Over-the-Counter Hearing Aids? Know Your Options

Right now, if you need a hearing aid, you typically need to see a physician or an audiologist to undergo a hearing test and get a prescription for a hearing aid that’s customized for you. Hearing aids can greatly enhance quality of life but tend to be quite pricey.

Soon, some people with mild to moderate hearing loss might have a less expensive option. The U.S. Food and Drug Administration (FDA) is considering regulations that would allow hearing aids to be purchased over-the-counter (OTC) without seeing a doctor.

UNC Health audiologist Patricia Johnson, AuD, is cautiously enthusiastic.

“I think there’s a place for OTC hearing aids as a first step, especially if you have mild hearing loss and aren’t doing anything about it,” she says. “But I also worry that some people with more severe loss will settle for something that might help a little but isn’t optimal.”

The Difference Between Prescription and OTC Hearing Aids

Prescription hearing aids are programmed by an audiologist or licensed dispenser to meet the specific needs of an individual, whereas OTC hearing aids would be preprogrammed. In some ways, the difference is like nonprescription eyeglasses you can buy at the drugstore that magnify images and more expensive prescription glasses that optimize a person’s sight in each eye.

“The biggest difference between glasses and hearing aids, though, is that visual improvement is immediate,” Dr. Johnson says. “There’s a brain learning process associated with hearing aids.”

This is because our brains work differently when our hearing is impaired.

“For many people, hearing loss occurs slowly over time,” she says. “Our primary sensory system can forget about sounds on the periphery of our perception. When we reintroduce sounds, it can be overwhelming. We (audiologists) help people relearn what to do with sound through counseling and technology.”

It may take a month or more of getting used to hearing more sounds and adjusting the settings on the hearing aids before a person is getting the optimal hearing improvements.

OTC hearing aids would not be adjusted by a professional, Dr. Johnson says. They would come preset or have limited settings.

Devices known as “personal sound amplification products” (PSAPs) are available now, but they are not regulated by the FDA.

“Amplifying devices have been available for decades,” Dr. Johnson says. “Some work better than others. It depends on your level of hearing loss. If you have a negative experience with OTC, consider seeing an audiologist for a more customized option.”

Potential Benefits of OTC Hearing Aids

If prescription hearing aids are more effective, why even consider an over-the-counter option? Price and accessibility.

Traditionally, hearing loss has been associated with the natural aging process rather than a treatable medical condition. Consequently, hearing aids are not covered by Medicare or most other health insurance. And they can be costly. Consumer Affairs estimates that the average cost is between $1,000 and $4,000. This often includes a hearing test, consultation, initial fitting and follow-up adjustments.

Some insurance plans cover an initial hearing test if a person has a referral from their primary care doctor. But none of the other services, including the consultation and follow-up appointments for adjusting the devices, are covered. OTC devices will not be covered either, but they are expected to cost significantly less.

“I would encourage anyone needing hearing aids to discuss lower-cost options with their audiologist,” Dr. Johnson says. “There are less expensive prescription hearing aids available.”

She also encourages patients to ask about payment plans that might ease the financial burden, especially when a person is on a fixed income.

“My goal is to match the treatment to the need,” she says. “If a hearing aid is programmed using best practice, it can be very effective, even at a value cost. The provider matters more than the product.”

How to Know if Your Hearing Is Deteriorating

For most people, the signs of hearing loss are subtle. “It sneaks up on you,” Dr. Johnson says.

High-pitched sounds, like your car’s turn signal or bird songs, may be the first to disappear. You may find yourself turning up the volume on the television or phone or asking people to repeat what they have said more often.

You can ask your loved ones if they’ve noticed a change. “Friends and family may be more aware of the sounds you’re not hearing anymore,” Dr. Johnson says.

Approximately 1 in 3 people ages 65 to 74 have difficulty hearing, and nearly half of those 75 and older have some level of hearing loss.

Dr. Johnson recommends that everyone have a baseline hearing test by age 65 so hearing loss can be measured as you age.

“It’s better to treat hearing loss sooner rather than later,” she says. “The goal is to maintain the brain’s ability to use sound.”

Don’t Ignore Hearing Loss

Numerous studies have linked hearing loss to depression, social isolation and even dementia, Dr. Johnson says. Hearing loss may also contribute to balance and walking problems.

“There’s a high correlation between hearing loss and cognitive decline,” she says. “People who have trouble hearing may start to isolate and not participate with others. That behavior can have long-term impacts on overall health.”

If you are concerned about hearing loss, talk to your doctor or find a physician near you.