Maybe you spent too many nights at ear-bleeding rock concerts in your younger days, ignoring your parents who begged you to wear some earplugs. Or perhaps you’ve worked in a noisy environment for years and didn’t take care to wear ear protection. Or maybe you’re just getting older and having trouble hearing like you used to. You’re not alone.
According to the National Institute on Deafness, roughly 25% of Americans between 65 and 74 have hearing loss that impacts their daily life, and the National Institute on Deafness and Other Communication Disorders says that 15% of those 18 and older have some issues hearing correctly.
Until 2022, the only recourse for anyone with hearing loss was to see an audiologist or doctor for an examination to determine if prescription hearing aids were necessary. Luckily, things changed that year when the FDA opened things up, making it possible for those with mild to moderate hearing loss to purchase over-the-counter hearing aids without a prescription or examination.
The market responded, with major headphone and earbud makers such as Jabra, Sony, Bose, and others offering affordable and feature-rich OTC hearing aids, often in conjunction with some of the best hearing aid makers in the world. The market continues to grow, making OTA hearing aids a viable alternative that could provide hearing benefits where none were possible before.
What are over-the-counter hearing aids, and who are they for?
Over-the-counter (OTC) hearing aids are hearing devices that consumers can purchase directly without requiring a prescription, medical exam, or fitting by an audiologist. Following FDA regulation changes, they became available in the United States in October 2022. These devices are specifically designed for adults (18 years or older) with perceived mild to moderate hearing loss. They’re ideal for people who have difficulty hearing in noisy environments, often ask others to repeat themselves, need to turn up the TV or phone volume higher than others prefer, or have trouble hearing on the telephone.
OTC hearing aids are not appropriate for children or teens under 18, people with severe or profound hearing loss, those with sudden, rapidly worsening, or single-sided hearing loss, individuals with ear pain, drainage, or excessive earwax, or people with a history of ear surgery or perforated eardrums. If you’re experiencing any of these more serious conditions, it’s essential to consult with a healthcare professional before considering OTC options. OTC hearing aids represent a more accessible and affordable option for many Americans with mild to moderate hearing loss who might otherwise go untreated due to cost barriers or limited audiologist access.
What’s the difference between over-the-counter and prescription hearing aids?
So why are over-the-counter hearing aids such a big deal over hearing aids that require a prescription? The difference can be summed up in a few important points:
- Affordability: Over-the-counter hearing aids are much more affordable than their prescription counterparts. Prescription hearing aids can cost several thousand dollars or more, which puts them beyond the reach of those who don’t have insurance that will cover them. Over-the-counter models, on the other hand, typically start at around $800 to $1,500.
- You don’t need a hearing exam: Over-the-counter hearing aids don’t require the same exams, fitting, prescriptions, or maintenance requirements as prescription models, which can also save a lot of time and money.
- Availability: Over-the-counter hearing aid models are easier to find. You don’t have to go to a specialized hearing care clinic to purchase them. You can visit common retail websites and order them in just a few minutes if you want
- Extra features: Over-the-counter hearing aids may come with extra features for consumer use — such as Bluetooth capabilities for connecting to devices for audio playback, and app accompaniment for further customization — that prescription models may not have.
Hearing aid or amplifier: what’s the difference?
Hearing aids and personal sound amplification products (PSAPs) differ significantly in design, purpose, and regulation. Hearing aids are sophisticated medical devices specifically engineered to address hearing loss by selectively amplifying certain frequencies based on an individual’s specific hearing deficit pattern, often featuring advanced digital signal processing technologies that reduce background noise, enhance speech clarity, and can be precisely programmed by audiologists to match a person’s unique hearing profile. They are regulated as medical devices by the FDA. They can be prescribed (traditional hearing aids) or purchased over-the-counter for adults with mild to moderate hearing loss (OTC hearing aids).
In contrast, sound amplifiers are consumer electronics products designed for people with normal hearing who want occasional sound enhancement in specific situations, such as bird watching or distant conversations; they typically amplify all sounds equally without the sophisticated processing capabilities of hearing aids, lack customization options, and are not regulated as medical devices nor intended to treat hearing loss.
While hearing aids usually cost between $1,000-$6,000 per pair with professional services included, amplifiers are significantly less expensive, typically ranging from $50-$500, reflecting their simpler technology and lack of professional services. Unfortunately, this price difference, combined with historical insurance coverage limitations for hearing aids, has led some people with hearing loss to inappropriately use amplifiers instead of proper hearing aids, potentially exacerbating their hearing problems by over-amplifying sounds across all frequencies.
What types of over-the-counter hearing aids are available?
Over-the-counter hearing aid models typically come in three different design options, each with their own advantages:
- Earbud models: These look like traditional earbuds that you might buy from Sony, Jabra, Apple, or other brands — and some are even offered by the same companies. The advantage, of course, is that it looks like you’re just wearing normal earbuds, and like today’s wireless earbuds, they are very easy to charge and use as needed.
- In-ear, low-profile models: These are designed to be as hidden as possible and are often available in skin colors to better mask them. The goal is to make it seem like they aren’t there at all. However, the small size typically means lower battery life and more limited use. They may also be more expensive.
- Behind-the-ear models: These come with a tiny earbud that’s connected by wire to a larger component that rests behind the ear. This is a more complicated, unwieldy setup that’s much more noticeable. However, you get more battery power and generally better hearing features, so they tend to be a better pick for more moderate hearing loss.
How to get OTC hearing aids
First, arrange a hearing exam with your doctor. Wait, but you just said — we know, we know, you don’t technically need a hearing exam to buy over-the-counter hearing aids, and that’s one of the advantages. But if you think you have hearing loss and you haven’t talked about it with your doctor yet, you really need to. It’s important to get a hearing exam to judge the extent of your hearing loss, and if over-the-counter models are the right choice for you. A hearing specialist may even be able to recommend certain brands or stores to try.
Next, find a retailer’s site or store that has your preferred hearing aid in stock. We suggest heading online for this step. You’ll find a lot more options in stock, and you can use regular payment methods that you may have already set up. Popular stores include:
Once you have found a pair of OTC hearing aids that you want, you can simply place them in your cart like any other purchase. There are no additional hoops you are required to jump through to buy them. Note that some models may only be available online, while others may not always be in stock, so remember to check the details as you check out.
Can over-the-counter hearing aids qualify for insurance coverage?
Insurance coverage for over-the-counter hearing aids varies significantly. Most private health insurance plans historically haven’t covered hearing aids of any kind, including OTC options. Medicare Parts A and B (Original Medicare) generally don’t cover hearing aids or hearing exams, though some Medicare Advantage (Part C) plans may offer hearing aid benefits that could potentially include OTC devices.
Some health insurers have begun to adapt their policies since OTC hearing aids entered the market in 2022. For instance, certain plans may offer:
- Discounts on OTC hearing aids through preferred providers
- Limited reimbursement through health savings accounts (HSAs) or flexible spending accounts (FSAs)
- Partial coverage through supplemental hearing benefits
For those with Medicaid, coverage varies by state. Some states provide coverage for hearing aids when medically necessary, but most haven’t specifically addressed OTC hearing aids in their policies yet.
If you’re considering purchasing OTC hearing aids, it’s best to:
- Contact your insurance provider directly to understand your specific coverage options
- Check if your employer offers any hearing benefits
- Look into whether you can use HSA or FSA funds for your purchase
The landscape of insurance coverage for these devices is still evolving as they become more established in the market.
What about the maintenance of over-the-counter hearing aids?
There is no counseling for caring for over-the-counter hearing aid models, so read the manual carefully. Fortunately, brands like Lexie already have guides on when and how to clean your hearing aids that will apply to over-the-counter models too. Don’t use any kind of water or cleaners on your hearing aids to avoid damage. For frequent cleaning, you may want to pick up a specialized tool.
