How to Choose the Right Over-the-Counter Hearing Aid for You

If you’ve ever thought about getting a hearing aid, there has never been a better time. The creation of an over-the-counter (OTC) category, via a 2017 law(Opens in a new window) that finally went into effect on Oct. 17, makes it easier and cheaper for people to get hearing aids.

You no longer need to visit an audiologist for a prescription. Now, retailers like Best Buy, CVS, and Walmart sell OTC hearing aids in stores and online for those 18 and older. By cutting out the middleman, the cost goes from $5,000 to $10,000 through an audiologist to $200 to $2,000+ at a retailer.

The problem is that shopping for a hearing aid is complex, and likely to become even more so as new OTC products debut. A Google search returns numerous devices across the price spectrum, each advertising unique features.

Still, it’s worth braving the shopping process. Hearing loss affects 30 million Americans and is a major contributor to depression, frustration, and social isolation. But a recent study(Opens in a new window) found only 3.5% of respondents with hearing loss actually wear hearing aids. Increasing the number of happy hearing aid wearers benefits everyone.

Here’s how to get started when shopping for an OTC hearing aid.

First, Take a Hearing Test to Gauge Your Status

CVS hearX online hearing assessment
(Credit: CVS)

OTC hearing aids are only approved for mild to moderate hearing loss, such as trouble following conversations (especially in noisy places) and needing to turn up the TV. There are a few ways to test if your needs fit this category.

Online screening tests, like those from Best Buy(Opens in a new window), CVS(Opens in a new window), and Eargo(Opens in a new window) perform a basic hearing assessment in minutes. The interface asks you to put headphones on, then click or type to indicate what you can hear. It then assesses whether you fall within the mild to moderate range or not.

Audiologists can also complete in-depth exams, even if you don’t go through with purchasing a hearing aid through them. Audiologists have decades of experience with a wide spectrum of issues, and can recognize if your symptoms are common or more specialized.

Consider Frequency of Use and Form Factor

Once you know if you fall in the mild to moderate OTC band, the first thing to think about is how often you plan to wear your device and in what environments. Do you only need them during work meetings? What about in restaurants or at special events? Do you plan to wear them all the time, from wake up to bedtime?

This will help you get a sense of how sophisticated and comfortable you expect the device to be, and what level of support and customization will make the purchase worth it for you.

Consider how visible you want the device to be, and how it feels. In general, there are a few form factors: behind the ear, in the canal, and varying levels of both behind and in the ear.

For example, Bose hearing aids ($799) have a piece that goes inside the ear, as well as a part that wraps around the back of the ear and is quite visible. Eargo makes tiny, nearly invisible hearing aids(Opens in a new window) ($1,500) that insert in the canal, as does Sony(Opens in a new window) ($999).

(Credit: PCMag via the FDA, HP, Bose, Eargo, and Sony)

The form factor will affect the amount of “occlusion” the hearing aid creates, or sound blocking, as if you’re under water or wearing an ear plug. “The number one thing I hate in a hearing aid is occlusion, blocking everything out,” says Eargo CEO Christian Gormsen, who wears a hearing aid for mild hearing loss. “The thickness of the material you put in your ear defines occlusion. A thick silicon, for example, will create a strong seal.”

Tech Features to Look Out For

The Jabra hearing aids recharge in their case.
(Credit: Jabra)

Hearing aids have benefitted from advancements in the wider tech industry in recent years. Many now have accompanying mobile apps, Bluetooth connectivity, and AI-enhanced sound quality. Here are some features you’ll want to consider.

• Rechargeable vs. Replaceable Batteries—Some hearing aids come with a charging cord, while others require you to purchase new batteries when they run out of juice. Most people find rechargeable to be easiest these days. Even the cheapest option on the market today, the GoLite ($199 at CVS(Opens in a new window), Walmart(Opens in a new window)), is rechargeable.

• Battery Life—Going back to your estimate of how often you plan to wear the hearing aid, rechargeable hearing aids will typically last 16 hours or less, or the course of the day, meaning you recharge at night. Replaceable batteries will last a few weeks. The product page should specify time to recharge or replace batteries.

• Companion Mobile Apps—Many devices come with a smartphone app where you can view battery life, adjust volume, take hearing screening tests, and more. When you buy the device, you download the manufacturer’s app in the app store. This can be a positive for techy-savvy users, or a negative for someone who prefers not to use an app for basic functionality and adjustments.

The Eargo app.
(Credit: Eargo)

• Bluetooth Pairing—If you answer the phone while wearing a hearing aid, or you go for a jog and are listening to music, you’ll likely want the sound to flow through the hearing aid rather than needing to take them out. Check out the Jabra Enhance(Opens in a new window) ($1,200-$2,000), formerly named Lively, which offer Bluetooth pairing and hands-free phone calls.

• Self-Fitting—Advanced OTC hearing aids are often called “self-fitting,” meaning they have an app that will initiate a hearing test while you’re wearing the device, and then calibrate the settings based on the results, mimicking an audiologist. Check out HP Hearing Pro(Opens in a new window) ($699), Jabra(Opens in a new window) ($799), and Sony(Opens in a new window) ($999). Any more expensive hearing aids likely have some version of this as well, even if not explicitly stated.

• Pre-Sets—The next step below self-fitting are pre-sets, meaning menu-like settings you can choose from that manipulate sound differently based on the environment you’re in.

(Credit: Jabra)

• Automatic Sound Adjustments—After the initial calibration of the hearing aid through self-fitting or pre-sets, the most sophisticated hearing aids have embedded artificial intelligence that adjust the sound settings as you’re wearing them. Rather than flipping through pre-sets or making adjustments in an app, the AI will automatically do things like reduce background noise and amplify the voice of the closest speaker—without any input or management from you. This feature, found on devices like the Whisper (Opens in a new window)($2,500) or the Eargo 6(Opens in a new window) ($2,655), is the mark of true luxury when it comes to hearing aids, and the more you pay the better you get. Cheap models like the Go Prime In-the-ear Rechargeable OTC Hearing Aid ($299 at CVS(Opens in a new window), Walmart(Opens in a new window)) dabble in feedback suppression and noise cancelling, but it’s not the same as true AI sound management.

‘Personal Sound Amplifier’ vs. Hearing Aid

Many retailers sell both hearing aids and something called “sound amplifiers.” These are often cheaper than hearing aids, but they are not considered FDA-regulated medical devices.

“If you’re seeing sub-$100 products, even in the $40-$50 range, most likely they are not actually OTC hearing aids and do not meet the requirements,” says John R. Luna, CEO of Nuheara, which created a new OTC hearing aid with HP(Opens in a new window) that starts at $699. “Personal sound amplifiers just enhance sound in certain environments, they’re not intended for hearing loss, they’re more of a basic consumer electronic product.”

Luna explains that someone may use a personal sound amplifier like a rudimentary hearing aid to listen to birds, turn up the volume at a lecture or specific event, or turn down the volume as a form of voice cancellation.

However, you may still want to try a sound amplifier—especially if you’re on a budget or only need to wear it occasionally. Amazon has quite a few on its bestsellers list(Opens in a new window).

Retailers: Who’s Selling What?

(Credit: Walmart)

Hearing aids are available online and in stores, though brick-and-mortar availability is still limited while retailers work to expand.

• Best Buy now offers 12 products(Opens in a new window) in 300 stores nationally, and about 20 products online(Opens in a new window). In store, the average price is $1,000, according to a Best Buy representative, though they range from $200-$3,000. Notably, Best Buy has invested in associate training to help shoppers. “Best Buy store associates have gone through training on topics like the anatomy of the ear, stages of hearing loss, general fitting techniques and different features of various devices and brands,” Best Buy tells PCMag.

• Walmart offers a vast online selection(Opens in a new window) of hearing aids, as well as online selection at its Vision Centers in Colorado, Michigan, Missouri, Ohio, Pennsylvania, Tennessee, and Texas.

• Costco has had hearing centers(Opens in a new window) in its stores for years, equipped with licensed audiologists (think “a store within a store”) who provide screenings, devices, and follow-up support. Costco declined to comment when asked about launching new OTC hearing aids for purchase on the main store floor.

Costco Hearing Aid Center
(Credit: Costco)

• Sam’s Club, owned by Walmart, offers hearing aids in 474 Sam’s Club Hearing Aid Center locations, according to the Walmart press release(Opens in a new window).

• CVS has four hearing aids available online(Opens in a new window). As of Nov. 1, you can find them in “select CVS Pharmacy locations in Texas, Tennessee, North Carolina, Connecticut, Rhode Island, New Jersey, Massachusetts, New Hampshire, and New York,” a CVS representative tells PCMag. The company recommends shopping online while it’s “looking at expanding our in-store offerings.”

• Amazon offers an endless array(Opens in a new window) of hearing aids from major manufacturers and small ones alike. With sub-$100 listings, however, remember they are likely to be more rudimentary, non-FDA approved hearing amplifiers.

• Manufacturer websites sell hearing aids direct to consumer. They come with customer support specific to their product, which can be a benefit over more generalized retailers. Check out Eargo(Opens in a new window), Sony(Opens in a new window), Bose (Lexie Hearing)(Opens in a new window), and Jabra Enhance (formerly Lively(Opens in a new window)) / Jabra(Opens in a new window)—all of which are also sold at retailers.

It remains to be seen which retail environment will see the most success with hearing aids, which are even popping up in wireless carrier stores. “They could be available at your local gas station,” says Luna. “Any retailer anywhere in the US can sell them on their own. If they see the patient need, they can start offering [hearing aids], and now they’re more available to those that need it.”

With a 30% Chance of Returns, Refundability Is a Must

Just because hearing aids are available OTC doesn’t mean they are any less frustrating or easier to fit correctly. The manufacturers we spoke to already see around a 30% return rate. Make sure the device you choose can be returned or exchanged, and don’t be discouraged if it takes a few tries before you find the right one.

Best Buy modified its return policy specifically for hearing aids. “Hearing aids have a 60-day return policy, which is more than our normal R&E policy, to offer customers a longer trial period since these devices can take some time to get used to,” a representative tells PCMag.

“The best advice I would give anyone is to do your research,” says Eargo’s Gormsen. “Talk to different people, figure out who you trust. Just because the price is attractive, [ask] who is there to help you if it doesn’t work. That’s important.”

If OTC hearing aids aren’t working for you, visit an audiologist. “I think there’s a good chance a lot of people will have underserved needs from their hearing loss with over-the-counter devices,” says Dr. Andrew Resnick, Au.D, an audiologist with 25 years of experience at his New York City practice.

A Note About Regulatory Categories

FDA-approved labelling on the HP Hearing Pro.
(Credit: HP, Nuheara)

If you’ve seen hearing aids online for a while now, the OTC ruling—and this article—may be confusing. Are we really so old-school that OTC only means over a physical counter at the store? 

Yes, we are. Online sales fall under “direct to consumer” legal rules, which have permitted sales through websites in the past few years. This was the first major breakthrough in making hearing aids more accessible by removing the audiologist gate.

The new FDA-approved OTC category brings those products into brick-and-mortar stores, as well as establishes two categories: Regular and Self-Fitting. Self-Fitting hearing aids, as described in the “Tech Features” section above, perform a audiologist-like assessment of the wearer’s hearing using technology in the device and an accompanying app.

Going forward, all online and in-store products will have a new FDA-approved labeling, which shoppers should look out for to avoid counterfeit sales and misrepresented efficacy.