The recent over-the-counter sale of hearing aids allows individuals to purchase the assistive devices without a hearing exam, prescription, or fitting by an audiologist. While the over-the-counter sales of hearing aids aim to make the devices more accessible to purchase, they are not the right choice for everyone.
Over-the-counter hearing aids are in a regulatory category of their own, as ruled by the US Food and Drug Administration (FDA) and finalized in August 2022. Congress originally passed bipartisan legislation in 2017 to require the FDA to create a separate category for over-the-counter hearing aids, but only recently has this been fully implemented. By allowing the over-the-counter sale of hearing aids, consumers can now purchase them in-person at pharmacies and big box stores or online retailers. Although the price of over-the-counter hearing aids will vary depending on the model and manufacturer, this ruling expects to make them more affordable and lower costs. There are key differences between the capabilities of over-the-counter hearing aids and their prescription counterparts. Over-the-counter devices have a lower maximum sound output compared to prescription, a limit for insertion depth in the ear canal, and are required to have user-adjustable volume control. These limitations and requirements are designed to make the correct use of the device easy to understand while ensuring safety to the wearer. Since over-the-counter hearing aids only require self-assessment of hearing loss, it is still advised to get a hearing test to choose the device that will best work for the individual’s needs and ensure they are a candidate for an OTC device.
There are three main types or styles of over-the-counter hearing aids available: in-the-ear (ITE), behind-the-ear (BTE), and receiver-in-canal (RIC) hearing aids. When contemplating what type of design might be the best option for you, consider factors like lifestyle, cost, and dexterity. By finding the style of hearing aid that is both the most comfortable to wear and to use, you are more likely to use your new assistive hearing device consistently.
Behind-the-ear (BTE) hearing aids tuck behind the user’s ear and deliver sound to the ear canal via a thin tube or wire and speaker bud. As BTE hearing aids do not sit too tightly in the ear, they also allow for natural sound to enter. Generally larger than the other hearing aid types, BTE devices generally have more power and deliver more features than their small counterparts. Receiver-in-the-canal (RIC) devices are similar to a BTE hearing aid, but more discreet. This style of hearing aid uses a thin wire which connects the hearing aid to the ear canal. An RIC hearing aid can also be paired with an ear mold instead of a wire. Whether coupling an RIC with an ear mold or wire will depend on the individual’s degree of hearing loss. In-the-ear (ITE) hearing aid devices sit inside the ear and are the most discreet. Although some may prefer ITE models because they are less noticeable and do not use any external tubes, this smaller size also means they usually have less power and features. Due to these factors, many ITE devices may be best suited for those with mild hearing loss.
Hearing loss is a spectrum ranging from mild to profound in severity. Over-the-counter hearing aids are intended for individuals with mild to moderate hearing loss. Those with severe or profound hearing loss will need to seek out an audiologist or other hearing professional to fit them with prescription hearing aids. People with mild hearing loss may have difficulty hearing softer sounds like those who speak quietly, children’s voices, or have to ask others to repeat themselves. If you are able to hear loud noises fine and more prominent vowel sounds, but struggle to decipher softer consonants and lighter noises, this may be an indication of mild hearing loss. For those who experience moderate hearing loss, vowel and consonant sounds are often both difficult to make out. Though people with moderate hearing loss can hear without use of assistive devices, they often struggle to understand what they are hearing.
While there are nor requirements or prerequisites to buy an OTC hearing aid, it is still advised to take a hearing screening before purchasing. Hearing screening tests can be performed by an audiologist or other hearing healthcare professional, and there are now even online hearing tests available for people to take on their own at home. While online hearing tests can be a good starting place, it is best to follow up with an in-person assessment, especially if the online test indicates a hearing loss. Seeking out a hearing healthcare provider can help you shop smarter and give better insight as to what type of OTC hearing aid will work best for your accessibility needs. This will also provide a more accurate and clearer understanding of your degree of hearing loss, rather than your self-perceived hearing loss.
The primary advantage of choosing an over-the-counter hearing aid is the accessibility and convenience. Compared to hearing aids from an audiologist or other healthcare professional, OTC hearing aids are relatively less expensive. The average price for a pair of prescription hearing aids is about $4,600, while in comparison the federal government estimates the cost of a pair of OTC hearing aids to be $1,600. As the OTC hearing aid market continues to expand and more competitors step into the market, prices may continue to be even lower. In addition to being more affordable, OTC hearing aids are more widely available for purchase and can be found in many pharmacies, big-box retailers, or be ordered online.
For those who may have previously been unable to afford a hearing aid or who cannot visit a professional for an in-person appointment, OTC hearing aids have helped remove these barriers as they do not require a prescription or screening. OTC hearing aids also allow the wearer greater customization, as they can tune the device to their own personal preference. However, for those who would prefer to have the guidance of a hearing specialist you can still take your OTC hearing aid to an audiologist or other professional for adjustments. This route can help individuals stay within their budget while still ensuring their assistive device will be suited to their unique needs.
Over-the-counter hearing aids may be more widely available for purchase, but they are suited for a narrower demographic than prescription hearing aids. In comparison to prescription hearing aids, there are far less variety of OTC hearing aids and no way to guarantee that the kind of OTC hearing aid you need will be available near you. One key way that OTC hearing aids are less customizable than prescription devices, is that OTC hearing aids are not programmable to match the wearer’s unique hearing range. The majority of over-the-counter hearing aids are what is referred to as self-fitting, meaning that the user is responsible for setting the hearing aid’s frequency themselves to match their own accessibility needs. Bearing this in mind, OTC hearing aid users can still take advantage of an audiologist’s expertise by bringing in their device for help to fit it properly and to their needs, as well as utilizing a professional hearing screening prior to purchasing, which will help guide them when deciding which brand and style of device will best meet their needs. Keeping in mind that OTC hearing aids are only suitable for individuals with mild to moderate hearing loss, taking a hearing test before beginning the shopping process will also ensure that you are a candidate for an OTC device. When researching and shopping for an over-the-counter hearing aid, potential buyers should also consider what features are most important to them in a device as well as the warranty or return options for the OTC hearing aid they are purchasing.
It is estimated that approximately 28.8 million Americans could benefit from hearing aids, and the introduction of OTC hearing aids aims to make this necessary technology more accessible to those who need it. Although a hearing screening is not required for OTC hearing aids, it is highly recommended to help determine what your hearing aid needs are and to be sure you fall within the the range of mild to moderate hearing loss to be eligible for an OTC device. Whether you are concerned about the visibility of your over-the-counter hearing aid or how effective the device will be, the first step in shopping for your over-the-counter hearing aid is determining what style is best for you. The Mayo Clinic offers an in-depth overview of the pros and cons of each style of over-the-counter hearing aid available, including models of how each style fits in the ear. Balance your design wants with the features that are necessary for you, as while a smaller device may appeal for being more inconspicuous, it is also unlikely to be able to offer the same capabilities or power for the improvement in hearing you are seeking. Features available on an OTC hearing aid will vary widely depending on device and you will want to make sure that the device you choose will be compatible with your lifestyle. Main features to consider when shopping for the right OTC hearing aid are: Bluetooth compatibility, battery type and life, synchronization if using two hearing aids, noise reduction, telecoils, directional microphones and water resistance. Finally, it is almost important to note whether or not the OTC hearing aid of interest offers a warranty and trial period. A trial period will allow you time to adjust to your new device and make sure it works for you over a longer period of time. Shoppers are advised to have the trial cost in writing and clarify whether the fee will be counted towards the purchase price, or how much of the charge is refundable if you elect to return the hearing aids mid-trial. Once you find the over-the-counter hearing aid you plan to purchase, consider opting for a warranty in the event that the device malfunctions or does not perform as expected.
After your new over-the-counter hearing aid arrives, you will want to allow yourself ample time to adjust and to familiarize yourself with caring for your device properly. Be sure to carefully read the user manual that will accompany your OTC hearing aid. Additionally, many manufacturers, like Sony and Jabra, also offer video tutorials that show how to properly fit and insert your hearing aid. Regular care and cleaning of your OTC hearing aids are vital in extending the life of your device and for optimal performance. Some cleaning procedures will need to be done daily, while others should be done on a weekly basis. Each day, carefully brush the microphone cover to remove wax or other debris, and wipe down the entire device with a clean cloth. Give the device a more detailed cleaning weekly and turn the hearing aid upside down while cleaning any ports so that any dirt or build-up falls out. Another tip is to leave the battery covering open at night to allow it to air out and help extend the battery life. To ensure you clean your hearing aids correctly and without damaging them, look into buying a hearing aid cleaning kit which will include necessary tools like a wax pick, wax removal brush, vent cleaner and more. This can help make the process easier, especially for beginners and new hearing aid users.
If over-the-counter hearing aids seem like the best option for you, keep these main points and must-do’s in mind to get started. First, begin by taking a hearing screening test as a benchmark for your current hearing levels. A hearing test will help you and any hearing healthcare professionals you may work with notice changes to your hearing loss and is also a crucial step to guide you toward the device that will provide the output you need. If prescription hearing aids are out of your budget, but you can afford a visit to the audiologist, consider making an appointment first for recommendation on over-the-counter hearing aids and for support after you purchase your OTC device. Remember to do plenty of research and read reviews on many devices and from multiple sources.
What are over-the-counter hearing aids?
Over-the-counter hearing aids are available to assist adults 18 or over with perceived mild to moderate hearing loss. OTC hearing aids are available for purchase without a visit to an audiologist or other hearing healthcare professional.
How do over-the-counter hearing aids differ from prescription hearing aids?
Compared to prescription hearing aids, over-the-counter hearing aids have limited volume-output and features in comparison to prescription models. Additionally, over-the-counter hearing aids are not suitable for children, those with an ear deformity, or individuals with severe or profound hearing loss.
Are over-the-counter hearing aids right for me?
Over-the-counter hearing aids may be a good option for you if you have mild to moderate hearing loss and would benefit from hearing aids, but are unable to afford a prescription device.
How do I choose the right over-the-counter hearing aid?
When shopping for an over-the-counter hearing aid keep the following considerations in mind: durability and cost, charging options, lifestyle, Bluetooth compatibility, does the OTC hearing aid require an app to be used, trial options and warranty. Do plenty of research on the various models and styles available and weigh the pros and cons of each.
How do I properly use and care for my over-the-counter hearing aid?
Regular daily and weekly care is important to extend your OTC hearing aid’s life and for best performance. Wipe down the device daily and brush off any wax or debris from the microphone cover. Once a week, set aside time for a more detailed cleaning and carefully remove wax from any ports and openings.
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