If you order a refurb, they only come with a small size ear loop, might fit a child. I have been on the phone several times sent pictures as requested for them only to tell me they don't have other sizes. The add shows that it comes with a small, medium and large and nothing about it has to be a new ear piece for the CS50 model. I guess if the Refub model had no ear pieces to start with you would receive one without an ear piece at all. The product work great just need an ear piece.