Been flying with hearing aids (Siemens) since 2010. I’m on my 3rd set, fully digital, behind the ear. I fly with Bose A-20’s, as well as my wife’s Lightspeed Zulu’s and a DC non ANR.
From day one, I’ve not had any issues nor have I needed special programming. I have 3 settings, Normal, Noisy and TV, all manually or Bluetooth adjusted. Before engine start I enable noisy setting and drop volume 2 clicks, then its go fly. No issues hearing ATC, ATIS or intercom chatter. Lucky I guess?