The 8 best OTC hearing aids for seniors, according to audiologist and medical professionals
Hearing aids enhance everyday life in several ways, from helping you hear conversations more clearly to enjoying music and TV at a comfortable volume. Wearing hearing aids has also been linked to improving quality of life factors such as improved cognitive function and reduced risk of depression and dementia. An estimated 48 million Americans suffer from some degree of hearing loss — yet only one in five people who could benefit from a hearing aid actually use one. In addition to aging, hearing loss can also be attributed to genetic mutations, noise exposure, exposure to therapeutic drugs that have ototoxic side effects and chronic conditions. Unfortunately, the very hefty cost of prescription hearing aids has traditionally prohibited many from having access to the best hearing aids.
In an effort to help make hearing aids more affordable and accessible, in 2022, the FDA approved the sale of OTC hearing aids. Now you can find the best over-the-counter hearing aids through major retailers, such as CVS, Amazon and Best Buy. Amanda Cooper, a licensed hearing aid specialist tells us, “While there is no way to reverse hearing loss, hearing aids can greatly support an individual’s hearing needs." Understanding the difference between over-the-counter (OTC) and prescription hearing aids is crucial in making an informed purchasing decision.
AOL spoke with Cooper and other hearing experts, including audiologists and doctors, to better understand how OTC and prescription hearing aids compare. We then took their feedback and reviewed 20 of the best over-the-counter hearing aids on the market. Each was evaluated on costs, sound quality, ease of set up, comfort, customer support and any special features unique to the hearing aid. Here are our top picks for the best over-the-counter hearing aids of 2024.
What to consider when buying a hearing aid
There are several key factors to consider when purchasing a hearing aid:
Style of hearing aid: There are multiple styles of hearing aids, each of which caters to different aesthetics and functionality.
Behind-the-ear (BTE): These rest behind the ear while a plastic tube directs amplified sound into the ear canal through an ear mold. BTE hearing aids are suitable for most types of hearing loss and are the most visible type.
Receiver-in-canal (RIC): Similar to BTEs but with the speaker or receiver placed inside the ear canal. Their size reduction often makes them less visible and more comfortable, and they can provide natural sound quality.
In-the-ear (ITE): Most ITEs are custom-made and fit within the outer ear; ITE aids are easier to handle and are often a top pick due to their discreet profile.
In-the-canal (ITC): Many of these devices are custom molded and fit partly in the ear canal, making them less noticeable than ITE models.
Completely-in-canal (CIC): This is the most discrete option that fits deep inside the ear canal. These are typically custom-fitted to be nearly invisible and are well-suited for mild to moderate hearing loss. However, they may be challenging for users with dexterity issues due to their small size.
Cost: Hearing aids can cost anywhere from a few hundred to several thousand dollars. Some insurance plans may cover hearing devices partially or entirely, and certain models are eligible as an FSA/HSA-approved expense. Consider your budget, insurance, and whether batteries and accessories are included in the cost.
Prescription or OTC: Prescription hearing aids require a medical evaluation and fitting by an audiologist, while OTC options are purchased without a prescription. An OTC model may be suitable if you have mild to moderate hearing loss and are comfortable with technology. On the other hand, a prescription hearing aid is likely the best option if you have moderate to severe hearing loss or prefer professional fitting and support.
According to Dr. Leigh Smith, whether you opt for a prescription or OTC model, a professional evaluation should be the first step to assess for any underlying medical conditions and determine the appropriate level of amplification needed.
Set-up: Prescription hearing aids require professional fitting and calibration, while OTC options are generally self-fitting. Users adjust the volume manually or use an app to customize sound settings and frequency. However, some OTC options now offer remote programming and assistance from a hearing professional. Remote access allows you to send data and receive tailored adjustments from an audiologist without an in-person visit.
App pairing: Basic models use physical buttons to adjust volume and settings, whereas many newer hearing aids offer a companion app for customizing sound profiles and tailoring the amplification level based on your environment. Consider whether you prefer a model with app pairing capabilities or if standard controls are sufficient.
Bluetooth capabilities: Models that connect to your smartphone via Bluetooth are great for streaming music, phone calls, and audio directly from the device, eliminating the need for headphones or an external speaker. If this is a feature you want, ensure your chosen model has Bluetooth capabilities and is compatible with your smartphone.
Extra features: Many hearing aids offer additional features such as rechargeable batteries, directional microphones, wind noise reduction, extended battery life, and advanced noise cancellation. Trial periods, warranty lengths, and professional support are also important, as each OTC model comes with varying levels of support.
Who should consider over-the-counter hearing aids?
Dr. Smith warns that not everyone with hearing loss should consider purchasing OTC hearing aids. For those with severe or profound hearing loss, tinnitus, ear infections, drainage, or those who have undergone ear surgery or have structural ear issues, the best course of action is to work with an audiologist.
Dr. Smith adds that if you wish to pursue OTC hearing aids as a matter of cost savings, you should do the following to ensure safety and efficacy:
Have your hearing tested by a professional to confirm your mild to moderate hearing loss?
Verify the return period of the device in case it doesn’t work properly or isn’t a good fit.
Visit a hearing care professional who utilized Real Ear Measurements (REM) after the OTC purchase to confirm if the hearing aids apply the appropriate volume amount based on your hearing test.
If you've already had a hearing evaluation and are confident in the level of amplification needed, an OTC model can be a cost-effective and convenient option. The most crucial factor to consider is whether the device meets your needs and preferences and provides the necessary amplification for your specific type of hearing loss.
How we chose our top OTC hearing aids
We spoke with hearing experts, including audiologists and otolaryngologists, to understand the types of hearing loss that may be suitable for OTC options. We also considered the features and specifications of different models, including price, sound quality, customization options, and support included after purchase. After researching a dozen brands and more than 50 models, we chose our top picks based on expert input, customer reviews, quality, and value for the cost. We also considered the availability of trial periods and warranties to protect your purchase.
How do hearing aids work?
“Hearing aids are designed to not just amplify sound but to do so in a way that improves speech clarity and understanding,” says Dr. Amy Sarow. They consist of several components, including a microphone, amplifier, speaker, and battery. The microphone picks up sound from around you and converts it into electrical signals. The amplifier then increases the strength of these signals before sending them to the speaker, which converts them back to sound waves and delivers them into the ear canal. The battery provides power to all of these components.
Modern hearing aids also include advanced technology, such as digital signal processing, noise reduction algorithms, and Bluetooth connectivity, to provide a more personalized and seamless listening experience. These features can help reduce background noise, improve speech clarity, and allow for direct streaming of audio from devices such as smartphones or televisions.
What is the difference between OTC and prescription hearing aids?
The main difference between OTC and prescription hearing aids lies in the level of customization and professional support. Prescription hearing aids require a medical evaluation and fitting by an audiologist, while OTC options can be purchased without a prescription.
“Prescription devices are fit precisely by a hearing professional to an individual's audiogram to provide specific amplification tailored to their hearing loss,” says Dr. Sarow. “For instance, if a person's lower-frequency hearing is normal or has mild loss, the hearing aid is programmed to offer minimal amplification in those ranges while providing more volume at higher frequencies where hearing loss is more pronounced.”
On the other hand, OTC hearing aids allow users to self-tune their devices via a test or other app-based feature, according to Dr. Sarow.
“For some individuals who are comfortable with technology, [OTC hearing aids] may provide an alternative to the traditional prescriptive approach to fitting hearing aids,” says Dr. Dave Fabry. “While this may serve as an entry into hearing aids for those with perceived mild-to-moderate hearing loss, it removes the hearing professional who is an essential resource for diagnosing and treating hearing loss and for selecting the best technology to meet the individual’s needs,” he adds.
Prescription hearing aids also tend to offer more ongoing support from a hearing professional to ensure the best fit and performance. Dr. Smith cautions that many people using OTC hearing aids are either over or under-amplified, which can lead to discomfort or further damage to the hearing. This results from not having the device professionally fitted and adjusted.
“We believe that the best patient outcomes are achieved when our technology is fitted by a qualified professional,” says Dr. Fabry.
Frequently Asked Questions
Are OTC hearing aids as good as prescription hearing aids?
“OTC hearing aids are a good choice for early-stage hearing loss,” says Dr. Sreek Cherukuri, who also recommends seeing an audiologist first. They may be ideal for those who want to avoid the often high costs of prescription hearing aids. However, he also notes that OTC models are difficult for users to adjust, leading to potential issues in finding the right amplification level.
Does Medicare cover OTC hearing aids?
Dr. Cherukuri says traditional Medicare does not cover hearing aids. “Some Medicare Advantage [Part C] and some employer-based insurance have hearing aid coverage,” he says. Private insurance coverage varies based on your carrier and plan. It’s best to check with your insurance carrier for coverage options.
How do I know if I need a hearing aid?
It may be time to consider a hearing aid if you are experiencing difficulty hearing, especially in social situations or conversations with background noise. “The average individual waits 7-10 years after they first notice hearing loss to take steps toward addressing their changes in hearing,” says Cooper. “Hearing loss is correlated with a multitude of health conditions as well as social isolation, which can impact an individual's quality of life.” Report any changes in your hearing to a medical professional who can help determine if a hearing aid is appropriate. “The earlier hearing loss is detected and treated, the better,” Cooper adds.
Are hearing aids easy to set up?
Every model is different, but most OTC hearing aids have a user manual and online tutorials to help you set them up. If you have any difficulty, customer support is usually available. Prescription hearing aids require professional fitting and calibration by an audiologist. Depending on the model, you may also need to visit your audiologist regularly for adjustments and maintenance.
Meet our expert panel
Amanda Cooper, licensed hearing aid specialist
Dr. Leigh Smith, AUD, audiologist and owner of Florida Audiology Associates, a hearing clinic located in Tampa, Florida
Dr. Dave Fabry, PhD, Starkey’s chief hearing health officer
Dr. Amy Sarow, clinical audiologist
Dr. Sreek Cherukuri, MD, board-certified ear, nose, and throat physician and founder of ClearCast