Over-the-Counter (OTC) Hearing Devices
Hearing loss is the third most common chronic condition in older adults in the United States. Nearly 30 million adults in the U.S. could benefit from amplification; however, research shows that only 20 to 25% of those experiencing hearing loss use hearing aids. Most adults wait an average of 7 years to seek treatment. People with hearing loss face many barriers to obtaining hearing aids—namely, cost, transportation, and lack of access. Recent studies show that even a mild untreated hearing loss can be a significant risk factor for cognitive decline, increased falls, and depression. Given the impact that untreated hearing loss can have on a person’s overall health, over-the-counter hearing aids can provide accessible and affordable treatment to a previously underserved population.
Most hearing losses are very treatable with hearing devices, and until recently, the only way to get a hearing aid was through an audiologist. However, as of October 17, 2022, OTC hearing devices are available in big box stores, pharmacies, and online.
Frequently Asked Questions
OTC hearing devices are indicated for those 18 years or older with a perceived mild to moderate hearing loss. They are not appropriate for any hearing loss greater than a moderate degree.
People who experience any of the following “RED FLAG” conditions should see a medical provider prior to wearing an OTC device:
- Physical ear deformity
- Fluid, drainage, or blood coming from the ear
- Hearing loss or ringing (tinnitus) occurring in only one ear or that is noticeably different between ears
- Ear pain or discomfort
- History of excessive wax
- Sudden, worsening, or fluctuating hearing loss
- Vertigo or dizziness
- Significant cognitive or dexterity issues
What is the difference between an OTC device and a prescription hearing aid?
| OTC device | Prescription hearing aid |
|---|---|
| Self-fitting | Fit by a licensed audiologist |
| Age 18 years+ | All ages |
| Hearing loss perception | Hearing loss diagnosed and confirmed |
| Perceived loss perception | All degrees of hearing loss severity |
| One size fits most | Customized to patient needs/wants |
| No return policy required | Return policy mandated in most states |
| Self-selected | Functional assessment with an audiologist |
| No verification of benefit | Verification of benefit |
| Not fully programmable | Fully programmable by an audiologist |
| N/A | Medical grade device |
| Cost on average: Up to $2,500 a pair | Cost on average: Starting at $2,000 a pair |
What are the pros and cons of OTC hearing devices?
Pros:
- Can reach more people in need due to increased access and low cost
- May be a good starting point for those with mild hearing loss who are on the fence about using hearing aids
- Overall health benefit and improved cognition
- Less loneliness, depression, etc.
- Because a full audiologic evaluation is not required to use an OTC device, many people will underestimate or overestimate their hearing loss, resulting in improper amplification. Hearing test apps can be a source for attempting to confirm the degree of hearing loss; however, a formal test with an audiologist is recommended to maximize benefit.
- OTC hearing devices are self-fitting, usually non-programmable, one-size-fits-most devices. The user can make changes to the volume; however, the sound quality of the devices may not be adjustable to reflect the preferences of the user. Some manufacturers offer limited virtual support. Additionally, objective benefit cannot be assessed to determine the effectiveness of the devices. However, with prescription hearing aids, an audiologist can objectively verify the device's benefit and make customized programming changes to personalize the sound quality for each individual. Services also include instructions on use and maintenance, cleaning/care, charging, and smartphone app and streaming assistance.
- The presence of previously mentioned “RED FLAG” conditions can negatively impact the benefit from OTC devices. Being evaluated by an audiologist for these conditions prior to purchasing an OTC is recommended.
The best way to know if OTC hearing devices will work for you is to have your hearing evaluated by a licensed audiologist. This is a visit routinely covered by insurance. At this visit, the audiologist will examine your ears and hearing for any medical conditions that would need medical attention prior to using hearing devices. Options will be discussed relative to OTC versus prescription devices depending on the results.
Some audiology practices will consider providing the instruction and benefit verification for a fee. Most OTCs are non-programmable so the sound quality cannot be adjusted. Yale Hearing and Balance is offering instruction and validation services for an out-of-pocket fee of $100. This visit will include instruction on use, manipulation, and maintenance of the OTC device as well as testing with the OTC device to objectively measure fit and benefit. After you have become comfortable with using the devices, Yale Hearing and Balance will continue to offer troubleshooting visits for $25 per visit. This type of appointment will include cleaning the devices and attempting to repair any issues. Note that OTC devices may not be able to be repaired in the office due to device limitations.