After several years of my wife telling me I was deaf, I finally went to a good ENT for a complete ear exam and hearing test. I was sure that I had hearing loss attributed to shooting. I've always doubled up with custom-fit ear plugs, and the best electronic muffs I could find (I own Peltor and Pro Ears).
After a complete test, the doctor assured me that what hearing loss was completely age related; I'm 67. He told me that my setup was correct, and to keep on using it. He did set me up for an annual exam, and that I had a baseline established to determine if further hearing loss would be age or shooting related.
I could probably start with hearing aids, but he said that any gain from aids would be minimal for now.
He's also a shooter, and ask me for my ear plug maker. I had her business card, and gladly helped.