CROS And BiCROS Hearing Aids: Features, Costs And More (2024)

Contralateral Routing of Signals (CROS) hearing aids are a type of hearing device designed for unilateral hearing loss, or hearing loss in only one ear. Though designed for single-sided hearing loss, CROS hearing aids are worn in both ears. A microphone is placed in the ear with impaired hearing, which routes the acoustic signal to a hearing aid worn in the other ear with better hearing, according to a review published in Otology & Neurotology. This rerouting allows sound on both sides of the head to be heard by a person’s good ear.

“The two devices work in unison together,” explains Rebecca Martin, an audiologist at Houston Methodist Hospital. “The microphone will pick up the sound on the side with poor word understanding and will transfer the sound to the ear that has hearing within normal limits.”

The technology used in CROS hearing aids allows a person with unilateral hearing loss to have improved audibility on both sides, says Allison Treseder, an audiologist based in Reno, Nevada. This method differs from other types of hearing aids, notes Dr. Treseder, some of which amplify sounds from both sides instead.

Bilateral Contralateral Routing of Signals (BiCROS) hearing aids are designed for people with hearing loss in both ears. Like the CROS system, the BiCROS system includes a microphone that picks up sounds from the ear with impaired hearing and a receiver, which amplifies sounds to make them more audible in the ear with better hearing—even if it experiences some degree of hearing loss.

BiCROS hearing aids are similar to CROS hearing aids but differ in the way they work. Instead of transmitting sound from the poorer hearing side to the better hearing side, a BiCROS hearing aid amplifies sound from both sides and sends it to the better ear, says Dr. Treseder. This may be beneficial for people with asymmetrical hearing loss or a difference in hearing ability in each ear, she adds.

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“The CROS/BiCROS systems are essentially the same,” says Dr. Martin. “The main difference between the CROS and BiCROS devices is the amount of amplification provided on the ‘hearing aid’ side of the device.”

A CROS hearing aid offers no amplification of sound and simply routes sound to the ear with better hearing ability. A BiCROS system reroutes the sound to the other ear and amplifies it to account for some degree of hearing loss in the ear. The CROS system is intended for people who have good hearing in one ear and difficulty hearing in the other ear. Meanwhile, the BiCROS system is better for individuals with total hearing loss in one ear and moderate hearing loss in another.

“The features available in CROS/BiCROS hearing aids vary between manufacturers,” explains Kelly Stahl, an audiologist and director of student experience at myHearingU, an online hearing aid specialist training program. Dr. Stahl notes rechargeability as one of the features users value most, as it can be a more convenient alternative to replaceable batteries.

Some CROS and BiCROS hearing aid models may also offer additional features including:

• Moisture, dirt, dust or sweat resistance
• Ear-to-ear streaming during phone calls
• Improved feedback management to help reduce any loud screeching, whistling or buzzing that occurs when sound waves hit the microphone
• Customizable options to reduce tinnitus, or ringing in the ears

The price of CROS and BiCROS hearing aids vary depending on several factors, and Dr. Martin notes the cost for fitting either hearing aid type averages between $3,000 to $5,000 per pair, depending on the facility. This is slightly more expensive than other types of traditional hearing aids, which often have fewer features and options for customization.

“All facilities range in pricing depending upon product, brand, technology levels, fitting fees, and bundled versus unbundled services,” says Dr. Martin. The cost of CROS and BiCROS hearing aids can vary based on location as well and can reach up to several thousand dollars, adds Dr. Stahl.

Though hearing aids aren’t usually covered by medical insurance, some plans may include coverage for hearing tests or hearing aid fittings. An audiologist or hearing care professional can also help evaluate your coverage and offer guidance for financing options if hearing aids are not covered by your insurance.

“CROS and BiCROS hearing aids are designed to help those who have unilateral or asymmetrical hearing loss,” says Dr. Treseder. “This includes anyone with one good ear and one deaf ear—or those with a significant difference in sound levels between their ears.”

Both CROS and BiCROS hearing aids can help people with hearing loss participate in conversations and understand speech in loud environments, she adds.

If you’re experiencing hearing loss, don’t hesitate to seek help. An audiologist, otolaryngologist or other hearing health professional can help pinpoint the cause of your hearing loss and determine the best course of treatment, which may include a CROS or BiCROS hearing aid or other hearing device.