The Best Hearing Aids for Severe and Profound Hearing Loss

February 8, 2024
Amy Sarow, AuD, CCC-A
Written by
Amy Sarow, AuD, CCC-A
Amy Sarow, AuD, CCC-A

Dr. Amy Sarow is a practicing clinical audiologist and serves as Audiology Lead for Soundly. Her expertise and experience span topics including tinnitus, cochlear implants, hearing aid technology, and hearing testing. She holds a doctoral degree in audiology from the University of Iowa. During her residency at Mayo Clinic, Dr. Sarow was inspired by the three-tiered, patient-centered approach, incorporating clinical work, teaching and research.

Soundly Staff
Reviewed by
Soundly Staff
Soundly Staff

Soundly conducts in-depth research to guide prospective hearing aid wearers. Our work is funded through reader support. When you buy through our links, we may earn a commission.

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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.

Which hearing aid style is best for severe hearing loss?

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: 

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 Photo
ReSound NEXIA BTE
Auracast-ready BTE

ReSound NEXIA BTE

ReSound NEXIA BTE

Listen to a demo
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RECHARGEABLE
BEHIND THE EAR
FIND MY HEARING AIDS
BLUETOOTH
REMOTE PROGRAMMING
SMARTPHONE CUSTOMIZATION

ReSound is known for their user-friendly, innovative hearing technology, ensuring that users stay connected to their world without interruption. Additionally, the ReSound Tinnitus Relief app offers soothing sounds, providing users with personalized support.

For individuals seeking a perfect balance between robust design and advanced technology, the ReSound NEXIA BTE model checks both boxes. Equipped with state-of-the-art features, these BTE hearing aids boast noise-cancellation capabilities and a broad range of customizable settings, making them ideal for people navigating complex listening environments. Users love the intuitive ReSound app, which transforms their Smartphones into a sophisticated remote control, granting them the autonomy to adjust their hearing preferences discreetly and in real-time.

Soundly Scorecard
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Pros
  • Auracast-ready
  • Seamless accessories for additional support: TV streamer, Multi Mic, Phone clip, and more
  • Made for iPhone and Android compatible
  • “Find My Hearing Aid” app feature
  • ReSound devices are compatible with Cochlear Americas
  • CROS compatible
Cons
  • Hands-free calls are not available for Android (phone mic will pick up your voice)
  • No fitness tracking options
Read Our Full Review 👉
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woman wearing phonak hearing aid
Phonak Naída Paradise
Best Bluetooth Connectivity

Phonak Naída Paradise

Phonak Naída Paradise

$2,798 - $4,598 / pair
Listen to a demo
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Behind the Ear
Bluetooth
Professional Fitting
Rechargeable (and disposable available)

This hearing aid features multi-channel and directional microphone systems that improve speech clarity and provide better sound quality. Its advanced features include wind-noise reduction and Bluetooth connectivity.

Overall notes: Phonak Naída Paradise is a great option for individuals with moderate to severe hearing loss who like to stay connected to their Bluetooth devices. Especially for Android phone users, Phonak works very well. The Naída Paradise has the amplification you need with the sleek style and connectivity options you want. 

Features: Rechargeable, Bluetooth and hands-free calling, behind the ear style, motion sensors, smartphone app customization, and remote programming available.

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Pros
  • Bluetooth Classic allows you to connect to any Bluetooth device for amazing connectivity
  • Good option for Android users
  • Roger technology is a fantastic, compatible assistive device for Phonak hearing aids
  • Hands-free phone calls and a tap control feature to answer phone calls (tap control is available with Phonak P-PR)
  • Compatible with Advanced Bionics cochlear implants
Cons
  • 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
See the latest Phonak Naída Paradise Pricing
See Prices
Oticon Real BTE
Oticon Real (BTE)
Best Wind Management

Oticon Real (BTE)

Oticon Real (BTE)

$3,198 - $4,798 / pair
Listen to a demo
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Behind the Ear
Bluetooth
Professional Fitting
Rechargeable (and disposable available with telecoil)

Oticon's Real is the latest flagship from the brand. Oticon Real is one of the most popular receiver devices on the market and the brand also offers a powerful BTE design for those with severe hearing loss. The Oticon hearing aid employs AI technology to amplify speech cues and filter out background noise, all while preserving the sound scene around you. Oticon Real puts a special focus on reducing wind noise.

Note that users with profound hearing loss may need to opt for Oticon Xceed. Exceed lacks some of the latest features that are available in Oticon Real devices.

Overall notes: Oticon is known for their Brain Hearing approach to sound processing, and the Real delivers an open sound quality to allow you to take in your surroundings. Oticon products are great for those who like to keep it simple.

Features: Rechargeable, behind the ear style, Find My Hearing Aid, Bluetooth, remote programming, and smartphone app customization.

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Pros
  • Options for CROS hearing aids
  • Convenient charger is easy to handle for patients with dexterity concerns
  • Rechargeable batteries can be changed directly in your hearing aid clinic (meaning no need to wait for it to come back from repair)
  • Popular among musicians or music lovers
  • New update allows for hands-free phone calls (iPhone 11 and up)
  • App is easy to use and has a "find my hearing aid" feature

Cons
  • While Oticon has great sound quality, the software an app don’t allow for as much customization as other hearing aid manufacturers
  • Phone call quality for the listener on the other end is not always clear

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Signia Motion BTE
Signia Motion Charge&Go
Best Battery Life

Signia Motion Charge&Go

Signia Motion Charge&Go

Listen to a demo
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Behind the Ear
Bluetooth
Professional Fitting
Rechargeable (and disposable available with telecoil)

The hearing aid features Signia's split processing for a better listening experience in noise and can be personalized based on the wearer's preferences with their AI feature in the app. It also boasts an impressive rechargeable battery with a lifespan of 61 hours.

Overall notes: Signia offers a range of hearing aid styles, chargers, and products to match your preferences and needs. Their Motion BTE works hard to detect your listening situation and apply the best settings for your needs at every point in time. The Signia Assistant makes it easy to further customize your settings when you need it. 

Features: Rechargeable, behind the ear style, Find My Hearing Aid, motion sensors Bluetooth, remote programming, and smartphone app customization.

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Pros
  • Signia's split processing has great sound quality and background noise reduction
  • Portfolio includes digital hearing aids for mild to severe hearing loss and also profound hearing loss
  • Chargers come in convenient travel options or chargers that also disinfect or dehumidify
  • Their rechargeable custom hearing aids are convenient and easy to charge even for those with dexterity concerns
Cons
  • No hands-free calls or tap control
  • Signia devices through TruHearing have more frequent quality control issues
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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.

Starkey Genesis AI Custom
Best Custom Invisible Hearing Aids

Starkey Genesis AI Custom

Starkey Genesis AI Custom

As Low As $2,998 / Pair
In the Ear
Professional Fitting
Rechargeable
Bluetooth

Starkey is a U.S.-based manufacturer with a full line of hearing aids that includes behind the ear and in-the-ear styles. They make the list for their elite status in custom molded (nearly invisible products). If you can afford to pay medical-grade prices and want an invisible style, you won’t be disappointed by Starkey.

Starkey is known for intelligent features like fitness tracking, a virtual assistant, and the smallest Bluetooth hearing aid on the market.

  • Overall Notes: Starkey Genesis AI is broadly considered the best for custom mold hearing aids. If you want a custom mold, and lead an active lifestyle, this product is a great choice.
  • Price: The national average price for Starkey Genesis Custom hearing aids is $6,443 per pair. Our research indicates that you can get Starkey Custom devices for as low as $3,198 for a pair. Click here for more on prices.
  • Features: Full range of styles and features including Bluetooth, rechargeability, and fitness tracking for larger devices.
  • What audiologists say: “Starkey has been making the smallest and best custom hearing aids for decades. Genesis AI is currently the smallest custom device on the market with Bluetooth streaming capabilities.” - Ramsay Poindexter, AuD
Pros

Smallest models are almost entirely invisible

Starkey is a leader in comfortable custom molded products

Larger sizes come with Bluetooth streaming and rechargeable batteries

Cons

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 Bluetooth enabled or rechargeable

Get the full Starkey Genesis breakdown 👉
Learn More
Phonak Virto Paradise
Most Innovative Design

Phonak Virto Paradise

Phonak Virto Paradise

$4,598
In the Ear
Professional Fitting
Bluetooth
Rechargeable

Phonak custom devices are often applauded for their stylish design aesthetic. If you choose a custom hearing aid from Phonak, you can select an entirely invisible titanium model or an earbud size version that comes with a Bluetooth connection.  

Overall Notes: When it comes to top-of-the-line custom molded products, two brands compete for the top spot. Starkey and Phonak. If the winner gets selected on style, then Phonak wins. If you want a custom-molded hearing aid that looks tech-forward and you can swing the price, Phonak Virto Paradise is a fantastic choice.

Price: Starting at $3,850 through Zip Hearing (walk-in prices $6K-$8K)

Features: Phonak Virto hearing aids come in an invisible style (without Bluetooth) and larger half shell size (with Bluetooth)

What audiologists say: “Phonak Virto has an impressive set of features packed into a small, modern aesthetic. Ask your audiologist if it's appropriate for your hearing, but if it is you'll be satisfied.” - Garrett Thompson, AuD

Pros

Tiny sized invisible product

Rechargeable and Bluetooth enabled half-shell product

Fully customizable by your hearing professional

Cons

Premium price point starting at $3,850

Invisible style requires battery changes every 4-6 days

Access pre-negotiated pricing from Zip Hearing and save 25%-40%
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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.

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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.

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