounted pricing through preferred provider networks. Coverage varies significantly by plan, so it’s worth reviewing your Summary of Benefits or contacting your plan administrator. Diagnostic hearing evaluations may be covered by Medicare Part B, and you do not need a doctor’s referral to book one at Big Sky Audiology in Billings. We accept Medicare. Call us with questions about your own plan.
Does Montana Medicaid cover hearing aids?
Big Sky Audiology does not accept Medicaid. Yes, Montana Medicaid (Montana Healthcare Programs) does provide hearing aid coverage for eligible members, though prior authorization is required for the hearing aids themselves. No prior authorization is needed for hearing aid services, supplies, or repair handling fees. Coverage details, including any age restrictions and device limits, follow Montana Healthcare Programs guidelines. If you are a Medicaid member, contact your plan to find a hearing provider in Billings that accepts it.
What is the difference between prescription hearing aids and over-the-counter (OTC) hearing aids?
Prescription hearing aids are custom-programmed by a licensed audiologist to match your specific hearing loss across multiple frequencies, based on a full diagnostic evaluation. They are appropriate for all degrees of hearing loss and come with professional follow-up care. Over-the-counter (OTC) hearing aids became available in 2022 for adults and are designed only for mild to moderate hearing loss. They are self-fit, cost less (roughly $300-$1,500 per pair), and come with no professional support. An audiologist in Billings can help you determine which option is appropriate for your hearing profile.
Hearing Aid Technology Questions
What hearing aid brands does Big Sky Audiology carry?
Big Sky Audiology in Billings works with leading hearing aid manufacturers, and is an authorized Signia provider. Major brands audiologists carry include Oticon, Phonak, Starkey, ReSound, and Widex — each with different strengths. Oticon is recognized for BrainHearing technology; Phonak leads in connectivity and rechargeable options; Starkey (an American-made brand) features AI-powered processing; Widex is known for natural sound quality and built-in tinnitus relief programs. Your audiologist will help match the right brand and model to your hearing loss, lifestyle, and budget.
How long do hearing aids last?
Most hearing aids last between three and seven years, depending on the device, how many hours per day they are worn, and how well they are maintained. Moisture, earwax, and physical wear are the most common causes of early failure. To extend the life of your hearing aids in Billings’ variable climate — from dry summer heat to cold winters — clean them daily, store them in a dry-aid kit or dehumidifier overnight, and schedule regular professional cleanings at Big Sky Audiology. When technology significantly advances or your hearing changes, replacement may make sense even before full wear-out.
Are rechargeable hearing aids better than battery-powered ones?
Rechargeable hearing aids offer real-world advantages for many people — no fumbling with tiny batteries, no running out of power mid-day, and lower long-term costs. Most lithium-ion rechargeable aids provide 16 to 24 hours of use per charge, with some models lasting up to 37 hours. They are especially popular among patients with dexterity issues or arthritis. Traditional disposable-battery aids offer flexibility for travel or multi-day outdoor excursions — common in the Billings area — where charging may not be convenient. Your audiologist can walk you through both options to find the best fit for your routine.
Can hearing aids connect to my smartphone or TV?
Yes. Most modern prescription hearing aids use Bluetooth technology to stream audio directly from iPhones, Android phones, tablets, and smart TVs. You can take phone calls, listen to music, and stream TV audio directly into your hearing aids — often in stereo. Many brands also offer companion apps that let you adjust volume, change listening programs, or even request remote programming adjustments from your audiologist. If seamless connectivity is a priority, let your Billings audiologist know at your fitting appointment so the right model can be selected.
What are the different styles of hearing aids?
Hearing aids come in several styles suited to different degrees of hearing loss and personal preferences. Behind-the-ear (BTE) and receiver-in-canal (RIC/RITE) styles sit behind the ear and are the most versatile, accommodating mild to profound hearing loss. In-the-ear (ITE) and in-the-canal (ITC) aids are custom-molded and fit within the outer ear or canal. Completely-in-canal (CIC) and invisible-in-canal (IIC) devices are the most discreet, sitting deep in the ear canal. At Big Sky Audiology in Billings, your audiologist will factor in your hearing test results, ear anatomy, and lifestyle when recommending a style.
Hearing Loss & Conditions Questions
What is tinnitus, and can it be treated?
Tinnitus is the perception of sound — ringing, buzzing, hissing, or humming — in the ears when no external sound is present. It affects an estimated 15% of adults and is often associated with noise-induced hearing loss or age-related hearing changes. While there is currently no universal cure for chronic tinnitus, several effective management options exist. Hearing aids that amplify ambient sound can reduce tinnitus perception for up to 80% of users. Tinnitus retraining therapy (TRT), sound masking devices, and cognitive behavioral therapy (CBT) are also proven approaches. Big Sky Audiology in Billings offers tinnitus evaluation and management services.
What causes hearing loss?
Hearing loss has many possible causes. Age-related hearing loss (presbycusis) is the most common, gradually affecting the ability to hear high-pitched sounds. Noise-induced hearing loss from repeated exposure to loud environments — such as farming, construction, or recreational shooting, all common in the Billings area — is the second leading cause. Other causes include earwax buildup, ear infections, certain medications (ototoxic drugs), head or ear trauma, hereditary factors, and conditions like Meniere’s disease. A thorough evaluation by an audiologist helps identify the type and likely cause of your hearing loss so the right treatment can be recommended.
What are the types of hearing loss?
There are three main types of hearing loss. Sensorineural hearing loss results from damage to the hair cells in the inner ear or the auditory nerve and is the most common type in adults — it is typically permanent but very treatable with hearing aids or cochlear implants. Conductive hearing loss occurs when sound cannot pass efficiently through the outer or middle ear due to earwax, fluid, or a structural problem — it is often medically or surgically treatable. Mixed hearing loss is a combination of both types. An audiologist in Billings can determine which type you have through a full hearing evaluation.
At what age should children have their hearing tested?
Newborn hearing screening is standard in Montana hospitals and should be completed before a baby leaves the hospital. If your baby did not receive a newborn screening, or if there are concerns about speech and language development, an audiological evaluation should be scheduled as soon as possible — hearing loss caught early leads to significantly better developmental outcomes. School-age children should be screened periodically, and any child who shows signs of not hearing normally — such as inattention, speech delays, or not responding to their name — should be evaluated by an audiologist promptly.
Can hearing loss be prevented?
Noise-induced hearing loss is largely preventable. The most effective strategies include wearing properly fitted hearing protection (earplugs or earmuffs) in loud environments, limiting exposure time to high-decibel situations, and keeping headphone and earbud volume at 60% or less. In Billings, where hunting, farming, and outdoor recreation are common, protecting your hearing during these activities is particularly important. Avoiding ototoxic medications when alternatives exist and treating ear infections promptly are also helpful steps. Annual hearing evaluations allow early detection before significant loss occurs.
Why does untreated hearing loss matter beyond just missing sounds?
Untreated hearing loss has well-documented connections to broader health outcomes. Research consistently links it to increased risk of cognitive decline and dementia, social isolation, depression, anxiety, and reduced quality of life. When the brain receives less auditory input over time, it must work harder to process speech, which can accelerate mental fatigue. A landmark Johns Hopkins study found that treating hearing loss with hearing aids significantly slowed cognitive decline in older adults at high risk. Addressing hearing loss early — rather than waiting until it becomes severe — is one of the most impactful steps a person can take for long-term brain health.
Living With Hearing Aids Questions
How do I clean and care for my hearing aids?
Daily maintenance extends the life and performance of your hearing aids significantly. Each evening, wipe the aids with a dry, soft cloth and use a small brush to remove earwax from the microphone ports and receiver tip. If your aids use disposable batteries, leave the battery door open overnight to reduce moisture buildup. Store aids in a dry-aid kit or electronic dehumidifier — particularly important given Billings’ humid summer months. Avoid exposing hearing aids to water, hairspray, or extreme temperatures. Bring them to Big Sky Audiology for professional deep cleaning every three to six months.
How long does it take to adjust to hearing aids?
Most new hearing aid wearers notice significant improvement in the first few weeks, but the brain takes time to relearn how to process sounds it has been missing — typically four to eight weeks for a comfortable adjustment. During this period, everyday sounds like refrigerator hum or your own voice may seem surprisingly loud at first. Your audiologist at Big Sky Audiology in Billings will schedule follow-up visits to fine-tune programming as your brain adapts. Wearing your aids consistently every day during this period, rather than only occasionally, is one of the most important factors in a successful adjustment.
Can I try hearing aids before I buy them?
Yes—at Big Sky Audiology in Billings, Montana, once your hearing aids are selected and professionally fit, we guide you through a 45-day adjustment period so you can experience hearing aids in your everyday environments.
Advanced Hearing Services Questions
What is a cochlear implant, and who is a candidate?
A cochlear implant is a surgically implanted electronic device that bypasses damaged hair cells in the inner ear and directly stimulates the auditory nerve with electrical signals. It is an option for adults and children with severe to profound sensorineural hearing loss who receive limited benefit from traditional hearing aids. Unlike hearing aids, cochlear implants require surgery and a rehabilitation process to learn to interpret the new sounds. Big Sky Audiology in Billings offers cochlear implant evaluation and post-surgical audiological programming and follow-up care as part of its hearing implant services.
What is a bone-anchored hearing device (BAHA)?
A bone-anchored hearing device (BAHA or BAHD) transmits sound vibrations through the skull bone directly to the inner ear, bypassing the outer and middle ear entirely. It is an effective option for people with conductive hearing loss, single-sided deafness, or those who cannot wear conventional hearing aids due to chronic ear infections or abnormal ear canal anatomy. Like cochlear implants, bone-anchored devices involve a minor surgical procedure. Big Sky Audiology provides hearing implant services including evaluation and candidacy assessment for these devices.
What is a balance or vestibular evaluation?
The inner ear controls both hearing and balance. A vestibular evaluation assesses the inner ear’s role in balance and spatial orientation, helping identify conditions like benign paroxysmal positional vertigo (BPPV), Meniere’s disease, vestibular neuritis, or labyrinthitis. Tests may include videonystagmography (VNG), which tracks eye movements in response to different head positions or temperature changes in the ear canal. Big Sky Audiology in Billings offers vestibular and balance evaluations, giving patients a comprehensive picture of their inner ear health and guiding referral to appropriate specialists when needed.
What is earwax removal, and when should I see an audiologist for it?
Earwax (cerumen) is a natural, protective substance produced by the ear canal. In some people, it accumulates faster than it naturally clears, causing muffled hearing, a feeling of fullness, ear pain, or ringing. At-home removal attempts with cotton swabs can push wax deeper and cause injury. Big Sky Audiology in Billings offers professional ear cleaning using safe clinical methods such as irrigation or microsuction. If you wear hearing aids — which can accelerate wax buildup — scheduling regular professional cleanings every six to twelve months is a sound practice.
