When It’s OK to Buy an Over-the-Counter Hearing Aid

Updated: Jan. 07, 2019

People want more affordable and accessible options for hearing loss. But is it really a good idea to fit yourself for a hearing aid?

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You can self-diagnose a cold and treat it with medication from the store. You can pick up reading glasses there too. But hearing aids? If you’re in the market for one, that means you (and your family and friends) are well aware that your hearing is failing you. You may also have zero patience or time for seeing a specialist. But how wise is it to skip the doctor and find a one-size-fits-all hearing device? How much of a difference can seeing a specialist really make?

While you can buy hearing aids online fairly easily, there’s still a need for better access to hearing aids in general: Only about 1 in 5 Americans with hearing loss actually wear an aid, according to the National Institutes of Health. And recent research has determined that untreated hearing loss, be it mild or severe, can have highly detrimental consequences, including a higher risk of depression, dementia, injurious falls, isolation, and less physical activity.

So if not using an hearing aid is so bad, how much worse can it be to simply buy one on your own? Well, there are “significant downsides to purchasing a hearing aid without seeing a specialist,” says Andrew Resnick, a New York City audiologist. “The quality of what you see advertised will vary greatly, and some of these devices have very poor sound quality. In addition, it is virtually impossible to self-diagnose one’s hearing loss. Hearing aids fit by a licensed audiologist are programmed to match the person’s individual hearing profile. It’s also important for a specialist to rule out medical conditions that might preclude the safe use of a hearing aid.”

Other concerns include the fact that sometimes hearing loss may be due to treatable causes such as a build-up of wax in the ear—easily and inexpensively managed at a clinic—or a noncancerous tumor called an acoustic neuroma.

While many audiologists understandably see dangers in allowing consumers to fit themselves with hearing aids access to consumers, it still may be the best option for people who stand to lose quite a bit if they don’t get help.

Thanks to new legislation, the Over-the-Counter Hearing Aid Act of 2017, which takes effect in 2020, consumers will soon be able to purchase hearing aids without the supervision of an audiologist or hearing aid dispenser. Audiologist Lindsey Banks in Boca Raton, Florida, believes it could force some good changes on hearing industry practice. “Most audiologists and hearing aid specialists ‘bundle’ the cost of the hearing device in with other services such as the professional evaluation, consultation, follow-up, and adjustments for the devices after they have been worn,” says Banks. “Many people are not using or don’t need the follow-ups, yet many offices don’t offer a low-cost option. In my opinion, it will only be the audiologists and hearing aid specialists that can adapt to the changes of OTC hearing aids and consider ‘unbundling’ the cost of the device from the cost of their services that will survive.”

According to a new study done by researchers at Johns Hopkins School of Medicine, Baltimore, some OTC hearing assistance devices can produce the same level of hearing improvement as prescription hearing aids. These devices, called PSAPs (personal sound amplification products), are not specifically labeled to treat hearing loss, but can significantly improve conditions for patients with mild to moderate hearing loss.

The study surveyed five OTC devices and found that four of them tangibly improved hearing ability. The devices were also technologically similar to prescription hearing aids but much less expensive than their prescription counterparts. The four brands tested were Sound World Solutions CS50+ (which was closest to prescription aids in terms of hearing improvement levels), Soundhawk, Etymotic BEAN, and Tweak Focus.

Each seems to have some form of automatic environmental adaptation settings and directional, amplifying microphones, so if you’re in the market for a new OTC hearing device, look for those features specifically.

One new one to try: Eargo Neo, rechargeable, nearly invisible OTC hearing aids that you can sync to a companion mobile app to customize your sound settings. You can also opt to have usage data sent via the cloud to Eargo’s team of licensed hearing professionals, who will update your sound settings accordingly so the hearing aids work best for you.