Here’s Who Should Think About Buying a Hearing Aid

Some notice their hearing problems years before getting seen and fit for a hearing aid. But now, hearing aids for many people might’ve just gotten a lot easier to find.

As of Oct. 17, hearing aids for adults with mild to moderate hearing loss are available over the counter, thanks to a new rule from the US Food and Drug Administration. While there are still some uncertainties in the hearing health industry about how this will roll out, many have been waiting for over-the-counter options because they remove the prescription barrier, which requires a doctor’s or audiologist visit and more money. (The average price of a pair of OTC hearing aids is estimated to be around $600 to $1,200 for a pair, which could save you as much as a few thousand dollars, depending on which device you choose and other factors.) 

This means you’re now able to buy a hearing aid at Best Buy, Walgreens, Walmart and other stores and pharmacies throughout the US, making getting your hands on a hearing aid almost as easy as tossing a pair of drug-store reading glasses into your cart. (Note: there’s a difference between an OTC hearing aid and sound amplification products, which have been available at stores and aren’t regulated for hearing loss like hearing aids are.) And while there is more nuance and user involvement in finding and fitting the correct hearing aid, proponents of the new FDA rule hope that the accessibility will help people who’ve had hearing problems get the tools they need. According to the American Academy of Audiology, people usually wait seven to 10 years after first experiencing symptoms of hearing loss before seeking help. Hearing — one of our most fundamental forms of communicating — can cause physical and mental health problems when it diminishes without treatment, including loneliness, reduced alertness, cognitive decline and more.

But with this new table of products come some questions: Who actually needs a hearing aid, and who should buy one over the counter vs. getting a prescription? How can you tell if you have “mild to moderate” hearing loss, anyway?

We talked to a couple of experts to narrow down whether you should consider shopping for an OTC hearing aid.

Why buy over the counter? 

Dr. Frank Lin is the director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. He said that about 90% of people with hearing loss could be served by an over-the-counter hearing aid.

“One flippant way of answering your question is if you think you have hearing loss, you will likely be served by OTC hearing aids in terms of their technical capabilities,” Lin said. He added that if you’re someone who has severe hearing loss and will need a more intensive hearing aid, it “won’t be subtle.” In addition to people with severe hearing loss, OTC aids for children and teens under 18 still require a prescription.

Lin says there’s such a lack of consumer education around hearing health right now, that it’s presented as so complicated you need to go talk to your doctor before figuring anything out. 

“Which I find offensive as a consumer, but as a clinician I can see why people say that,” Lin added. “But it doesn’t make sense.” 

Barbara Kelley, executive director of the Hearing Loss Association of America, says it’s important to remember that the fact that hearing aids will now be easier to get doesn’t mean you shouldn’t or can’t get an official hearing test, it just means that you don’t have to wait for one. 

“Of course, this doesn’t preclude somebody from getting a hearing screening or an audiological evaluation, but you don’t have to,” Kelley said. 

That is, it’s probably still a good idea for you to see a doctor or audiologist to make sure that you have the correct fit and that there’s not another health condition at play interfering with your hearing. But now you’re able to get a head start on hearing again instead of waiting on appointment times, more money or other barriers that can interfere with health care.

If you have signs of ‘mild or moderate’ hearing loss 

One subtle, but fast, way to know whether you might need an OTC hearing aid is if you’re just starting to notice some changes in your ability to hear, Tricia Ashby-Scabis, senior director of audiology practices at the American Speech-Language-Hearing Association, told CNET in August. Maybe you think people are mumbling more often, or people with higher-pitched voices, like women and children, are harder to hear.

To help people decide if they have mild or moderate hearing loss, the American Academy of Audiology lays out three criteria: 

• You’re still able to hear easily in quiet or one-on-one settings. 
• You can think of a few situations where you’d want to wear a hearing aid, but maybe you don’t think you need one in “most communication settings.” 
• Turning up the volume on the TV or your phone just slightly helps you hear better. (People around you might find it a little loud, but it’s not so loud that it’s bothering them.) 

Of course, the most accurate way to know whether you have hearing loss, and to what degree, is by going to see an audiologist or a doctor for an official hearing test. The American Academy of Audiology recommends you get screened before trying an OTC device, and the American Speech-Language-Hearing Association says that the “best way” to know whether you’re a good candidate for a hearing aid is to be examined by an audiologist, because it’s easy to underestimate your level of hearing loss.

In an effort to bring audiologist-level tests to you, companies like Soundly are expanding into the telehealth space. Soundly, a hearing-aid comparison website founded by Blake Cadwell after his own experience trying to find a hearing aid, just announced its partnership with Tuned, merging Tuned’s network of audiologists with Soundly’s users. An hour-long Tuned consultation with an audiologist is $150, and Soundly users get a 10% discount. (Soundly also offers a quick, free hearing screening on its website.)

In another initiative to quantify hearing loss, Lin and his team have created Johns Hopkins’ Hearing Number, which pairs with either the Mimi or SonicCloud app for a hearing test, which inputs your score into Apple’s Health App and tells you on the Hearing Number website whether you might have mild or moderate hearing loss. (This is only available for iPhone users at this time.) This metric for gauging hearing ability mirrors other health metrics we’ve gotten comfortable with, like measuring our blood glucose and counting our steps. The goal, Lin says, is to “push out a consumer-facing metric.” 

If you like to manage your own care

Consumer electronic companies like Bose and Sony have announced partnerships with hearing health companies in order to navigate this new market. While there are differences among the over-the-counter devices, they are all “self-fit” and require you to set up your hearing aid yourself after you buy it. In the case of Sony’s hearing aid, as well as of Lexie Hearing’s and Bose’s, you’ll be guided by a paired app for things like ear measurements (to make sure the device fits and you don’t need a different piece) or self-tuning. 

Catherine Palmer, past president of the American Academy of Audiology and director of the audiology program at the University of Pittsburgh, said in an email that a good candidate for an OTC hearing aid “would be someone who is able to and enjoys self-managing care, meaning that they will need to take time to figure out the fit of the device.”

While the guided apps will likely offer some help, this type of hands-on care may not be enjoyable or even tolerable for everyone. If you’d like to minimize your involvement in this process, you might still choose to get fitted with an audiologist even if you’re otherwise a good candidate for OTC hearing aids — they can help you select one that best suits your needs. 

Read more: New Bose-Lexie Hearing Aid to Enter Over-the-Counter Market 

Signs you shouldn’t buy an OTC hearing aid

People who are experiencing hearing loss but also have physical symptoms or pain should think twice before buying a device without first seeing a doctor, according to ASHA. Symptoms to look out for — and signs you should not get an OTC device right now — are: 

• You have what ASHA calls an “ear deformity,” such as Stahl’s ear, a protruding ear or a constricted ear
• You have fluid, puss or blood coming out of your ear 
• You have hearing loss or a ringing (tinnitus) in one ear only or that’s noticeably different in one ear
• There’s pain or discomfort in your ear 
• You have sudden or fluctuating hearing loss (maybe it comes and goes) 
• You have vertigo or severe dizziness

Aside from physical symptoms, people with “complex” listening needs should be evaluated because they might need more individualized care, Palmer says. This includes people who have trouble hearing when there are other mental or environmental factors at play, like anxiety or being in a busy or noisy environment. This could possibly indicate another health or cognitive issue other than hearing loss that should be addressed. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.