I bought two Gem hearing aids from Costco about a week ago. First time HA user so I have nothing to compare to but they seem to work well. I like the multiple programs and the remote that allows volume and program changes as well as turning them on/off. They came with a small carrying case, travel case, hearing aid dryer and spray for cleaning as well as 30 replacement batteries. I was told that because of the small size that the batteries would last about 3 days (gives off a beep). My first set of batteries lasted 5 days which wasn't too bad. I like the small size unit as it is virtually un-noticeable. The only issue I have had is finding the right domes. I have been experimenting with different ones and still have an issue in one ear. I would like to find a local (Atlanta) location that sells replacement domes for the Gem as I'm not sure that Costco has one that will be totally comfortable in that ear. Overall a very good hearing aid at a great price.