Bluetooth Connectivity Guide for Hearing Aids

Master wireless streaming from your phone, TV, and devices while understanding compatibility, troubleshooting common issues, and preparing for emerging technologies.

Understanding How Bluetooth Works in Hearing Aids

Bluetooth hearing aids don't work like typical Bluetooth devices, and understanding this distinction is the key to successful connectivity. When you pair wireless headphones to your phone, you're using what's called "Bluetooth Classic"—the standard protocol that's been around for decades. Hearing aids, however, require constant, energy-efficient connections that won't drain tiny batteries in a few hours.

Why hearing aids use specialized Bluetooth protocols

Standard Bluetooth would deplete hearing aid batteries in just a few hours of streaming. Hearing aids need to maintain wireless connections all day while preserving battery life for amplification and signal processing. This led to the development of specialized, low-energy Bluetooth protocols specifically designed for hearing devices. These protocols reduce power consumption by up to 80% compared to standard Bluetooth while maintaining high-quality audio streaming.

Modern hearing aids use digital signal processing to convert audio signals from your connected devices into personalized sound tailored to your specific hearing loss. This happens in real-time, with sophisticated algorithms adjusting frequency response, compression, and noise reduction—all while maintaining the Bluetooth connection. The result is audio that's not just louder, but actually clearer and more intelligible than what you'd hear through regular headphones.

The three main Bluetooth protocols for hearing aids

Understanding which protocol your hearing aids use matters tremendously for compatibility and functionality. Here's what you need to know about each one:

• Made for iPhone (MFi): Apple's proprietary protocol, introduced in 2014, allows direct streaming from iPhone, iPad, and iPod touch to compatible hearing aids. MFi uses Bluetooth Low Energy and integrates directly into iOS accessibility settings, providing stable connections and hands-free calling on newer iPhone models (iPhone 11 and later). This protocol is extremely reliable and offers native control through your phone's settings without requiring a separate app for basic functions.
• Audio Streaming for Hearing Aids (ASHA): Google developed ASHA as the Android equivalent to MFi, launching it with Android 10 in 2019. ASHA-compatible hearing aids can stream directly from Android phones running Android 10 or later with Bluetooth 5.0 or higher. The protocol provides energy-efficient streaming similar to MFi, though historically it hasn't supported two-way audio for hands-free calling (you hear the caller through your hearing aids but must speak into your phone). Many newer Android devices and hearing aid models are addressing this limitation.
• Bluetooth Classic: Some hearing aids use standard Bluetooth Classic, which offers wider compatibility with various devices including both iPhones and Android phones. This approach often requires a companion device (sometimes called a streamer or intermediary device) that acts as a bridge between your phone and hearing aids. While this adds a piece of equipment, it provides universal compatibility and often supports two-way audio for hands-free calling on both platforms.

Pairing Your Hearing Aids: iPhone and Android

Pairing procedures differ significantly between iPhone and Android devices, and following the correct steps for your specific setup is essential for success. The good news: once you've successfully paired your hearing aids the first time, they'll typically reconnect automatically whenever they're turned on and in range of your phone.

Pairing Made for iPhone (MFi) hearing aids

Apple has integrated hearing aid connectivity directly into iOS, making the pairing process relatively straightforward once you know where to look. The system recognizes hearing aids as accessibility devices rather than standard Bluetooth peripherals, which is why you won't find them in the regular Bluetooth menu.

Here's the step-by-step process for pairing MFi hearing aids to your iPhone or iPad:

1. Prepare your hearing aids for pairing: If your hearing aids have replaceable batteries, open and close the battery doors. For rechargeable models, place them in the charger for 5-10 seconds, then remove them. This puts them in pairing mode. Some models have a specific button press sequence—check your manual if the battery door method doesn't initiate pairing.
2. Navigate to the correct iOS menu: On your iPhone or iPad, go to Settings → Accessibility → Hearing Devices. (Note: This is NOT the standard Bluetooth menu.) With your hearing aids in pairing mode, your phone will begin searching for them.
3. Select your hearing aids: Within 30-60 seconds, your hearing aids should appear under "MFi Hearing Devices" with their model name or custom name set by your audiologist. Tap on the name when it appears.
4. Confirm pairing: Your iPhone will display a Bluetooth pairing request. Tap "Pair" when prompted. If you have two hearing aids (one for each ear), you'll need to pair each one separately—follow the same process for the second device.
5. Verify connection: Once paired, you'll see your hearing aids listed under "MFi Hearing Devices" with battery level indicators. You can now control them from this menu or from Control Center (swipe down from top-right on newer iPhones, or swipe up from bottom on older models).

After successful pairing, your hearing aids will automatically connect whenever you turn them on and Bluetooth is enabled on your iPhone. You'll see a notification confirming the connection, and audio from phone calls, music, videos, and notifications will stream directly to your hearing aids.

Pairing ASHA-compatible hearing aids to Android

Android's ASHA pairing process varies slightly depending on your phone manufacturer and Android version, but the general procedure is similar across devices. Most hearing aid manufacturers provide dedicated apps that simplify the pairing process and offer additional controls.

Follow these steps to pair ASHA hearing aids to your Android phone:

1. Verify Android compatibility: Confirm your Android phone is running Android 10 or later and has Bluetooth 5.0 or higher. Go to Settings → About Phone → Android Version to check. Not all Android phones support ASHA even if they meet these requirements—check your hearing aid manufacturer's compatibility list.
2. Download the manufacturer's app: While not always required, downloading your hearing aid manufacturer's app (such as Phonak myPhonak, ReSound Smart 3D, Oticon Companion, or Signia app) typically provides the smoothest pairing experience and additional functionality. Install the app from Google Play Store before beginning pairing.
3. Prepare hearing aids for pairing: Just as with iPhone pairing, open and close battery doors for replaceable battery models, or place rechargeable hearing aids in the charger for 5-10 seconds then remove them. This initiates pairing mode.
4. Start pairing through the app or Settings: If using the manufacturer's app, open it and follow the on-screen pairing instructions. If pairing without an app, go to Settings → Accessibility → Hearing Aids (the exact path varies by phone manufacturer). Your phone will search for available hearing aids.
5. Select and confirm pairing: When your hearing aids appear in the list, tap on them to pair. You may need to confirm the pairing request. Like with iPhone, pair each hearing aid separately if you have two devices.
6. Test the connection: Once paired, test streaming by playing music or a video. ASHA hearing aids should automatically connect when turned on and disconnect when turned off or placed in the charger.

Streaming TV Audio and Using Accessories

While streaming from your smartphone is convenient, watching TV presents unique challenges. Most Bluetooth hearing aids don't connect directly to televisions because TVs use standard Bluetooth protocols rather than the specialized protocols in hearing aids. This is where TV streamers and accessories become essential tools for maximizing your hearing aid experience.

Why you need a TV streamer

Even if your TV has Bluetooth capability, it likely won't connect directly to your hearing aids. The reason is technical: TVs use Bluetooth Classic for audio output, while your hearing aids use MFi, ASHA, or proprietary low-energy protocols. It's like trying to have a conversation where each person speaks a different language—the devices simply can't communicate effectively.

TV streamers solve this problem by acting as intermediaries. These small devices connect to your TV's audio output (via optical cable, HDMI ARC, or analog connections) and then transmit the audio to your hearing aids using the correct protocol. The result is crystal-clear sound streamed directly to your ears at your preferred volume, while others in the room can listen at their comfort level through the TV speakers.

How TV streamers work and what they offer

Modern TV streamers offer significant advantages beyond basic connectivity. Most are plug-and-play devices about the size of a deck of cards that require minimal setup. You connect the streamer to your TV once, pair it with your hearing aids (your audiologist typically does this initial pairing), and then it automatically connects whenever you turn on your TV and hearing aids.

Key benefits of using a TV streamer include:

• Independent volume control: You can adjust the streaming volume in your hearing aids without affecting the TV's speaker volume. Your family can watch at their preferred level while you hear clearly at yours.
• Superior sound quality: Direct streaming eliminates room acoustics, reverberation, and distance-related sound degradation. Dialogue becomes more intelligible, and you'll notice sounds and details you've been missing.
• Low latency: Good TV streamers minimize audio delay (latency), so the sound matches the on-screen action. This prevents the frustrating experience of lip movements not matching audio.
• Extended range: Most TV streamers work within 20-30 feet, giving you freedom to move around your room while maintaining connection.
• Multiple user support: Many streamers can connect to multiple hearing aids simultaneously, so if your partner also has compatible hearing aids, you can both stream from the same TV streamer.

Popular TV streamer options include the Phonak TV Connector, ReSound TV-Streamer+, Oticon TV Adapter, Starkey TV Streamer, and Signia StreamLine TV. Each is designed specifically for that manufacturer's hearing aids. Prices typically range from $200-350, though some audiologists include them as part of your hearing aid package.

Other helpful Bluetooth accessories

Beyond TV streamers, several other Bluetooth accessories can enhance your hearing aid experience in specific situations:

• Remote microphones: These clip-on devices can be worn by a conversation partner in noisy environments, streaming their voice directly to your hearing aids. They're particularly helpful in cars, restaurants, or lectures. Some models also function as table microphones for group conversations, using directional microphones to capture speech from multiple people.
• Remote controls: Small, discreet devices that let you adjust hearing aid volume and programs without touching your ears or pulling out your phone. Useful if you prefer not to use smartphone apps or want quick access to controls.
• Phone clips/intermediary devices: If your hearing aids use Bluetooth Classic rather than MFi or ASHA, you may use a phone clip that hangs around your neck as a bridge device. Audio from your phone streams to the clip via standard Bluetooth, then the clip transmits to your hearing aids using the manufacturer's proprietary wireless protocol.

Troubleshooting Common Bluetooth Problems

Even with correct pairing, Bluetooth connections can occasionally fail or behave unpredictably. Most connectivity problems stem from a handful of common issues that have straightforward solutions. Before contacting your audiologist or getting frustrated, work through these troubleshooting steps—they resolve the vast majority of Bluetooth problems.

When hearing aids won't pair initially

If your hearing aids won't appear in your phone's pairing menu or the pairing process fails, try these solutions in order:

1. Verify you're in the correct menu: On iPhone, ensure you're in Settings → Accessibility → Hearing Devices, not the standard Bluetooth menu. On Android, check Settings → Accessibility → Hearing Aids or follow your hearing aid app's pairing instructions.
2. Restart the pairing sequence: Turn your hearing aids off completely (open battery doors or place in charger), wait 10-15 seconds, then initiate pairing mode again. Sometimes the pairing window times out before you complete the process.
3. Check for interference: Move away from Wi-Fi routers, microwave ovens, and other electronic devices that can interfere with Bluetooth signals. Get as close as possible to your phone during initial pairing—place your phone between your hearing aids if possible.
4. Ensure Bluetooth is actually on: It sounds obvious, but verify Bluetooth is enabled on your phone and that airplane mode is off. These settings sometimes change after phone updates or battery-saving modes activate.
5. Check for existing connections: If your hearing aids were previously paired with another device (like a family member's phone during demonstration), they may try to connect to that device instead. Make sure the other device has Bluetooth turned off or is out of range.
6. Update software: Verify your phone's operating system is up to date. iOS and Android regularly update Bluetooth functionality, and outdated software can cause pairing failures. Similarly, check if your hearing aids need firmware updates through their companion app or by visiting your audiologist.

When previously paired hearing aids won't connect

If your hearing aids paired successfully before but now won't connect, the fix is usually simpler:

• The universal reset: Turn Bluetooth off and on again on your phone. Then turn your hearing aids off and back on (battery door open/close or in/out of charger). This simple restart resolves connection issues about 70% of the time.
• Check battery status: Low batteries significantly affect Bluetooth reliability. Rechargeable hearing aids should be fully charged before extended streaming sessions. If using disposable batteries, replace them more frequently than you might for non-Bluetooth hearing aids—streaming drains batteries faster than amplification alone.
• Close unnecessary apps: Background apps can interfere with Bluetooth connections. On iPhone, swipe up from the bottom (or double-press the home button on older models) to see open apps, then swipe them closed. On Android, use the recent apps button and close unused applications.
• Move closer to your phone: Bluetooth range is typically 30 feet, but walls, body position, and interference can reduce this significantly. If you're experiencing dropout or connection failures, ensure you're within 10-15 feet of your phone with minimal obstructions.

The "forget and repair" solution

When simpler troubleshooting fails, removing the pairing completely and starting fresh often resolves persistent problems. This is the nuclear option but is remarkably effective:

1. Forget the devices on your phone: On iPhone, go to Settings → Accessibility → Hearing Devices, tap the (i) icon next to your hearing aids, then select "Forget This Device." Do this for both hearing aids. On Android, go to Settings → Bluetooth or Settings → Accessibility → Hearing Aids, find your hearing aids in the device list, tap the settings icon, and select "Forget" or "Unpair."
2. Delete and reinstall the hearing aid app: Remove your hearing aid manufacturer's app from your phone, restart your phone, then download and install the app fresh from the App Store or Google Play.
3. Restart everything: Power off your phone completely (not just screen off—actually shut down). While it's off, open and close your hearing aid battery doors or place rechargeable aids in the charger. Restart your phone, wait for it to fully boot, then follow the initial pairing procedures again from the beginning.

This complete reset removes any corrupted pairing data and starts with a clean slate. It resolves stubborn connection issues that resist other troubleshooting attempts.

Audio streaming only to one ear

If audio streams to only one hearing aid instead of both, try these specific fixes:

• Check physical positioning: Your body can block Bluetooth signals. If your phone is in your left pocket, the left hearing aid may receive a stronger signal than the right. Try moving your phone to a more central position or switching pockets.
• Verify both devices are paired: You may have successfully paired only one hearing aid. Check your phone's hearing device settings to confirm both left and right devices appear and show as "Connected."
• Check for wax or debris: While this seems unrelated to Bluetooth, if one hearing aid receiver is blocked, you may not hear streaming audio through that ear even though the Bluetooth connection is working properly. Clean your hearing aids and ensure receivers are clear.
• Restart the Bluetooth connection: Turn Bluetooth off and on, then restart your hearing aids. This often resolves temporary one-sided streaming issues.

Managing Battery Life During Streaming

Bluetooth streaming significantly increases power consumption in hearing aids. Understanding how streaming affects battery life and implementing smart management strategies will prevent unexpected power failures during important calls or TV watching.

How streaming affects battery drain

Streaming audio consumes substantially more power than standard amplification because your hearing aids are maintaining a constant wireless connection and processing audio data in real-time. Rechargeable hearing aids typically provide 16-30 hours of battery life during normal use, but this can drop to 10-20 hours with heavy streaming. Disposable battery life decreases proportionally—batteries that normally last 5-7 days might last only 3-5 days with frequent streaming.

Different streaming activities consume varying amounts of power. Phone calls and music streaming are relatively efficient, while video streaming (especially from video calls with camera on) consumes more power due to the continuous data transmission. TV streaming through a dedicated TV streamer is typically more battery-efficient than streaming directly from a smartphone because the streamer uses optimized wireless protocols.

Battery management strategies

Smart charging and usage habits can maximize your hearing aid battery life while still enjoying Bluetooth features:

• Charge nightly for rechargeable models: Make charging part of your bedtime routine. Place your hearing aids in the charger every night, even if they don't seem low. Modern rechargeable hearing aids use lithium-ion batteries that handle daily charging well without degrading quickly.
• Carry spare disposable batteries: If your hearing aids use disposable batteries and you stream frequently, keep spare batteries in your wallet, purse, or car. Change batteries at the first low-battery warning rather than pushing them to complete depletion.
• Monitor battery levels through apps: Most hearing aid apps display current battery levels for each device. Check these levels before leaving home for extended periods or before important meetings where you'll rely on streaming.
• Use TV streamers for extended viewing: TV streamers typically use more energy-efficient protocols than smartphone streaming. If you watch TV for 2-3 hours daily, a TV streamer will drain batteries less than streaming through your phone app.
• Disconnect when not actively streaming: If you paired your hearing aids primarily for occasional phone calls but keep them connected all day, consider disconnecting Bluetooth when not in use. The constant connection consumes power even when not actively streaming audio.

Most modern rechargeable hearing aids support quick charging—15-30 minutes in the charger can provide several hours of additional runtime in emergency situations. If you're traveling or away from your charger longer than usual, a brief midday charge can ensure you have power through evening activities.

The Future of Hearing Aid Connectivity

Bluetooth technology for hearing aids is evolving rapidly. Two emerging technologies—Bluetooth LE Audio and Auracast—promise to transform wireless connectivity in ways that will benefit everyone with hearing loss. While full implementation is still developing, understanding these technologies helps you make informed decisions about current hearing aid purchases and know what capabilities to expect in coming years.

Bluetooth LE Audio: the next generation

Bluetooth LE Audio (Low Energy Audio) is a new standard that addresses many limitations of current Bluetooth protocols. Unlike MFi and ASHA, which are manufacturer-specific, LE Audio is an open standard developed by the Bluetooth Special Interest Group. It launched in 2020 but device support has been gradual—by 2025, many premium hearing aids and flagship smartphones support it.

LE Audio offers several significant improvements over current protocols:

• Better audio quality at lower bit rates: LE Audio uses a new codec (LC3) that delivers superior sound quality while using less data, resulting in clearer audio and longer battery life simultaneously.
• Universal compatibility: Because LE Audio is an open standard, it works across all devices and platforms. This means the same hearing aids can connect to iPhones, Android phones, Windows computers, and future devices without manufacturer-specific protocols.
• Multi-stream audio: LE Audio supports multiple simultaneous audio streams, allowing you to listen to music while still hearing navigation directions or take a phone call without disconnecting from your TV streamer.
• Lower latency: Reduced audio delay improves synchronization for video watching and gaming, making lip-reading easier when streaming video calls or TV shows.
• Hands-free calling everywhere: LE Audio includes built-in support for bidirectional audio, enabling hands-free calling on both iPhone and Android without requiring additional hardware or workarounds.

Several hearing aid manufacturers released LE Audio-compatible models in 2024-2025, including devices from Starkey (Genesis AI), Jabra (Enhance Select 500), and others. As smartphone support expands (Android 13+ supports it now; iOS support is expected soon), LE Audio will likely become the standard protocol for hearing aids, replacing the current patchwork of MFi and ASHA.

Auracast: broadcast audio for public spaces

Auracast is perhaps the most exciting development for people with hearing loss since the invention of Bluetooth connectivity itself. Built on LE Audio technology, Auracast enables public audio broadcasting that anyone with compatible hearing aids or earbuds can access.

Imagine walking into an airport and automatically receiving gate announcements directly in your hearing aids. At a sports bar, you could select which TV's audio you want to hear. In a movie theater, films could broadcast their audio directly to your hearing aids without requiring special equipment. Museums could offer audio tours without lending devices. Places of worship could stream sermons directly to congregants' hearing aids. Gyms could make TV audio accessible without cranking up the volume.

Auracast works differently than current assistive listening systems:

• No special equipment required: Unlike telecoil systems that need hearing loop installations, Auracast uses Bluetooth transmitters that are relatively inexpensive and easy to deploy.
• Personal device control: You control which broadcast you receive and at what volume through your smartphone or hearing aid controls. No need to ask staff for assistance or borrow equipment.
• Multiple broadcasts in one space: Airports can broadcast different gate information to different areas, or restaurants can offer different TV audio streams, each accessible through your phone's Auracast menu.
• Universal accessibility: Auracast isn't just for hearing aids—anyone with compatible earbuds or headphones can access public audio broadcasts, reducing stigma and increasing adoption by venues.

Auracast implementation is beginning in 2025. Several airports, sports venues, and conference centers are piloting systems. Android 13 and 14 support Auracast broadcast audio reception, and hearing aid manufacturers are incorporating it into new models. Full widespread adoption will take several years, but the infrastructure is developing rapidly.