Over my nearly 30 years of clinical practice, nearly all hearing aids have been dispensed under the same sales model, directly from a provider’s office. One of the drawbacks of this model is the time and commitment it takes to get to the provider’s office, which is only amplified by COVID-19.
This is where a company like Eargo comes in. A true disrupter in the hearing aid space, Eargo puts the entire process online, so you can take a hearing loss test and start the process of getting a hearing aid whenever and wherever you want.
For this year’s review, I took Eargo’s online hearing test, spoke with their head audiologist for about an hour, and had several interactions with their support staff. I found a lot of what Eargo is doing to be very helpful and innovative, and they were kind enough to provide us with samples of their product for this review.
Eargo is not for people with severe hearing loss or people who need Hearing Assistive Technologies1 like telecoil, but as you’ll see below they have done a nice job focusing their product on first-time users with early-onset hearing loss. And I give them a thumbs-up for price and convenience. Let’s start by going through Eargo’s online hearing test!
Eargo uses an online hearing test to screen potential candidates. I like that the test uses speech alongside background noise, which is more “real world” than a traditional hearing test that uses “beeps” in silence. However, the online test may be less accurate if a person has a central processing difficulty, such as those with head injuries or some degenerative cognitive disorders.
I took their online hearing test twice. I know that I have a very slight high-frequency hearing loss in both ears as tested in a traditional testing booth. The first time, the test suggested I had a serious deficit. I spoke with their in-house folks who indicated they knew about it and were working on it. I took the test about a week later and the results much more closely match what I know my hearing levels to be. Here is a screenshot of my results.
I like this “thermometer” display because it’s very easy to understand. It’s a bit counter-intuitive at first glance because my “loss” is on the top. However, this makes sense if you’ve ever seen a standard audiogram which plots normal hearing on the top and severe hearing loss near the bottom. In the example above, my hearing isn’t perfect, but it’s only a little “not-great” suggesting that I’m probably not quite ready for hearing aids.
Because Eargo has defined their niche very well, they can easily recommend which of several “stock” settings will work for you. With a combination of an online hearing test and extensive interactive interviews, their remote hearing care professionals select the configuration most likely to meet your needs and ship the devices and charger to you. You can adjust further once you get the device.
For their mid and top tier products, a smartphone app allows even further adjustments. If you’d rather have an expert assist you, Eargo offers the option to remotely program the devices in a “telemedicine” framework. This live or “synchronous” type of telehealth is, in my experience, is also different than the typical manufacturer.
During my conversation with their in-house folks, I pressed them about what happens if a person is not quite right for the predetermined configurations. They were quite clear that they only want to fit folks who will succeed and refer those falling outside of their lane to a partner audiologist for a more traditional hearing evaluation. If someone is on the fence, they may require a copy of a traditional hearing test before making a final determination of candidacy.
Shortly after my conversations with the EARGO audiology team, they were kind enough to send me a pair of Neo HiFi hearing aids to try out. The pre-delivery communication was very good, including a suggestion to have my ears cleaned so that wax wouldn’t interfere with the fitting.
I also got shipping updates and delivery confirmation.
The packaging is well designed and efficient. One of my pet peeves is over-boxing. EARGO’s box is just big enough to hold all the components and documentation.
The build quality of the charger and devices themselves is not only a rugged feeling but well designed in terms of both ergonomics and visual design. They look cool and technologically current. The devices themselves are very small, but the Right/Left markers are very large and clear, which is great. In my nearly 30 years of fitting hearing aids, one of the most common issues with new users is getting them in their ears correctly so this is a big help.
One I got the EARGOs unpacked, I downloaded and installed their smartphone app (I use an Android device, but it’s also available for Apple products). Very straight forward workflow. Below are a few screenshots to give you the idea. Overall, I found the app to be intuitive, clean in its design, and most importantly, functional. I was able to connect and set up the hearing aids in under 10 minutes.
|Setup begins with the standard acceptance of terms and conditions. I actually read them and found them reasonable. If you want, you can check out the app features, or jump right in and connect the charger. This creates a link between your app and the charger, which in turn, communicates with the hearing aids.||When the charger is found, it displays blue lights. This is a helpful verification that you're connected to the correct charger in case there are multiple users in the house.||This screen starts you on your way to configuring your hearing aids.|
|Here's a sample of the info screens detailing different functions of the Eargos. Again I like the clean design.||Next, you can try out each present and adjust as needed. Based on the discussions I had with Eargo, the majority of folks with early-onset hearing loss will find one that works and be able to adjust the tone control to sound acceptable.||After you've adjusted everything to your liking, place the devices into the charger and save the update. You'll get the following confirmation screen. And that's it.|
This process can also be used to have one of Eargo’s on-line audiologists further fine-tune your devices if, after wearing them for a few weeks, you still have trouble. This is, in my opinion, a very good balance of support and independence. I always strive for my patients to take ownership of their hearing loss rehabilitation. If I’m the only one who can adjust their devices, I find many are less “bought-in” because all the good and bad are on me, the dispenser.
Eargo’s approach will likely be best for younger folks (under 65) who have grown up with technology and tend to be more DIY (Do It Yourself) than the generation before. That said, it appears that Eargo provides enough support for even those folks if their hearing loss is within the fitting range.
The Eargo comes in three levels of technology and price all built on the same physical platform.
The Eargo Max is designed to be an affordable, “entry-level” device for people with mild to moderate, mostly high-frequency hearing loss. Because it was designed for this type of loss, there is very little low frequency (bass) response. This seems like a negative, but in my opinion, it’s OK. As long as the pre-fitting interview and test correctly identify the client’s hearing loss shape, there is no reason that this frequency response will be a limiting factor. That said, the major downside to this hard limit is that it doesn’t allow for any significant changes in hearing over time. If we look at the typical trajectory of hearing loss, where low and mid-speech frequency (500 Hz to 2000 Hz) changes faster for males than higher frequencies, this may limit the useful life of the Eargo Max1
The Eargo Neo is the “mid-range” product in the lineup. The physical form factor is essentially the same, but the digital amplifier is newer and allows for more fine-tuning as well as compatibility with the Eargo Mobile App.
The top tier Eargo is the Neo HiFi. Like the Neo, it uses the newer internal circuit, is compatible with the mobile app, but offers a wider frequency response, allowing it to fit people with more hearing loss in the very high frequencies.
Extra Flexi Palms, chargers, and wax guards are all available to be purchased as accessories on the Eargo website.
Every Eargo customer is paired with a personal hearing professional who will provide you with lifetime support. You will receive a welcome call when you first get your hearing aid so that all hearing aid functions can be explained to you. You can also reach out to this person for however long you have the hearing aid. Consultations and hearing checks are done remotely from the safety of your home.
There are video tutorials available online 24/7 as well as a customer service line that is staffed Monday-Friday from 9 AM – 9 PM EST.
All hearing aids come with a 45-Day Easy Return policy if you're not 100% satisfied. This is longer than most state’s compulsory 30-day return option, which I like, especially given the inherent limitations of the way the Eargo was designed.
Eargo is a very interesting “disruptive” technology in hearing aids. While not the first “stock” in the ear hearing aid, their ability to provide an acoustically non-occluding “open” fit, rechargeability, and synchronous remote programming make it a product to at least look at.
Eargo has done a good job in my opinion of focusing their product features and configurations to the majority of first-time users with early-onset hearing loss.
I give them a thumbs up for price and convenience. I like that their online test was speech-based and used background noise, and it appears that the initial issues with the test have been corrected.
They appear to have good folks on the support side. Several folks there were very helpful with me during my inquiries.
Eargo is not appropriate for more severe hearing loss or folks who rely on Hearing Assistive Technologies like telecoils, remote microphones, and media streaming, but certainly worth looking at if you’re in the early stages of hearing loss. Check out my interview with Jeff Hoyt on that below.
The Journal of the Acoustical Society of America 88, 813. (1990). Age changes in pure‐tone hearing thresholds in a longitudinal study of normal human aging.
As a practicing audiologist since the 1990’s, Brad Ingrao, AuD has fitted thousands of hearing aids to seniors and people of all ages. Brad is the Official Audiologist for the International Committee on Sports for the Deaf and a well-known speaker. Dr…. Learn More About Brad Ingrao