Table 1 Compare Best Hearing Aids
Battery | Rechargeable | Rechargeable | Rechargeable with disposable options | Rechargeable | Rechargeable |
Bluetooth | No | Yes | Yes (except the Mini) | Yes for adjustments only, no streaming | Yes for adjustments only, no streaming |
Warranty | 1 year | 3 years (Enhance Select 50R, 300, and 500) | 2 years | 1–2 years | 1 year |
Financing | No | Yes | Yes | Yes | Yes |
What are OTC hearing aids?
OTC hearing aids are FDA-regulated medical devices that can be bought directly from the manufacturer. You don’t need a hearing exam, prescription, or appointment with an audiologist to purchase OTC hearing aids.
OTC hearing aids are designed and best for people who:
- Are age 18 and older with perceived mild to moderate hearing loss
- Do not require a prescription or monitoring from a licensed hearing health professional
- Can comfortably complete a hearing loss self-assessment
- Will be able to independently control their hearing aid settings and software without assistance
According to the FDA’s final rule on OTC hearing aids passed in August 2022, this class of devices is appropriate for people over the age of 18 with perceived mild to moderate hearing loss. [8]
How much do OTC hearing aids cost?
OTC hearing aids range in price from $99 per pair to more than $3,000 per pair. Basic hearing aids with less audiology support and fewer features are often cheaper than those with more tech-forward sound enhancements and in-depth customer care. The average price is expected to come down, though, as more manufacturers enter the market.
The federal government estimates Americans can expect to save up to $3,000 per pair compared to the average price of prescription hearing aids. [3]
Our survey of 600 hearing aid users found that cost was a major factor in respondents’ buying decisions. Price ranked as the second-most important factor when customers were deciding which hearing aid to buy, right behind ease of use.
What to look for in an over-the-counter hearing aid
How do you decide which of the best non-prescription hearing aids will meet your needs? After 5,300 hours of research, our Reviews Team made a list of the best expert shopping advice they had to give on several important points. Here’s what to look for.
Style
OTC hearing aids are available in a variety of designs, from in-the-ear (ITE) to receiver-in-canal (RIC) and behind-the-ear (BTE) styles.
This is the starting point for many people when thinking about which hearing aid is best for them. Not only for how it looks, but for how it feels in the ear. It’s important to buy a hearing aid that’s comfortable since you’ll be wearing it for eight or more hours every day.
Features and Technology
OTC hearing aids come in a wide range of models, from very basic devices to advanced hearing instruments that can be personalized to your hearing profile. It can be tempting to buy the most high-tech hearing aids available, but consider which features you’ll use before paying for them.
For instance, are you looking for OTC hearing aids with Bluetooth? The volume and settings on Bluetooth hearing aids can be adjusted using a smartphone app, but some people prefer making adjustments with buttons or dials on the hearing aid itself. Do you want hands-free calls? Some Bluetooth hearing aids can stream audio from your phone.
Also, consider your lifestyle. If you spend most of your time at home, in quiet environments, or in small groups of friends and family, a more basic and affordable hearing aid like Audien or Lexie or the least expensive MDHearing models may be fine for your needs.
But if you’re often in noisy environments that present listening challenges, you may want a higher-end device with more advanced sound processing abilities and options for customization to your hearing needs in each environment. Brands like Jabra Enhance, Eargo, and Lexie offer some of the best over-the-counter hearing aids with higher-end technology.
Customization
Over-the-counter hearing aids are available as preset or self-fitting devices. A preset hearing aid is pre-programmed when the user receives it, allowing them to choose from a handful of programs or adjust the volume. While these hearing aids tend to be easier to use and more affordable, they’re not as customizable to the environment or user needs. A self-fitting device allows the user to adjust the settings in a Bluetooth-connected app, which allows them to make changes until they find the exact settings that work best for them. These are highly customizable, but they tend to be more expensive and a little more difficult to use.
Battery type
Are you interested in disposable or rechargeable batteries? You’ll pay several hundred dollars more for rechargeability in most cases, but you may find the convenience is worth the extra cost.
Trial period
Because most OTC hearing aids don’t come with the option of seeing an audiologist in person for adjustments and support, it’s important to look for a brand offering a trial period to allow you time to make sure the hearing aids fit well and help with your hearing loss.
Most states require hearing aid dispensers to provide a trial period. To view a list of each state’s requirements, see the Hearing Loss Association of America.
Warranty
Warranty length is also important, as hearing aids are complex electronic devices. You’ll want to find out not only how long the standard warranty is but also what it covers. Among OTC hearing aids, a one-year warranty covering manufacturer defects is common.
Some manufacturers include loss, damage, or wear and tear in their standard warranties. Jabra Enhance is a good example, with a three-year manufacturer’s warranty and three years of coverage for loss and damage.
Other brands provide a short and/or limited warranty, with the option to purchase extended warranty coverage. MDHearing and Lexie both offer this type of coverage.
Take a look at Table 1 at the beginning of this review to compare the warranty lengths of every brand.
Brand reputation
New manufacturers are emerging constantly in the rapidly changing OTC hearing aid market. Consumers need to know how to spot reputable companies and avoid handing their money over to those making false claims or selling devices that aren’t true hearing aids.
One of the best ways to find out if a company is registered with the FDA is to search the FDA establishment registration and device listing, which includes medical device registrations. [7]
It’s also important to read independent customer over-the-counter hearing aid reviews of any devices you’re interested in buying. Don’t take the company’s word for their reputation; check out sites like the Better Business Bureau (BBB) and TrustPilot to see what others have to say.
Who are OTC hearing aids for?
Because they need to be self-fitted and self-adjusted, over-the-counter hearing devices are best for adults over the age of 18 who are comfortable with:
- Using technology
- Making adjustments on their own
- Cleaning and maintaining their own devices
- Communicating with remote audiology support
We spoke with Frank Lin, M.D., director of the Cochlear Center for Hearing and Public Health at Johns Hopkins University in Baltimore, Maryland. He noted that different people have different needs when it comes to hearing loss treatment.
“In treating hearing loss, there is technology and there are services. They’re two different things. For example, I can think of many of my patients in their seventies and eighties who theoretically could benefit from an OTC hearing aid, but they’re still going to need the assistance of an audiology or other health professional to help guide, counsel, and educate them.
“And I have other people, who are probably younger, who could get an OTC hearing aid and be fine. They don’t need my help or another audiologist’s help.”
Hearing aids are not always the appropriate treatment for hearing loss. There are sometimes other issues that need to be addressed before you start using a hearing aid. A hearing care specialist has the equipment to determine your level of hearing loss better than an online hearing test can and will physically examine your ears and go over your medical history to rule out any other problems, such as:
- Sudden change or loss of hearing
- Injury to the head or ear
- Pain or discomfort in or around the ear
- Fluid, blood, or pus in the ear
- Tinnitus, a ringing sound in one or both ears
- Earwax buildup or other obstructions in the ear
What hearing aid is best for my level of hearing loss?
People with mild to moderate hearing loss are the best candidates for OTC hearing aids. For those who have a higher than moderate level of hearing loss, it’s best to consult a hearing professional before purchasing OTC devices.
Here are the four degrees, or levels, of hearing loss:
- Mild hearing loss: You have a hard time hearing soft sounds, like whispers, but can hear most normal speech unless you’re in a noisy or crowded environment.
- Moderate hearing loss: You have trouble hearing normal levels of speech and miss a lot of what’s being said. It may seem to you that people are mumbling.
- Severe hearing loss: You cannot hear others talking at normal levels but are able to hear some sounds that are loud, like lawnmowers.
- Profound hearing loss: You cannot hear any speech but can hear sounds that are very loud, like construction noise.
Over-the-counter hearing aids pros and cons
While OTC hearing aids are an exciting opportunity for more people to have access to affordable hearing aids, they can have drawbacks compared to prescription hearing aids. Let’s look at the pros and cons of OTC hearing aids.
Pros
- Cost: The OTC hearing aids on the market are less expensive than prescription hearing aids, and the price is expected to drop even more due to increased competition.
- Availability: OTC hearing aids are available online and in a few stores that carry health care devices. Retail chains that sell OTC hearing aids include Walmart, CVS, and Walgreens.
- Ease of use: OTC hearing aids are designed to be adjusted by the user. Manufacturers have made them easy to use right out of the box with clear instruction manuals, volume dials, and program settings that can be adjusted directly on the hearing aids—or in a smartphone app for some models. Our Reviews Team found that nearly every brand was easy to set up and use without professional assistance.
Cons
- Limited in-person care: If you’re new to hearing aids or don’t feel at ease using technology, the lack of in-person care by a hearing specialist could be a drawback. Every brand except Audien offers remote support from audiologists or other hearing specialists, and you can also call or email your hearing aid manufacturer for help. But remote support doesn’t give you the option of having your hearing aid fitted in person with a specialist.
- Fewer features: Because OTC hearing aids are less expensive than prescription hearing aids, they don’t include the most advanced hearing technology some top-of-the-line brands do. For instance, prescription brand Oticon uses machine learning to teach the hearing aid which sounds you hear most often and adjust itself accordingly. You won’t find that type of technology in an OTC hearing aid, but many people find they still have a high level of success with simpler OTC devices. If you have a specific type of hearing loss, such as one-sided hearing loss or tinnitus, you may need a more personalized prescription device.
- Not appropriate for all levels of hearing loss: Remember that OTC hearing aids are only approved for use in adults with mild to moderate hearing loss. If you’ve been told by a hearing specialist you have severe or profound hearing loss, you will need to get prescription hearing aids.
Bottom line
Over-the-counter hearing aids are a significant step forward in making hearing loss treatment more accessible to millions of Americans. If you have mild to moderate hearing loss and budget is your primary concern, Audien is a low-cost hearing aid that may meet your needs.
For people who want a higher level of technology, customer care, and financing options, Jabra, Eargo, Audien, Lexie, and MDHearing are our top picks for the best OTC hearing aids.
Sources
- Bigelow RT, et al. Association of Hearing Loss With Psychological Distress and Utilization of Mental Health Services Among Adults in the United States. Journal of the American Medical Association (2020). Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372323/
- Desjardins, JL. Analysis of Performance on Cognitive Test Measures Before, During, and After 6 Months of Hearing Aid Use: A Single-Subject Experimental Design. American Journal of Audiology (2016). Found on the internet at https://pubs.asha.org/doi/10.1044/2016_AJA-15-0067
- The White House. Statement by President Joe Biden on FDA Hearing Aids Final Rule. Found on the internet at https://www.whitehouse.gov/briefing-room/statements-releases/2022/08/16/statement-by-president-joe-biden-on-fda-hearing-aids-final-rule/
- MDHearing. MDHearing Receives 510(k) FDA Approval for Its Self-Fitting Smart Hearing Aids. Found on the internet at https://www.mdhearingaid.com/blog/mdhearing-receives-510k-fda-approval/
- Hearing Loss Association of America. Medicaid. Found on the internet at https://www.hearingloss.org/hearing-help/financial-assistance/medicaid/
- U.S. Department of Veterans Affairs. Rehabilitation and Prosthetic Services. Found on the internet at https://www.prosthetics.va.gov/psas/Hearing_Aids.asp
- U.S. Food and Drug Administration. Devices@FDA. Found on the internet at https://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm
- U.S. Food and Drug Administration. FDA Finalizes Historic Rule Enabling Access to Over-the-Counter Hearing Aids for Millions of Americans. Found on the internet at https://www.federalregister.gov/documents/2022/08/17/2022-17230/medical-devices-ear-nose-and-throat-devices-establishing-over-the-counter-hearing-aids
- Federal Register. Medical Devices; Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids. Found on the internet at https://www.federalregister.gov/documents/2022/08/17/2022-17230/medical-devices-ear-nose-and-throat-devices-establishing-over-the-counter-hearing-aids
- U.S. Food and Drug Administration. Are There “FDA Registered” or “FDA Certified” Medical Devices? How Do I Know What Is FDA Approved? Found on the internet at https://www.fda.gov/medical-devices/consumers-medical-devices/are-there-fda-registered-or-fda-certified-medical-devices-how-do-i-know-what-fda-approved/
- Hearing Loss Association of America. Hearing Loss Facts and Statistics. Found on the internet at https://www.hearingloss.org/wp-content/uploads/HLAA_HearingLoss_Facts_Statistics.pdf