OTC hearing aids are OTW. Here’s what an audiologist wants you to tune into.

September 06, 2022
Man looks down while woman's hands put hearing aid on his left ear.
The federal government estimates almost 30 million Americans could benefit from hearing aids. iStock

As retailers from Best Buy to Walgreens prepare to sell over-the-counter hearing aids when they become available next month, an MUSC Health audiologist has some advice for people considering buying them.

First of all, they aren’t for everyone with hearing loss, said Meredith Duffy, AuD.

“These devices are really only recommended for people with a perceived mild to moderate hearing loss. If there are other symptoms or issues like ringing in the ears, a history of ear infections, drainage, pain in the ears, ear deformities, vertigo or dizziness or a sense that one ear is better or worse than the other, these are all reasons to see both an ear, nose and throat doctor and an audiologist before pursuing the OTC hearing aids. They would probably need to be fit with the more traditional prescriptive hearing aids.”

Duffy said they’re also not recommended for people under the age of 18. “It is very important for children and teens with hearing loss to be fit correctly with hearing aids by a pediatric audiologist. The customized programming is very important to ensure the hearing aids never get too loud, are appropriate for the child’s hearing level and age and provide access to important speech sounds needed for normal language development and learning in school.”

But people who do qualify for over-the-counter hearing aids could see – and hear – real benefits, Duffy said. 

“It definitely gives more access to people who don’t have the financial ability to buy traditional hearing aids. It also might push people who are aware of their hearing loss to try amplification sooner than later. The OTC options will give those with less hearing loss improved access to devices that meet their needs and are less expensive than current options.”

a woman sitting points to a device in the hand of a standing female audiologist 
Audiologist Meredith Duffy shows patient Lindy Brennan her new hearing aid in 2021. Photo by Sarah Pack

Duffy said the over-the-counter hearing aids will probably cost between $500 and $1,000 per ear. “They will either be sold single ear or as a set. Currently, most are sold as sets.”

Prescription hearing aids cost substantially more than that. “They typically range from $1,000 up to $3,000 per device on average, depending on the technology inside of the hearing aid.”

Her reference to the technology level gets at a key difference between over-the-counter and prescription hearing aids. 

“In prescription hearing aids, the price is mostly affected by the number of automatic features and the number of channels – or bands – that the sound gets filtered through to create both a natural sound and an improved ability to separate background noise and speech information for better listening in noisy environments.”

You can’t get those features in over-the-counter hearing aids, Duffy said. “You'd have to go to an audiologist for that.”

You’d also have to go to an audiologist to get a full hearing test. “We test your hearing at different frequencies or pitches. Often, people have different hearing across the pitch range, and they may have different hearing in each ear. When an audiologist programs hearing aids, we use the hearing test to more accurately assign appropriate output for each ear and per pitch. It’s a much more customized experience.”

That customization includes making sure the prescription hearing aids are the right fit. “We run tests with the hearing aids in the patient’s ears to verify that the hearing aids are giving the correct amount of gain, we call it, or output that’s necessary for their hearing loss. We also show them how to use the hearing aids, how to put them in their ears, how to charge them or change the batteries and how to keep them clean and maintain the devices.”

But Duffy said cost has muffled demand for hearing aids among people who aren’t financially comfortable. Selling them over the counter as well as by prescription could help change that. 

The over-the-counter versions have been tweaked to help protect the public. “The new FDA ruling has lowered the maximum output level so that a wearer is not at risk of noise-induced hearing loss on top of the hearing loss they already have. They also limit the depth that the hearing aid goes into the ear so it does not put the eardrum at risk of being touched or damaged,” Duffy said.

“Other than that, they are going to be accessible for pretty much anyone. It’s still strongly recommended that you see an audiologist to confirm that the hearing loss is no more than a mild to moderate severity and to rule out other medical issues that may be causing the hearing loss, ranging from earwax buildup to a tumor.”

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