How to Shop for an Over-the-Counter Hearing Aid
Prices are lower than prescription models and choices plentiful
If you’re among the 30 million Americans struggling to keep up with conversations in noisy restaurants or battling with your spouse over the TV volume, your life is about to get better.
High-quality over-the-counter (OTC) hearing aids that are more affordable than those bought through health professionals are hitting stores now. And you won’t need a prescription.
“Almost 90 percent of people with hearing loss have mild to moderate losses, and the vast majority could be helped by OTC hearing aids,” says audiologist Nicholas S. Reed, assistant professor at the Johns Hopkins University Bloomberg School of Public Health and coauthor of AARP’s Hearing Loss for Dummies. “This market has been innovative but hasn’t had this kind of competition before.”
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Pharmacies and other retailers began to stock OTC hearing aids in mid-October. But shopping for these hearing aids, which are also sold online, may not be quite as simple as going to the drugstore to buy aspirin or even reading glasses.
Not only do these long-anticipated devices let millions of adults with mild to moderate hearing loss purchase hearing aids without a prescription, they also don’t require an exam or consultation with an audiologist or doctor.
This should mean far lower costs for most consumers since traditional hearing aids can run $2,000 to $4,000 a pair, according to Kate Carr, president of the Hearing Industries Association trade group in Washington, D.C. Premium aids can cost as much as $6,000 per ear.
“It’s going to be the wild, wild west for a couple of years” because OTC hearing aids are a whole new category of help for people who are hearing-impaired, said Frank Lin, M.D., director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health and Dummies coauthor.
“Everybody is figuring out how to price them, how to market them,” said Lin, speaking at an AARP virtual event. “Right now, the prices we are seeing, $200 to $1,500, are all over the map. What is the price that consumers are willing to pay?” He predicted that prices would drop, perhaps to the cost of wireless earbuds.
As manufacturers raced to get their products to market, we talked with audiologists, consumer advocates, industry experts and the makers of major U.S. hearing aid brands to answer your most pressing questions.
Hearing Loss for Dummies
Authors Frank Lin and Nicholas Reed at the Johns Hopkins School of Medicine lay out the steps to hearing health, including new advice on just-released over-the-counter hearing aids.
3 types of hearing aids
1. Behind-the-ear (BTE) models. The device tucks in behind your ear. Sound is delivered into your ear canal via a thin, hollow tube or via a wire and speaker bud that tucks into your ear canal.
These don’t fit tightly in your ear, so natural sound can also enter. Traditionally, these devices’ larger size means more power and more features than smaller hearing aids can deliver.
2. In-the-ear and “invisible” in-the-ear-canal models. These small hearing aids are more difficult to see — a cosmetic advantage.
Completely in-the-canal models may be best for mild hearing loss. Their small size has traditionally meant less power and fewer features, Reed and Lin note in their book. But that could change with competition driving innovations in the months and years ahead.
3. Rechargeable earbuds. They look like conventional Bluetooth wireless earbuds for your phone or listening to music and are best for part-time use for a few hours at a time, such as when you’re dining in a noisy restaurant.
“Our products are for situational use,” says John Luna, CEO of Nuheara, maker of OTC hearing aid earbuds called HP Hearing Pro. “Most first-time wearers with perceived mild to moderate hearing loss will have a need sometimes but not all the time. They’re not meant to be worn 12 to 14 hours a day, as you would for moderate to moderate/severe hearing loss.”
Your questions, answered!
Consumers may have trouble navigating store shelves and websites to determine which models and features not only properly fit their ears but also fit their budgets. Here is some advice to help you get started.
Q. How do I know if an OTC hearing aid is right for me?
A. OTC hearing aids can help if you have mild to moderate hearing loss. For severe or profound hearing loss, you’ll need to see an audiologist or another hearing professional.
• Mild to moderate loss. You have trouble hearing a conversation in a noisy restaurant, ask people frequently to repeat what they said or turn up shows or music to levels that are uncomfortable for others in the room. Or you may have difficulty understanding what people say if you can’t see their lips moving.
• Severe loss. You can’t hear a conversation in a quiet room or loud sounds such as power equipment or trucks.
Q. How much will these new hearing aids cost?
A. Makers we interviewed estimated their models may sell for $200 to $1,000 a pair, but some could cost more. Walmart says it is selling OTC hearing aids that range from $199 to $999 a pair. Models sold at Best Buy carry a similar starting price but climb to around $3,000 a pair. CVS, Hy-Vee and Walgreens are among other retailers selling the devices.
Q. Should I get a hearing test just in case?
A. Yes. Private insurance and Medicare may cover a professional hearing test if you have a referral from your doctor and if the purpose is to “see if you need medical treatment,” according to Medicare. You also can get a basic sense of the state of your hearing with smartphone app self-tests such as Mimi or SonicCloud that provide pure-tone audiometry results, Lin says.
These programs test your hearing thresholds at 500, 1,000, 2,000 and 4,000 hertz (Hz). You “know your number” by adding up these thresholds and dividing by 4.
“If your number is between 20 and 60, an OTC hearing aid could help you,” he says. “Over 60, [and] a prescription hearing aid or even a cochlear implant could help you.”
Q. How much hand-holding will I get in a store?
A. Don’t expect the same amount of attention from a retailer as you would get at a hearing clinic. Some pharmacists or other retail staffers have received training, but this isn’t true across the board.
“There’s definitely going to be a steep learning curve for both retail channels as well as the consumer in this kind of transition phase,” says Nic Klopper, chief executive of South Africa–based hearing aid manufacturer Lexie Hearing.
At Best Buy, which plans to open hearing centers in about 300 stores this fall, store associates have been trained on topics that include the anatomy of the ear, stages of hearing loss, general fitting techniques and different features of various devices and brands, the company says.
“If you need a lot of extra help … and you’re not really capable of understanding how your phone works or your tablet works, you should absolutely go to a clinic and get that extra level of what I would call hand-holding,” says Christian Gormsen, Eargo chief executive. His company’s nearly invisible in-the-ear hearing aids, at $2,950 a pair, are among the most expensive now available without a prescription. But “over the counter will be good enough for the vast majority” of people who might need a hearing aid.
Q. Where will I find hearing aids in a store?
A. Some retailers will carry OTC hearing aids on regular store shelves, at a kiosk or in designated well-marked areas. Other products, such as the $799 Lexie Lumen hearing aid, will be behind the pharmacy counter, according to Luke Rauch, Walgreens’ senior vice president and chief merchandising officer.
Q. Will I be able to program and customize them?
A. OTC hearing aids must be “customizable” to a user’s unique needs because each person experiences different levels of hearing loss at different sound frequencies. In addition, each ear can have different ranges of hearing loss. But that doesn’t mean every OTC hearing aid can be perfectly calibrated to your specific hearing profile.
OTCs that call themselves “self-fitting” must be able to deliver results on par with a fitting from a hearing professional using a smartphone-based hearing test. Based on the results, an app automatically calibrates low-, medium- and high-frequency sound output for each ear.
Some will offer a choice of preprogrammed settings that represent common hearing-loss profiles. You toggle between them to find one that sounds best. These models may be less expensive, but they may not offer the perfect fit for your hearing needs.
Both types of OTC aids will also offer a variety of features that tweak sound for better hearing in specific situations, such as reducing background noise when at a restaurant, allowing a wider volume range for all sounds at a concert or tamping down whooshing wind on a blustery day.
Q. When should I consult a hearing professional?
A. If your hearing loss is sudden or severe, or you can only hear out of a single ear, seek medical help. The new hearing aids are approved only for people with mild to moderate hearing loss, so those with severe hearing loss should still consult an audiologist.
Some indications your hearing loss might be severe:
•You can’t detect any speech in a quiet room.
•You have difficulty hearing loud music, power tools, engines and other noisy things.
“I think a lot of audiologists and hearing aid specialists are going to carry a few of these devices in their practices because some [consumers] will show up and say ‘I would at least like a test and find out,’ ” says audiology consultant Thomas Powers, who founded Powers Consulting in Oxford, New Jersey.
Carr of the Hearing Industries Association agrees.
“There are experts out there who know a lot about hearing aids. And they’re hearing professionals,” she says. “If you’re struggling, look to one of them for some type of assistance.” You will have to pay a fee for their help.
What to look for when you buy
1. The words “over- the-counter (OTC) hearing aid” on the package. This is the FDA-regulated designation that says you’re purchasing actual hearing aids and not some type of amplification device. Several models may also carry the designation “Self-Fitting OTC Hearing Aid.” That includes the recently announced $1,000 inside-the-ear-canal Sony CRE-C10 sold at Sony’s website, as well as at Amazon, Best Buy and elsewhere.
2. Requirements for smartphones. Many, but not all, OTC hearing aids require users to download and use an app on their smartphone. For details about types compatible with your phone — some work only with iPhones, not Androids — you’ll have to go to the maker’s website or read the material inside the package.
3. A 30-day (or more) return policy. The Hearing Loss Association of America recommends choosing devices with a generous return policy. It can take several weeks to know whether new hearing aids work for you, in part because your brain has to acclimate to all the new sounds you’ll hear, says Sarah A. Sydlowski, past president of the American Academy of Audiology.
You’ll want to allow yourself time to get used to wearing a hearing aid and testing it out in different environments. See how different tips, domes or petal sizes feel on models that have them, and which types feel more comfortable.
Soundly founder Blake Cadwell, who wears hearing aids, says to make sure you have at least 45 days to check them out.
“Even if you get a product that is $400 or $500, you can always return it if you don’t like it,” he says. You’ll also want to ask about what kind of support is available once the trial expires, including the cost of replacing a damaged or lost hearing aid.
4. Added features. More expensive OTCs work with telecoils, which pick up signals sent directly to your hearing aids in movie theaters and concert halls. Others may come with Bluetooth options that allow you to stream phone calls and other media wirelessly through your hearing aids.
Different hearing aid manufacturers will market different features. Jabra says its OTC $799 Enhance Plus earbuds have been engineered for phone calls and listening to music.
On the higher end: Models with more powerful speakers, processors, directional microphones that can focus on the person you’re talking with, features that can filter out background noise and hearing aids that exploit the latest artificial intelligence technologies.
Some hearing aids can automatically adjust to different volumes at different frequencies. Premium models let you customize your hearing profile, typically via Bluetooth and a smartphone app.
“Our ears are as unique as a fingerprint,” says Klopper of Lexie Hearing. As part of the setup of the Eargo 6 hearing aid, you can choose three specialized listening environments — such as dining in a restaurant, watching TV or attending a meeting — to complement a fourth normal setting for quiet listening. When you’re out and about, you can double-tap each hearing aid to switch modes on the fly.
5. Rechargeable versus battery-powered. Choose a power option that allows you to wear hearing aids during all your waking hours. Your brain needs to receive input consistently to acclimate to the new device. More expensive models tend to include rechargeable batteries and sometimes wireless charging options. Generally, less expensive hearing aids require you to periodically replace the batteries. For example, the $999 Lexie B2 hearing aid promises up to 18 hours of battery life after a three-hour charge.
6. A look that you like. Hearing professionals say wearing your hearing aids regularly is crucial to helping the wearer make the most of them and may even protect hearing from further loss. So buying a look that you are comfortable with is important. The biggest appeal for some people who spring for the pricey Eargos may come down to appearance. Unlike hearing aids that fit behind the ears or stick out some, all you see of the Eargos when they’re inside your ears are barely visible threads that help you remove the hearing aids.
Sari Harrar is an award-winning reporter and contributing editor to AARP publications who writes on health, public policy and other topics.
Edward C. Baig is a contributing writer who covers technology and other consumer topics. He previously worked for USA Today, BusinessWeek, U.S. News & World Report and Fortune and is author of Macs for Dummies and coauthor of iPhone for Dummies and iPad for Dummies.