Your Health
CAN YOU HEAR ME NOW?
Big prices, small selections, lots of confusion have hurt the launch of over-the-counter hearing aids
Last fall, shortly after over-the-counter hearing aids first came to market following their approval earlier in 2022 by the U.S. Food and Drug Administration, Colleen Price went shopping for a pair. “It was crazy,” says Price, 63, of Philadelphia. “Too many brands. Too much confusing marketing. And prices from $49 to thousands of dollars.”
The official arrival of OTC hearing aids came with the promise of an affordably priced, easy-to-access remedy for the 30 million American adults with mild to moderate hearing loss. (People with severe hearing loss still need prescription hearing aids.) But instead of instant solutions, many consumers found confusion in the first several months of availability. “I think someone new to hearing aids would be completely lost,” says Stephen Frazier, 85, a volunteer hearing support specialist for the Hearing Loss Association of America. Surveying stores around Albuquerque, New Mexico, last fall, he found a small selection (or no hearing aids at all) and often employees who couldn’t answer questions or even find the devices—a real problem considering that in a December 2022 survey of 1,000 Americans, 80 percent of older adults said they knew little to nothing about OTC hearing aids.
“It’s like the Wild West out there,” acknowledges D’Anne Rudden, an audiologist in Longmont, Colorado.
Few people know the names of the more reputable or established hearing aid manufacturers, making shopping hard. Prices vary like crazy. Sorting through the dizzying array of features and advertising claims isn’t easy. And until recently, online reviews of OTC hearing aids done by impartial, reputable organizations were nowhere to be found. (Since April, several independent review roundups and buying guides have appeared on sites such as Consumer Reports, Everyday Health, Forbes and CNET. AARP also provides lots of advice at aarp.org/hearing.)
All this has made potential customers wary: Early sales figures for many OTC hearing aids were “very, very, very low,” says Kate Carr, president of the Hearing Industries Association. In a March 2023 Northwestern University study of 1,037 midlife and older adults, 84 percent said they would rather buy hearing aids from a hearing professional.
But as more consumers experiment with them and the market settles down and grows wiser, OTC hearing aids still likely have a bright and important future. “There’s still a lot of buzz,” says Alicia D.D. Spoor, an audiologist in Highland, Maryland, and past president of the Academy of Doctors of Audiology. Here’s what you need to know to cut through the confusion.
1. Yes, OTCs can be as good as Rx hearing aids
In a just-published study, researchers tracked 68 older adults with mild to moderate hearing loss who got their first Rx or OTC hearing aids. The OTC group set up their devices themselves—downloading a smartphone app, taking a hearing test to adjust the sound and contacting the hearing aid maker’s support center for help. Audiologists helped the Rx group. After six weeks, both groups had nearly identical scores for ease of communicating with others and ability to hear speech in background noise.
“That’s a very significant takeaway,” says Nicholas S. Reed, an audiologist and assistant professor at the Johns Hopkins University Bloomberg School of Public Health and coauthor of AARP’s Hearing Loss for Dummies. He was not involved with the study. “You can basically hand someone this product, and they can improve their hearing.”
2. Your choices are getting clearer
Your biggest decision is between lower-tech (and lower-cost) OTCs with preset sound programs and higher-tech “self-fitting” models that personalize sound output for your unique hearing-loss profile, via a hearing test you take through your new hearing aids connected to a smartphone app.
What’s better? Experts say self-fitting models can be as good as prescription hearing aids that cost thousands of dollars more. “Really advanced [prescription] hearing aids will have up to 48 frequency channels,” Reed says. “But there’s not a lot of scientific evidence you need all these channels. A device with four or eight might have the same outcome.”
If you prefer hearing aids that do not require a smartphone for setup and use, or want to spend less, OTCs with preset programs are a good option, particularly if your hearing loss follows common patterns.
“Often I see presets for high-frequency hearing loss—for people whose hearing is good in the low pitches but have age-related or noise-induced hearing loss at higher ranges,” Spoor says. “It’s very easy to put them on, choose an option, and it meets the target pretty well.”
There are a number of other issues to consider when buying. There are two main categories of hearing aids. Behind-the-ear (BTE) aids hook over your ear and use a thin tube and earpiece to transmit sound; these are the most popular and allow natural sound to easily enter your ear. In-the-ear, or in-the-canal (ITC), aids are smaller and less visible; they’re molded to fit directly into your ear canal. They have benefits, but their smaller size means fewer features and more difficulty handling.
Another important consideration is battery life: Usage time for hearing aids with rechargeable batteries can vary from 12 to 24 hours (important to know if you plan to wear your hearing aids all day as audiologists recommend). Other devices use tiny button batteries that need to be replaced every several days, but which can be hard to handle with stiff hands or low vision. A recent review of dozens of OTC hearing aids by the National Council on Aging found one low-priced model came with a tiny screwdriver for volume control.
Innovations are emerging constantly. Lucid Hearing lets users of two of its OTC models bring them into its Sam’s Club Hearing Aid Centers (if they are Sam’s Club members) and for an extra $200 convert them into prescription hearing aids with adjustments made by a hearing professional. That’s what Colleen Price did, and she found that the extra attention and customized sound made all the difference. Other notable features include directional microphones, so you can choose which sounds get amplified (useful for hearing your companion in a busy restaurant). And a class of OTC hearing aids that look like wireless earbuds come equipped with Bluetooth for high-quality music listening.
3. Pricing will remain at several tiers
Hearing specialists told AARP they were frankly disappointed and surprised by high OTC prices. While low-tech OTC models sell for as little as $99, high-tech, feature-packed models go for as much as $2,950. “Everybody thought these minicomputers we put in our ears and use every day would be $100, but basic models are more in the $500 range,” Spoor says.
Look for a generous return policy, which will allow you to test out the many different facets of the hearing aid. Researching and comparing features (and prices) is critical, says Kathleen Cameron, senior director of the NCOA’s Center for Healthy Aging.
If you’re shopping for a bargain device, keep an attentive eye out for deceptive marketing. Unscrupulous sellers market devices called personal sound amplifiers (PSAPs) as “hearing aids.” They aren’t. Others claim that their OTC hearing aids work for all levels of hearing loss (they can’t), or they use label language such as “FDA-approved,” Carr warns. Only hearing aids that meet FDA OTC requirements, including those for sound customization and safe volume limits, can be marketed as OTC hearing aids, says FDA spokesperson Carly Kempler.
If you’re considering a higher-priced OTC, experts recommend scheduling an appointment with an audiologist, getting a professional hearing test and discussing options. Prescription-grade hearing aid makers are trying to remain competitive with OTC competitors, so they discount their products heavily. Some budget-priced Rx models come bundled with audiology tests and after-purchase expert adjustments for as little as $1,000.
4. Finding them should get easier
Seeing OTC hearing aids in person before you buy is easier now, though you may have to visit several stores to find a variety. Best Buy locations across the U.S. stock nine OTC models, while other sellers have more limited offerings. Walmart’s in-store Vision Centers stock OTCs from Lexie powered by Bose, HearX and Hearing Assist. Sam’s Club’s 473 in-store hearing centers sell Lucid OTCs. At press time, Walgreens, Beltone hearing aid stores, Victra-Verizon retail stores and Hy-Vee supermarkets each carried just one brand or one model.
Online shopping is another alternative, with options ranging from giant sellers such as Amazon to manufacturer websites. Hearing specialists interviewed for this story recommended checking reviews and information at websites that employ audiologists, including AskAnAudiologist.com, HearingTracker.com and Soundly.com.
Sari Harrar is a contributing editor to AARP The Magazine and writes about health and other topics for the AARP Bulletin. Additional reporting by Stewart Wolpin.