Imagine the sound of a vacuum cleaner as just barely audible. Normal conversation is impossible to understand without lipreading. Do you—or someone you know—experience severe hearing loss?
As an audiologist, I work with patients who experience various degrees of hearing loss. In the US, approximately 44 million have hearing loss and of those an estimated 15 million adults aged 20 and over have at least a moderate hearing loss.
Those with severe hearing loss require an appropriate fit for their hearing aids to assist them to hear their best. Severe hearing loss means that normal conversational volume is inaudible, making it nearly impossible to communicate without relying on visual cues. Therefore, for anyone with severe hearing loss, choosing the right hearing aid is crucial.
You've Got Options
Fortunately, modern technology has advanced to a point where hearing aids can improve communication with others with customization to your needs. Many of the latest hearing aids (including those for severe hearing loss) now have Bluetooth, rechargeable batteries, and advanced background noise management.
When it comes to considering the best hearing aids for severe hearing loss, there are points to consider:
- You will likely need earmolds or a custom-molded device
- Not every style of hearing aids will offer you full benefit
- We recommend you work with a licensed audiologist due to the level of customization and experience needed
In this comprehensive guide, I will share my professional knowledge and experience to help you choose the best hearing aids for severe hearing loss. We'll explore earmolds, hearing aid styles, cleaning tips, and the top hearing aids that can make all the difference in your life.
- The best hearing aid options for severe to profound hearing loss are behind-the-ear or BTEs (the most popular) and in-the-ear or ITE style hearing aids.
- For either style, your provider will usually take an ear impression to create your earmold or custom hearing aid.
- CaptionCall is a no-cost option to help those with hearing loss who need captions for phone calls. Fill out the form here.
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Best Hearing Aids for Severe Hearing Loss
Let's get into some of my favorite products for anyone with severe hearing loss. While all of the products below are high-quality and appropriate for severe hearing loss, your preferences and lifestyle will determine your best option.
I've broken the products into two groups: BTE and ITE.
We'll start with my favorite behind-the-ear devices. 👇
ReSound NEXIA BTE
- ReSound NEXIA's BTE hearing aid has more power for severe and profound hearing loss
- Auracast-enabled for seamless Bluetooth streaming, developed in collaboration with Bluetooth SIG
- Impressive 30-hour battery life on a single charge, ideal for all-day wear
- Strong performance in background noise, enhancing clarity in busy environments
- Custom prescription programming provided by a local audiologist
ReSound Nexia stands out for its legacy of innovation and modern design. Here’s what makes it a top pick:
- Proven Expertise: ReSound has led the hearing aid industry with tech-first developments, from the earliest made-for-iPhone hearing aids to today’s Auracast-enabled models. With millions of users worldwide, ReSound brings trusted experience and reliability.
- Accessory and Cochlear Compatible: ReSound NEXIA BTE hearing aids are compatible with ReSound accessories like Multi-Mic and TV Streamer. ReSound NEXIA hearing aids are also compatible with Cochlear Americas.
- Superior Background Noise Handling: NEXIA's advanced beam-forming tech and innovative in-ear microphone deliver exceptional clarity in noisy environments, making it one of the best in the market for handling complex soundscapes.
ReSound NEXIA combines sleek design with high-performing technology, ideal for those who want both discretion and power.
ReSound NEXIA receives strong reviews for its crisp sound quality. Some users note issues with Bluetooth connectivity on Android devices and slight discomfort from the in-ear M&RIE receiver. Read more reviews via our partners at ZipHearing.
- "I had gotten so used to diminished hearing, I had no idea what I was missing. I no longer say “can you repeat that” or “what?” And my phone rings in my ear and all I have to do is tap the unit behind my ear. No more fumbling to get me phone out of my pocket in time to answer." - Richard
- "I love my new Resound Nexia 9. They seem to pick up sounds my previous 5-year old hearing aids picked up and they seem to process background noise much better. I am very happy with my purchase." - Mitch
- "My new Nexia “ears “ are very comfortable behind the ears. They seemed very loud at first but I have adjusted and are obviously better than my old “ears” . The sound is clear and less tinny . I can hear a phone conversation very clearly using the Bluetooth ability, although I still need my phone very close for the caller to hear me. After a day of wearing my “ears” the left one hurts, I think from the wire, however I have not had a follow up appointment so that may be fixable. The right side is no problem." - Fiona
- "The rechargeable battery is a HUGE plus—no more keeping batteries on me at all times. The moisture resistance is another plus—no more bulky desiccant case. The charging case is small enough to be easily portable, but might be a bit uncomfortable in a pocket—maybe in a jacket pocket. It took me a few days to figure out a good workflow for getting the hearing aids to connect and stay connected to my Pixel 5 (listed on the manufacturer's website as compatible). The connectivity is good when it works but sometimes one of the hearing aids drops out and has to reconnect. I was not able to get them to connect to my work computer (a MacBook) using MFi." - Matt
- Powerful, clear sound for severe and profound hearing loss
- Great for background noise management
- Cochlear Americas compatible
- 30-hours of battery life
- Hands free calling for iPhone only Android users must keep their phone close to pick up their voice
- No fitness tracking features
Phonak Naída Paradise
- Multi-channel and directional microphones improve speech clarity and sound quality.
- Advanced features include wind-noise reduction and Bluetooth connectivity for seamless device pairing.
- Ideal for severe-profound hearing loss, especially for Android users who prioritize connectivity.
- Strong amplification and customization options.
- Rechargeable battery, hands-free calling, motion sensors, smartphone app control, and remote programming capabilities.
Phonak Naída Paradise stands out as a premium option for users with severe-profound hearing loss who need robust connectivity and advanced sound features.
- More power: Compared to Phonak's other hearing aids, Naida Paradise has more built-in power and a specialized design for severe and profound hearing loss cases.
- Industry-Leading Manufacturer: Phonak is renowned globally for its expertise in handling complex sound environments, providing excellent background noise management and speech clarity.
- Bluetooth Connectivity: Ideal for Android and iPhone users alike, Naída Paradise enables hands-free calls and seamless audio streaming for an effortless user experience.
- Advanced Features: With integrated motion sensors, wind-noise reduction, and remote programming via a smartphone app, this model combines convenience and cutting-edge functionality.
- Rechargeable Convenience: The behind-the-ear style is both sleek and practical, offering powerful sound and a rechargeable battery—ideal for those seeking reliability and ease of use.
Overall, Naída Paradise is a top choice for those who want high-powered and high-quality sound.
- Compatible with Advanced Bionics cochlear implants
- Compatible with Phonak's Roger Microphone technology (clip on mic for partners and classrooms)
- Powerful sound designed for severe and profound hearing loss
- Bluetooth Classic allows you to connect to any Bluetooth device for amazing connectivity
- Hands-free phone calls and a tap control feature to answer phone calls (tap control is available with Phonak P-PR)
- Slightly Larger than receiver-in-canal devices from Phonak
- Tap control can glitch if you don't hit it correctly
- If you create custom programs they will disappear after your audiologist connects your hearing aids to the software
Oticon Intent
- Advanced four-sensor system tailors sound to your environment for a natural listening experience
- Professionally programmed in-clinic for personalized fit and optimal performance
- Bluetooth LE-ready for future-proofed streaming, including upcoming Auracast functionality
- Sleek, behind-the-ear design in Oticon's smallest form factor for a discreet, comfortable fit
Oticon Intent is one of the most popular hearing aids in the U.S., second only to Phonak, and offers a few standout features.
- First, its wide range of advanced sensors intelligently adapts to different environments, making it excellent at handling background noise. This advanced noise management puts Oticon in a race with just a few brands for the best sound management.
- Second, Oticon Intent’s devices are professionally programmed, providing highly customizable settings tailored to the user's unique hearing profile.
- Oticon Intent offers Bluetooth streaming from iPhone and Android and the ability to use Auracast when it is more widely available.
This combination of popularity, intelligent sound processing, and precise, in-clinic programming makes Oticon Intent one of the best on the market at this time.
Oticon Intent reviews are nearly all positive with most users reporting clear sound and strong underlying performance. Lower than 5-star ratings typically come down to ongoing challenges hearing in tough environments. A few sample reviews from our partners at ZipHearing:
- "I've had these Oticon Intent hearing aids for a couple of weeks now, replacing Phonak Audio Lumity hearing aids. My impression is that I am hearing sibilant sounds slightly better and hearing conversations in restaurants slightly better. Even slight gains mean a lot to me. I have moderate hearing loss in the upper registers (normal in the lower). Anything that improves comprehension is welcome. In addition, the design of these hearing aids makes them more comfortable for me than the Phonaks and I wear them all the time without noticing that they are in except very occasionally feeling a little itching in the left ear, which goes away if I take out the hearing aid for a moment and rub the area. I would recommend these hearing aids to others." - John
- "Certainly like the change of hearing clarity. Very simple to use without making adjustments due to background noises or audiences. Very comfortable and no feedback. Glad I moved forward with Oticon Intent." - David
- "These hearing aids are great for me. I am able to hear with no problem at all. they are just as good or better than another brand that I tried that cost over 3 thousand dollars more. they are doing fine and I use them everywhere. I am outside most of the time and they do fine by staying in and not having to worry about them falling out or getting knocked out of my ear." - Stephen
- "I have been wearing HA for over 10 years. Experience with COSCO and others. Although these took some getting used to, my conversational hearing has greatly improved. My husband and friends have noticed without my asking. Still have to get used to the sound of my own voice - which is strange to me - but patience prevails. The music setting works pretty well such that I have resumed playing piano - which I had abandoned. This was an unexpected element in my hearing impaired world! While no hearing aids can provide total hearing correction, I no longer feel isolated in conversational situations. Thank you to the engineers at Oticon!" - Arlene
- Well balanced and intuitive sound processing
- Bluetooth streaming from Android and Apple devices
- Offered with both rechargeable and disposable batteries
- Oticon Intent hearing aids start at $2,898 and can cost as much as $7,000 with walk in care
- Oticon Intent hearing aids require a visit to an in person audiologist and are not sold online
- Oticon Intent is a fully customizable, prescription hearing aid appropriate for mild-severe hearing loss
- If you have severe hearing loss, your care provider can fit you with a custom earmold to reduce feedback
- If you have profound hearing loss, you may be a better fit for Oticon Xceed
- Oticon Intent is a prescription device fit and programmed by a professional
- After an initial fitting, you can connect with your care provider remotely through the Oticon app
- Oticon Intent comes with a new, smarter operating system. Intent uses Oticon's Deep Neural Network to sort background noise from speech. Many users describe Oticon's sound quality as "relaxed", "natural" and "comfortable."
- The new 4D sensors give a customized listening experience for the user, and potentially enhanced clarity and balance.
- Oticon Intent is a very comfortable product with a wide-variety of possible earmolds, domes, and fits. Oticon Intent sits behind your ear with a receiver (speaker) inside the ear.
- Oticon Intent hearing aids sit behind the ear
- Oticon's smallest RIC hearing aid to date
- Intent comes in 9 colors including chroma beige, silver grey, silver, terracotta, chestnut brown, steel grey, diamond black, olive green, and sky blue
- Intent is only availabe in a rechargeable battery option at the moment.
- The rechargeable version of Oticon Intent gets 20 hours of power on a single 2-hour charge, even with streaming.
- Oticon Intent allows Bluetooth streaming, music listening, and phone calls across all models. iPhone users can take calls hands-free, and compatible Android users will also enjoy hands free calls.
- Oticon Intent uses Bluetooth LE and is Auracast-capable
- Oticon Intent is reasonably easy to handle but does require the wearer to place the hearing aid behind their ear and insert the receiver into the ear (consistent across all behind-the-ear styles)
- Single push button
- Oticon Intent is water resistant with an IP rating of 68
- This hearing aid can withstand dust and water submersion in one meter of water for up to 30 minutes
- Remote care: included in the new Oticon Companion app
- Customization: volume, program change, streaming sound quality (treble/bass), SpeechBooster
- Tinnitus masking: your hearing care provider can create a tinnitus masking program
- Find my hearing aid: available in the app
- Health tracking: not available
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Signia Motion Charge&Go
- Ideal for severe to profound hearing loss
- Tube connection between ear and hearing aid for power
- Bluetooth enabled for seamless streaming
- Rechargeable battery with over 60 hours of power
Signia Motion Charge&Go is a specialized option within Signia’s lineup, designed specifically for individuals with severe to profound hearing loss. While it may be less popular than the Pure Charge&Go model, it’s highly recommended for those who need extra durability and power. Here’s why we picked it:
- Powerful Amplification: Provides exceptional support for severe to profound hearing loss.
- Durable Tube Connection: Uses a stable tube instead of a wire, enhancing durability.
- Bluetooth-Enabled: Supports streaming from smartphones and other Bluetooth devices.
- Extended Battery Life: Rechargeable with over 60 hours of power for worry-free, continuous use.
- Power for severe and profound loss
- Customizable by your hearing professional
- Long-lasting batteries and Bluetooth connection
- Acces to Signia's smartphone apps
- Connects to Signia's accessories
- No hands-free calls or tap control
- Larger than Signia Pure Charge&Go
These are two of my favorite custom-molded in-the-ear devices for severe hearing loss. 👇
Remember, if you have severe hearing loss you may need to opt for a slightly larger in-the-ear style to accommodate your amplification needs.
Phonak Virto Infinio
- Invisible-style or earbud style devices custom molded to your ear
- Advanced tech with noise cancelation and speech enhancement for clarity
- Optional titanium form factor for even sleeker and more durable design
If you’re a Phonak fan who prefers an in-ear device, Virto is a strong choice. Here’s why we picked it:
- Custom Fit: Each Virto is molded to fit your ear canal, providing exceptional comfort and invisibility.
- Enhanced Sound Quality: Equipped with SmartSpeech Technology, Virto adapts seamlessly with AutoSense OS to enhance speech clarity and reduce listening effort across different environments.
- Expert Support: Phonak has a broad network of local experts skilled with Virto, ensuring users receive knowledgeable care for the best results.
- Tiny sized invisible product
- Rechargeable and Bluetooth enabled half-shell product
- Fully customizable by your hearing professional
- Premium price point starting at $3,850
- Invisible style requires battery changes every 4-6 days
- Regardless of size, Phonak Virto Paradise hearing aids are fully customizable, prescription hearing aid appropriate for mild-profound hearing loss
- If you have profound hearing loss, you will want to select the largest Virto model which comes with an higher-powered speaker
- Phonak hearing aids are prescription devices fit and programmed by a professional
- To create your custom hearing aids, a professional will take earmold impressions in a clinic or in your home. They will then send those impressions to the Phonak manufacturing facility where a one-of-one replica will be created for your hearing aids
- After an initial fitting, you can connect the largest half or full-shell wireless models to the Phonak app to receive remote care
- Phonak Virto offers strong underlying sound algorithms consistent with Phonak's Paradise technology platform (Phonak now offers newer tech in their Lumity Receiver-in-Canal products).
- The largest Virto model includes directional microphones to manage complex environments
- Phonak Virto custom-molded devices sit comfortably in the ear. Some users with better hearing in lower frequencies prefer an open-fit behind-the-ear style hearing aid that allows more natural sound to pass into the ear canal
Learn more about the choice between in-the-ear vs. behind the ear styles here.
- Sit inside the ear
- Available sizes include Virto-P Titanium Battery Size 10, Virto-P Battery Size 10, Virto-P Battery Size 312 Non-Wireless, Virto-P Battery Size 312 Wireless
- Available Body colors: Blue, Brown, Pink, Red, Cocoa and Black,
- Available Faceplate colors: Black, Brown, Cocoa, Pink
Phonak Virto hearing aids only use disposable batteries
- Phonak offers Bluetooth enabled and non Bluetooth-enabled options with a size 312 battery (lasts 7-10 days)
- Phonak offers titanium and standard shell options with a size 10 battery (lasts 5-7 days)
- Virto Paradise half-shell and full-shell styles can be equipped with Bluetooth streaming
- Bluetooth models use Bluetooth classic connection and offer hands-free calling for iPhone and Android devices
- Telecoil is optional in all sizes but can not be selected alongside Bluetooth
- All sizes within the Phonak Virto Paradise family require regular disposable battery changes and good dexterity. The smallest sizes are especially difficult to manage due to their smaller size 10 battery.
- All sizes can include an optional push-button, three largest sizes can include an optional volume wheel
- The smallest models of Phonak Virto Paradise have an IP68 rating which means they can sustain 30 minutes of water exposure in up to one meter of water
- Larger 312 models do not include an IP rating
The larger wireless version of Virto Paradise has full access to the Phonak app. Smaller sizes do not have access to the smartphone app.
- Remote care: Available through the Phonak app in coordination with your provider
- Customization: Volume, treble/bass, adjustable custom programs in the app
- Tinnitus masking: Available through your healthcare provider
- Find my hearing aid: N/A
- Health tracking: Tracks length of wear time and step count
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Starkey Signature Series
- Latest custom hearing aid line from Starkey, a leader in custom styles
- Made in the U.S. with options from fully invisible to larger rechargeable models
- Powered by Starkey’s AI-enabled Neuro processor for enhanced background noise management
Starkey's Signature Series leverages a long history in custom hearing aids, even trusted by President Ronald Reagan in the 1980s. Here’s why it stands out:
- Custom Fit: Each Signature Series device is crafted to each user’s ear from an in-clinic ear impression, providing unmatched comfort and discreetness.
- Versatile Styles: From a nearly invisible-in-the-canal (IIC) model to a larger rechargeable style with up to 38 hours of power and IP68 water resistance, the Signature Series offers flexibility to suit different needs.
- American-Made Quality: Starkey is the only major hearing aid manufacturer based in the U.S., combining local innovation with decades of expertise.
Starkey’s commitment to personalized, high-quality hearing solutions has made it a trusted name for generations.
- Smallest models are almost entirely invisible
- Starkey is a leader in comfortable custom molded products
- Larger sizes come with Bluetooth rechargeable batteries
- This is a premium device which costs $3,000-$7,000 per pair
- Custom molds require additional lead time and replacement time
- The smallest version of Starkey Genesis AI customs are not rechargeable
- None of the Signature Series devices are Bluetooth enabled
- Regardless of size, Starkey Genesis AI hearing aids are fully customizable, prescription hearing aid appropriate for mild-severe hearing loss
- If you have profound hearing loss, you may be a better fit for Starkey's BTE-style hearing aids
- Starkey Genesis AI hearing aids are prescription devices fit and programmed by a professional
- To create your custom hearing aids, a professional will take earmold impressions in a clinic or in your home. They will then send those impressions to the Starkey manufacturing facility where a one-of-one replica will be created for your hearing aids
- After an initial fitting, you can connect with your care provider remotely through the Starkey app
- Starkey Genesis AI hearing aids come with robust background noise management features including Starkey's deep neural network that makes up to 80M adjustments per hour to match your environment
- Genesis AI custom-molded devices sit comfortably in the ear. Some users with better hearing in lower frequencies prefer an open-fit behind-the-ear style hearing aid that allows more natural sound to pass into the ear canal.
Learn more about the choice between in-the-ear vs. behind the ear styles here.
- Sit inside the ear
- Available sizes include full-shell, half-shell, completely-in-the-canal, invisible-in-canal
- Starkey offers 5 colors including black, pink, light brown, medium brown and dark brown
- Starkey's IIC style is on our list of the best invisible hearing aids available
- Starkey's half-shell and full-shell models are rechargeable with up to 36 hours of battery life
- Starkey's completely-in-canal and invisible-in-canal models use a size 10 disposable battery (lasts 5-7 days)
- Genesis AI offers Bluetooth streaming in full-shell and half-shell models
- Genesis AI does not offer Bluetooth streaming for completely-in-canal (CIC) or invisible-in-canal (IIC) models
- iPhone users can take calls hands-free, while Android users must keep their phones close to pick up outbound audio.
- Genesis AI devices use Apple's MFI connection and Android's ASHA connection to stream content through Bluetooth
The larger, rechargeable models of Genesis AI custom-molded hearing aids are reasonably easy to handle, while the smaller, disposable battery-powered models require more dexterity.
- All models have a single piece that sits in the ear vs. RIC styles with a piece in and behind the ear
- Larger sizes include a push button, while smaller sizes do not
- Rechargeable models use port charging vs. conduction charging (slightly more challenging to handle)
- The smallest sizes require regular battery changes (requires good dexterity)
- Starkey Genesis AI are water resistant with an IP rating of 68
- This hearing aid can withstand dust and water submersion in one meter of water for up to 30 minutes
- Remote care: available through the app with care provider coordination
- Customization: Edge Mode and adjustments in the app
- Tinnitus masking: programs can be created by your hearing healthcare provider
- Find my hearing aid: yes
- Health tracking: activity tracking
Note that Starkey's CIC and IIC sizes do not come with connection to the Starkey app.
Which hearing aid style is best for severe hearing loss?
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For severe hearing loss, there are two hearing aid style options that work well: a custom ITE or a BTE hearing aid.
So let's talk more about how to know which one you should get.
Hearing Aid Styles
There are different kinds of hearing aids available and as an audiologist, I recommend patients select one that suits their lifestyle and needs.
The two main types of hearing aids available for severe hearing loss are custom molded hearing aids that sit in the ear (ITE) and behind-the-ear (BTE) hearing aids.
Custom hearing aids are made from an earmold that is tailored to fit into the wearer's ear canal snugly. BTE hearing aids feature a small device that rests behind the ear and is connected to an earmold that sits inside the ear.
Let's take a closer look at these styles.
Behind-The-Ear (BTE) With Custom Earmolds
Most wearers with severe hearing loss opt for a behind-the-ear (BTE) style device. BTE devices typically come with a custom-molded piece that fits the ear. Earmolds are typically made from silicone or acrylic materials and prevent sound from leaking out and creating feedback.
Some quick points on how earmolds work:
- Earmolds are specially made to fit the exact shape of your ear
- Earmolds enable the hearing aid to pick up sound accurately
- Earmolds create a tight seal that prevents sound leaking and feedback
To get the perfect fitting earmold, you'll see your healthcare provider to have an ear impression made. They'll recommend a style, such as skeleton or full shell, and then you can select a color (clear or a fun color, if you prefer). Next, the impression is sent off. After a few weeks you'll come back to get fit with your earmold and hearing aid.
Nowadays BTE hearing aids include Bluetooth, smartphone app features, and rechargeability. You will find several of our favorite BTE devices below.
I recommend BTEs for most patients with severe hearing loss for all of these reasons. However, if there are dexterity challenges or petite ears, a custom molded in-the-ear hearing aid may work better.
In-The-Ear (ITE) Custom Molded To Your Ear
An in-the-ear—also called an ITE—is a good option for patients with petite ears, glasses, or dexterity challenges.
For some, having one piece can be more manageable and easy to insert than putting a piece behind the ear and an ear mold in the ear canal.
Another reason patients often ask about custom hearing aids is the desire for a discreet option.
One note here is that custom hearing aids range in size. However, severe hearing loss usually requires a larger sized custom device, such as an ITE or ITC. (FYI: An IIC or invisible hearing aid is the smallest style but not the best option for severe hearing loss due to its lack of power.)
Some manufacturers, such as Signia and Starkey, offer rechargeable ITEs for those who prefer to avoid traditional batteries. More on that below:
Having trouble on the phone? Consider a caption phone.
For individuals with hearing loss and difficulty on the phone, a caption phone can be a great help. The process is easy to get started with CaptionCall. You can either fill out an online form or call (833) 691-1600 to start the process. Read more about caption phones in our guide here.
Final Thoughts
Choosing the right hearing aid for severe hearing loss can be a daunting task, but the key is to understand your individual requirements, lifestyle, and budget.
Whether you prioritize Bluetooth connectivity, customization, noise management, or battery life, a multitude of high-quality options are available. Phonak Naida Paradise, GN ReSound ENZO, Oticon Real, and Signia Motion Charge&Go all offer unique features that cater to different user needs. In-the-ear options like Starkey Genesis AI and Phonak Virto can also get the job done and fit your lifestyle.
If you need more help, consult with your healthcare provider, discuss your specific needs and preferences, and explore Soundly's other resources to make an informed decision. Remember, the best hearing aid is the one that fits your life and hearing loss properly.
