• Posted October 17, 2022

You Can Now Buy Hearing Aids Over-the-Counter.  Experts Offer Tips for Consumers

It's official: Older Americans with hearing loss can now stroll into a big box store or pharmacy -- or just visit a website -- and buy hearing aids without a prescription.

The U.S. Food and Drug Administration recently approved this new class of over-the-counter hearing aids in order to lower prices and improve their availability.

About one in three Americans between 65 and 74 -- and half of those who are older -- have hearing loss severe enough to affect their daily life, according to the U.S. National Institute on Deafness and Other Communication Disorders (NIDCD).

But the American Academy of Audiology said about 70% of those who need hearing aids haven't taken steps to manage their hearing loss.

"Hopefully, the price will come down for hearing aids so they can be more accessible to more people,"said Kathleen Cameron, senior director of the National Council on Aging's Center for Healthy Aging. "I also hope that as a society, we look at hearing aids differently, too. I'm hoping it's going to help reduce some of the stigma associated with wearing hearing aids and the ageism often associated with those."

But before you go shopping for an over-the-counter (OTC) hearing aid, there are some questions you should keep in mind.

How do I know if I need an OTC hearing aid?

The FDA specifically defines OTC hearing aids as medical devices intended to treat mild to moderate hearing loss in adults 18 and older. You don't need a hearing exam or prescription to buy them, and they are designed so you can fit and tune them yourself.

There are some specific signs that you have the sort of hearing loss that these devices are intended to address, the NIDCD says. They include:

• Finding that speech or other sounds regularly seem muffled.
• Having trouble hearing over background noise.
• Struggling to understand speech in a phone call, on the television, or when you can't see who is talking.
• Regularly asking others to speak more slowly or clearly, to talk louder, or to repeat themselves.
• Getting regular complaints from family or friends that you've turned the sound up too loud or aren't hearing them properly.

Hearing problems more severe than that -- for example, requiring someone to speak to you loudly even in a quiet environment -- likely means that your hearing loss is outside the range intended for OTC devices, according to the Council on Aging.

I don't need to see a doctor or audiologist, but should I consult with one anyway?

There are a number of red flags that should lead you to consult your family doctor before purchasing an OTC hearing aid, experts say. These include injuries or medical problems like:

• Fluid, pus or blood coming from an affected ear.
• Sudden or fluctuating hearing loss.
• Better hearing in one ear than the other.
• Ringing or buzzing in both ears.
• Constant pain in one or both ears.
• Vertigo or dizziness.
• A full or plugged feeling in an ear.

These "are an indication where you wouldn't want to rush to get an over-the-counter product. You really should see a physician that makes sure that there's not a medical condition,"said Barbara Kelley, executive director of the Hearing Loss Association of America.

You might even consider consulting an audiologist anyway, although it's not required, Cameron added. Audiologists can sell OTC hearing aids and help you fit them.

"I think for many older adults, they do need an audiologist to really measure their level of hearing loss,"she said. "Particularly for those who might have waited a long time to get a hearing aid, perhaps their hearing loss has progressed and they might need a prescription level of hearing aid instead of the OTC kind."

Some companies selling OTC hearing aids offer online hearing tests as an option, "but I've yet to see how those compare to an in-person assessment of hearing,"Cameron said. "I wish I knew that right now."

What should I keep in mind when shopping for an OTC hearing aid?

Return policies: The FDA requires that a return policy appear on the packaging of OTC hearing aids. The first device you buy might not adequately address your hearing problems, so it's important that you know the time period in which you can return it.

"It does take time to adjust to a hearing aid, even if you have a mild or moderate hearing loss. It's important that the products have a return policy so people have the time to try them out,"Kelley said. "There's not a one-size-fits-all for hearing loss, so if I tell you that I just bought this OTC hearing aid and it's great, it still might not work for you."

Set up: Many of the new OTC hearing aids require a smartphone to adjust the device.

"Older people might not be savvy about downloading an app or fiddling with their smartphone,"Kelley said. "It should be clearly labeled on the box if you need an additional piece of equipment like a smartphone to make a device work."

Battery: The package also should tell you what kind of battery the device uses, Cameron said.

"Some of the older versions of hearing aids have replaceable batteries. Some of the newer ones have rechargeable batteries, where you just plug them in every night,"she said. "It can be very difficult for older people to take out the batteries or replace the batteries, so understanding that aspect of hearing aids is important."

Customer support: Before you buy, know what kind of help the company will provide if you have a problem later.

"If you do have problems and want to address your issues, what's going to be available? Is it only going to be through a website? Do you actually talk to someone? What other support is provided?"Cameron said. "That varies, I think, from company to company."

More information

The Hearing Loss Association of America has more on over-the-counter hearing devices. The National Council on Aging offers a buyer's guide on OTC hearing aids.

SOURCES: Kathleen Cameron, MPH, senior director, National Council on Aging's Center for Healthy Aging, Arlington, Va.; Barbara Kelley, executive director, Hearing Loss Association of America, Rockville, Md.