LSTN

Hearing Health Guide

OTC Hearing Aids

Definition

Over-the-counter (OTC) hearing aids are a category of hearing devices established by the FDA in October 2022 under the Over-the-Counter Hearing Aid Act. Adults 18 and older with perceived mild to moderate hearing loss can purchase, fit, and adjust OTC hearing aids without a medical evaluation, a prescription, or a visit to a licensed audiologist or hearing instrument specialist.

The 2022 FDA Rule: What Changed

Prior to October 2022, all hearing aids in the United States required purchase through a licensed audiologist or hearing instrument specialist, following a professional fitting and evaluation. The OTC Hearing Aid Act of 2017 directed the FDA to create a new OTC category, which took effect in October 2022.

The rule created two classes of hearing aids: prescription hearing aids (for all degrees of loss, fitted by a licensed professional) and OTC hearing aids (for adults with perceived mild to moderate loss, self-fitting). Think of it like eyeglasses: reading glasses are available OTC for common refractive issues, while complex prescriptions require an optometrist.

Who OTC Hearing Aids Are For

The FDA OTC category is for adults 18+ who believe they have mild to moderate hearing difficulty. This includes people who frequently ask others to repeat themselves, struggle in noisy environments, or need the TV at high volume, but who have not had a clinical diagnosis of severe or profound loss.

OTC aids are not appropriate for children, anyone with sudden or asymmetric hearing loss, anyone with a history of ear infections, ear drainage, ear deformity, or severe to profound hearing loss. These cases require professional evaluation.

OTC vs Prescription Hearing Aids: Key Differences

Prescription hearing aids are fit by an audiologist who measures your exact hearing thresholds across frequencies and programs the device precisely to your audiogram. They can address a wider range of hearing loss, including severe and profound. They typically cost $3,000-$7,000 per pair including professional services.

OTC hearing aids are self-fit using a smartphone app. They offer adjustable amplification profiles but without the precision programming of a professionally fitted prescription device. They typically cost $200-$1,500 per pair. For mild to moderate high-frequency loss, the outcome difference between OTC and prescription aids can be minimal. For complex loss patterns, professional fitting is strongly preferred.

Common Questions

OTC Hearing Aids FAQ

Do I need a hearing test before buying OTC hearing aids?
It is not legally required, but it is strongly recommended. Taking a hearing screening first helps you understand whether your loss falls in the mild-to-moderate range (where OTC aids are appropriate) or whether you may have a more significant loss that warrants professional evaluation. It also gives you a baseline to compare against after fitting.
How do OTC hearing aids compare to prescription hearing aids in quality?
For mild to moderate high-frequency hearing loss (the most common pattern in adults), OTC aids from reputable manufacturers (Jabra, Sony, Lexie, Eargo) perform comparably to entry-level prescription devices in several studies. The key difference is the fitting process: precision audiogram-driven programming by an audiologist produces better outcomes for complex loss patterns or when frequency-specific amplification is critical.
Can I return OTC hearing aids if they do not work for me?
Most OTC hearing aid manufacturers offer 30-45 day return policies. Check the specific policy before purchasing. This is an important consumer protection that prescription hearing aids have typically not offered, since professional fitting services are bundled into the cost.
Are OTC hearing aids covered by insurance?
Most private insurance plans and Medicare do not currently cover OTC hearing aids. Some plans cover prescription hearing aids with varying copays. Check your specific plan. HSA and FSA funds can typically be used for FDA-regulated hearing aids, including OTC models.
What Are OTC Hearing Aids? FDA Rules, Costs & Who They're For — LSTN