Hearing aids (HAs) are often left unused. Several investigations have shown that the use of HAs and the skills to use them can be significantly improved through counselling. Follow-up counselling is often restricted by increased cost. The objective of the study was to assess the cost and the effect of follow-up counselling on HA use. In a prospective pre-post design study, 98 first-time HA users were counselled 6 months after the fitting of a HA, and the use of and benefit from HAs were measured by means of an interview and the short form of the hearing handicap inventory for the elderly (HHIE-S) and the EuroQoL (EQ-5D) questionnaires. The results obtained before and 6 months after counselling were compared and the cost of counselling was calculated. After follow-up counselling, over half of the occasional users of a HA and as many as one third of the non-users became regular users. The number of regular users increased by 16 subjects, and non-users decreased from 29 subjects to 17. The HHIE-S results showed a significant positive change, but the EQ-5D results showed practically no change. The additional expense of follow-up counselling at home was approximately 8.8% (83 euro per visit) of the calculated 942 euro cost of fitting a HA. Bringing one unused HA into regular use required 508 euro. The results show that HA use and the consequent benefit can be significantly increased through counselling. The expense caused by follow-up counselling at home is highly acceptable in addition to the cost of fitting a HA.