2 packs of size 13 batteries included. As the close-up on the Signia itself indicates, the earpiece 'eartip' itself is customized and NOT included.. Simply visit any Signia dealer and have one fitted and molded (under $150).  I have also shown the generic earpieces (from Amazon) I ordered.  If these arrive in time, I will toss a few into the package, as a courtesy, but if you are a Signia customer already, you may already have your own earpiece.  Why am I selling?  Signia offers a new (pricey) PAIR of aids which may suit my particular problem better.