How To Decide Between Over-The-Counter and Prescription Hearing Aids

November 1, 2022
Amy Sarow | Doctor of Audiology
Written by
Amy Sarow | Doctor of Audiology
Soundly Staff
Reviewed by
Soundly Staff
OTC Vs. Prescription hearing aids

On October 17, 2022, over-the-counter (OTC) hearing aids became available at stores across the country for the first time in 50 years. 

Until the change, anyone with hearing difficulty started their treatment with a visit to a hearing healthcare professional, received a hearing test, and then had an appointment to be fit with hearing aids. 

If you're like many Americans, you might be curious and even excited about the new availability of over-the-counter hearing aids. And it's good news! Individuals on a budget now have easier access to support. 

The new care model might also leave you with some questions. 

In this guide, we'll cover some fast facts on OTC hearing aids, who is a candidate, where to purchase them, and important takeaways. 

Fast Facts About OTC Hearing Aids? 

OTC hearing aids are a new addition to the landscape and a change from the traditional prescription hearing aid model. 

Classification: These hearing aids are a special class of hearing devices, more specifically, FDA-cleared class II (self-fitting air conduction) medical devices. 

Age: These hearing aids are only available for adults 18 and older with mild to moderate hearing loss. Why the restriction? Amplifying sound louder than needed for moderate hearing loss is best managed by a professional to prevent potential damage from over-amplification. 

Output: The maximum output of OTC hearing aids is 117 dB, which can benefit those with mild-to-moderate hearing loss but won't be as helpful to those with more severe cases. 

Programming: OTC hearing aids are self-fitting devices, meaning that there is no professional involved in the process. 

The hearing aids will be fit by the user on a Smartphone app. Each OTC hearing aid brand will work slightly differently in the self-fitting process. Read more on the most recent OTC hearing aids

Price: Compared to their prescription counterparts, OTC hearing aids are more affordable. On average, prescription hearing aids can range from $2,000 to $4,500 in out-of-pocket expenses. OTC devices average around half of that price at around $1,000. 

Who Is a Good Candidate for OTC? 

  • Mild to moderate hearing loss
  • Normal ear canal geometry
  • Comfort with technology
  • Independent and able to follow directions

Mild to moderate hearing loss

Individuals with mild to moderate hearing loss can benefit from this technology. Do you have difficulty hearing a normal conversation, even in quiet environments? This suggests a greater degree of hearing loss, and an OTC hearing aid will not provide adequate benefit.

Normal ear canal geometry

Normal ear anatomy will work best for OTC hearing solutions. If you're unsure what that means, let's think about it this way. Have you had ear surgeries (i.e. eardrum surgeries or mastoid cavity)? Do you have trouble getting regular earbuds to stay in your ears? Your answers to these questions will determine whether your ears may be better suited for hearing aids through a hearing care professional rather than OTC.

A hearing professional can take custom molds or help choose receiver wire lengths to manage any irregularities in your ears.

Comfort with technology

Are you comfortable with using an app on a Smartphone? A good candidate for an OTC hearing aid feels comfortable with some technology, mainly because they will program the hearing aid themselves to suit their own hearing needs. Programming is typically completed by visiting a website, following prompts in an app, or following the instructions in a user manual. 

Most reputable OTC providers have customer service teams that can provide remote technical support over the phone. 

Independence

How do you feel about understanding written instructions or looking at pictures and following them? Some people are comfortable with self-guided projects, while others prefer more support. Setting up your OTC hearing aids will involve reading instructions, looking at pictures, and implementing directions. For example, an OTC device will require the user to put the device in their ear and select the correct dome tip size. 

Where can you buy OTC hearing aids? 

In the past, hearing aids were only available through a hearing care professional. OTC hearing aids are now available for purchase in CVS, Walgreens, Walmart, and online through manufacturers' websites. 

Regardless of the retailer you choose, here are a few things to consider before purchase: 

  • How long is the trial period? Most return policies should be 45-60 days. Set a reminder halfway through and check in with yourself on the overall performance of your product.
  • Can you get support if you need it? Does the individual OTC brand provide customer service and remote support? Note that most retailers like CVS or Walgreens will not provide their own support so you will work directly with the manufacturing brand.

You can use this site to compare most of the leading OTC and prescription products side-by-side. We've included details like return policies and customer service on all products so that you can shop with confidence.

How are prescription hearing aids different than OTC? 

To understand the prescription process, you should know a little about how specialists measure hearing. Eyesight is measured in how well you can see at which distance. A doctor evaluates how well you can hear different volumes at different pitches. Simply put, sometimes people with hearing loss hear perfectly well one pitch but struggle with another. 

The prescription process matches amplification to the specific shape of your audiogram. Read more about how audiograms work here.

Most OTC devices give you the ability to do this through a smartphone app, but a professional has more tools and the ability for more precision. 

Hearing professionals can also create custom products and are helpful partners in understanding smartphone apps, volume control, and hearing aid maintenance. 

The prescription process costs more but comes with more built-in support. For many, the tradeoff is worth it. 

Get to know your hearing before you decide between OTC and prescription hearing aids

Deciding between OTC and prescription hearing aids leaves a lot to consider. One thing that helps is knowing more about your own hearing loss.

Consider a hearing test

If you've never had a hearing test, the best thing to do is have a comprehensive hearing test from a licensed professional. Although not a requirement for an OTC hearing aid, it can be hard to know what a "perceived" mild to moderate hearing loss means for the average person. 

An audiologist or ENT can then explain your hearing loss and discuss options that can help. One of these options includes OTC hearing aids. 

You can also get a free hearing test at Costco or Sam's Club or take our hearing screener to get a feel for the process. 

Key Takeaways 

OTC hearing aids are less expensive and are programmed from home. At this time of this writing, they come with fewer features and slightly less premium sound quality (this might change over time). 

Prescription hearing aids are more expensive and require a doctor's visit. At the time of this writing, they come with more features like Bluetooth and background noise reduction. They also come with hands-on support and precise programming. 

Pros:

  • Affordability
  • Convenient access online, at a retail store, or pharmacy
  • A good option for those with mild to moderate hearing loss and comfort with technology

Cons:

  • No hands-on assistance from a professional included
  • Support in background noise may not be as advanced
  • No custom hearing aid options

Some find it helpful to compare reader glasses to OTC hearing aids. Often, readers have the same prescription in both eyes, and they don't account for special needs like astigmatisms. The same is true for hearing aids. OTC hearing aids can provide benefits, but more complex or specific cases can use more support from a prescription hearing aid through a hearing care professional.

If you still aren't sure which product is right, spend some time exploring this site to learn more about your available options. If you have specific questions, you can email us at hello@soundly.com.

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–The Soundly team