Over The Counter Hearing Aids: How to Choose the Right One

Just like our TVs, cell phones, and even our refrigerators have changed, so have hearing solutions. Hearing aid technology has dramatically advanced, providing opportunities for affordable hearing aids that are smaller, lighter, and more stylish and discreet than ever before.

Key takeaways:
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    OTC hearing aids may be a good, affordable option for those adults over 18 years of age who have mild to moderate hearing loss.
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    OTC hearings may cost significantly less than prescription hearing aids, but some higher-end models may approach similar costs.
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    Look for sales but remember that Medicare and most insurance companies do not cover the cost of hearing aids.
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    It is important to understand your particular hearing loss. It may still be prudent to have both an ENT physician make sure your ears are healthy and an audiologist or hearing professional perform testing to make sure you are a good candidate for OTC hearing aids.

In August of 2022, the US Food and Drug Administration (FDA) established a new category of hearing aids that can be purchased over the counter (OTC). The FDA guidelines went into effect on October 17, 2022.

The FDA guidelines were designed to ensure that OTC hearing aids are:

  • Safe and effective.
  • Designed to treat mild to moderate hearing loss in adults 18 years of age and older.
  • Designed to allow the purchase of a hearing aid without a medical examination, prescription, or professional fitting.
  • To be accompanied by sufficient product labels that include warnings and other information that you should know before buying or when using the hearing aid or if you may need to see a doctor instead.

Of course, the key issue in everyone’s mind is cost. The fact is that as many as 25% of people over 65 have some hearing loss, which doubles over age 75, and are in income brackets that cannot afford prescription hearing aids.

The result is that many people wait ten years or more to get hearing aids. In addition to the cost of the hearing aids are the time and costs involved in multiple visits to the audiologist, including fitting, servicing, and need for repairs.

The new FDA guidelines and the availability of over-the-counter hearing aids are meant to address these important issues.

What is the difference between an OTC hearing aid and a prescription hearing aid?

Prescription hearing aids can only be purchased from a licensed professional, such as an audiologist or hearing aid specialist. Any licensed physician can perform a physical examination of the ear and rule out any medical reasons for the hearing loss, although that is mainly done by ear-nose-and-throat (ENT) specialists.

The best prescription hearing aids are chosen based on your specific hearing loss requirements. These requirements take many factors into account, including both your hearing at specific frequencies or pitches, and whether you can understand the sounds that you are hearing, also called speech discrimination. Most commonly, speech discrimination is the bellwether sign used to determine what hearing aid will work best for you.

The main difference between OTC and prescription hearing aids is that OTC hearing aids can be something you choose yourself, in addition to the lower cost.

Much like OTC reading glasses found at a pharmacy, you choose the style, make sure it fits properly, and make adjustments to the sound, sometimes using an app on your smartphone.

Often, a hearing test can be performed using the Internet and your smartphone, tablet, or computer. Again, OTC hearing aids are only intended to help adults over 18 with mild to moderate hearing loss. The problem with these hearing tests is they may give variable or even subjective results, underestimating the actual severity of the hearing impairment.

Prescription hearing aids are intended for all ages and all degrees of hearing loss, from mild to profound.

Audiologists are licensed to administer tests, analyze the results, prescribe hearing aids, and fit and program prescription hearing aids. It is recommended that an ENT physician further evaluate your ears to make sure you don’t have any medical issues related to your hearing loss such as tinnitus (ringing), dizziness, or ear pain.

A scientific formula is needed for prescription medication, which considers the patient's physical characteristics (age, weight, etc.) and the disease being treated.

To fit prescription hearing aids, the audiologist uses a hearing test and other critical information such as outer ear size/condition, cognitive wellness, and speech-in-noise ability to fit and program the hearing aids.

Can I use Dr. Google when considering an OTC hearing aid?

Today, the ability to manage your healthcare is greater than ever before. “Dr. Google” is at your fingertips and online hearing tests promise an accurate diagnosis in minutes. The availability of OTC hearing aids allows consumers to decide for themselves how much hearing loss they have and the ability to choose their treatment.

If the following things are true, then OTC hearing aids might be an option for you:

  • Adults over the age of 18.
  • Perceived mild hearing loss.
  • NO other symptoms such as tinnitus (ringing in the ears), dizziness, imbalance, falls, ear pain, ear drainage, sudden hearing change, diabetes, memory concerns, stroke, or cardiovascular disease.

What are the costs compared to a prescription hearing aid?

The average pair of prescription hearing aids cost about $4,600, but over-the-counter hearing aids cost much less, and good options are about $1,600. That’s $3,000 in savings. And some OTC options cost far less.

Due to sales and incentives, expect to see prices even lower, especially for the holiday season. There is some speculation that some over-the-counter hearing aids may be as low as $300 per ear this year or even less.

This pricing may encourage many people with hearing loss to finally get help with their hearing. It is estimated that 37.5 million people in the United States are affected by disabling hearing loss, but only about six million use prescription hearing aids. The new over-the-counter hearing aids may dramatically improve hearing aid use.

What are some of the top OTC hearing aid brands?

Neither the author nor HealthNews endorses any specific hearing aid brand. Here is an overview of a few popular ones.

Audien is a brand that starts its price at a very affordable $99 per ear. These don’t have many features compared to other higher-priced models, but they can still be a good place to start. If price is a concern, Audien may be a good fit.

Other companies to consider are Audicus and Lively. These companies make OTC hearing aids with features such as Bluetooth streaming, rechargeable batteries, and feedback suppression which can be helpful in settings such as restaurants where there is background noise. Both Audicus and Lively hearing aids begin at about $2,000 per pair.

Examples of higher-end models include the Omni made by Audicus, which costs $3,400 for the pair, comparable to prescription hearing aids.

Other companies to explore include:

  • Eargo: $1,450 to $2,950 per pair
  • MDHearing: $299 to $699 per pair
  • Signia Silk: $2,000 to $6,000 per pair

It is estimated that 37.5 million people in the United States are affected by disabling hearing loss, but only about six million use prescription hearing aids. In October of 2022, the US Food and Drug Administration approved the sale of over-the-counter hearing aids, which may encourage many people with hearing loss to finally get help with their hearing.

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