“And then (blank) said (blank)!! Isn’t that funny?”
What if you couldn’t fill in the blanks? What if sentences like these were perpetually incomplete, leaving you confused and excluded from conversations?
If you are one of the 37.5 million adults with hearing loss, this frustrating exchange can be a daily occurrence, sometimes causing you to smile and nod during group conversations, although completely unaware of the context. For those with hearing loss, hearing aids are an invaluable resource. However, only since 1969 have audiologists prescribed hearing aids. Earlier, hearing aids were only available commercially and without testing, leading them often to be fitted inappropriately.
To offset this trend, the FDA approved the dispensation of over-the-counter (OTC) hearing aids, available without an audiologist’s prescription, in 2022. OTC hearing aids are often more convenient and carry a lower price point than prescription aids. However, does bypassing a professional audiologist represent a positive change?
What are hearing aids?
Hearing aids are small electronic devices that consist of three components: a microphone, an amplifier, and a speaker. Sound comes through the microphone, then heads to the amplifier, ending up in the ear canal via the speaker. Since most people who wear hearing aids experience hearing loss as the result of dead sensory cells in the inner ear, hearing aids trigger these cells more effectively, resulting in better hearing.
Types of hearing aids
Not all hearing aids are created equally, however. There are five types of hearing aids that differ in size, as well as capabilities.
The first two aids, Behind-the-ear (BTE) and Receiver-in-the-ear (RITE) look like stereotypical hearing aids, with the body of the aid resting behind the ear. However, the BTE electronic device is situated outside of the ear, whereas the RITE includes a receiver in the ear, which creates a more natural sound. In both cases, there is a custom earpiece connected to the body that ensures lower feedback than the ear tips found on earbud-like OTC models. BTE is suitable for mild to profound hearing loss, while RTE targets those with mild to severe loss.
The next three aids are barely visible or completely invisible externally. In-the-ear (ITE) and In-the-canal (ITC) are visible, while Completely-in-the-canal (CIC) is not. The OTC versions of these look just like earbuds, with ear tips attached. These hearing aids are often for less severe hearing loss than BTE and RITE. Further, while prescription hearing aids are available in each style for every applicable hearing range, in OTC models, each model is usually only available in one style.
Audicus: Top-of-the-line OTC device
Audicus is a brand most comparable to prescription hearing aids, ranging in cost from $1400 to $2000 per pair. For comparison, the cheapest prescription hearing aids sell for about $2000 per pair. Audicus aids include most of the same features as prescription aids, including Bluetooth and noise-canceling abilities. Most are RITE, with adjustable ear tips, that target mild to severe hearing loss. Since the earpieces are not customized, however, there is a greater possibility of feedback.
Audicus measures the customer’s degree of hearing loss through a 10-minute hearing test, the results of which list different frequencies in each ear with each frequency labeled “no difficulty” to “severe difficulty”. In comparison, in-office audiology tests provide a detailed audiogram, or a graph of one’s hearing loss. To its credit, however, Audicus does provide customers with virtual, next-day audiology appointments.
Linner: Budget hearing aid
Forbes listed Linner hearing aids as one of the best 2025 OTC options. With each pair of hearing aids ranging from $99-$399, it is easy to see why. The majority of Linner hearing aids are ITE and CIC with adjustable ear tips and are for mild to moderate hearing loss. Linner even has its own size, Over-the-ear, a conspicuous mode that looks like an earbud with the receiver hanging out of the ear. There is only one RITE aid that is for severe hearing loss, but there are two that offer Bluetooth and wireless charging. Speech differentiation varies. Further, Linner hearing aids are covered by HSA and FSA, making them an accessible choice for many.
Prescription hearing aids
Obviously, a major deterrent to prescription hearing aids is the higher cost. Each pair ranges from $2000-$7000, and are not covered by Medicare. Paying for hearing aids is left to private pay or CareCredit, a healthcare credit card, and part of the cost is covered by insurance ‘sometimes’.
However, the advantages of prescription hearing aids are many. They involve custom tests, which are most beneficial for those with various degrees of hearing loss, including severe and profound. In an interview with Harvard Medical School, Dr. John Naples, a professor of otolaryngology (also known as ear, nose, and throat or ENT) at Beth Israel Deaconess Medical Center in Boston advises, “If you have severe or profound hearing loss, you still need to see an audiologist for a full exam.”
In addition, prescription hearing aids often contain better technology than OTC hearing aids. According to the professionals at Audibel hearing clinics, a few of the features prescription hearing aids include are the ability to only amplify the tones the wearer struggles to hear. While many OTC hearing aids include similar features, an important difference is that, while most prescription hearing aids provide these features, only high-end OTC hearing aids with similarly high price tags do as well.
Obtaining prescription hearing aids also involves an ongoing relationship with an audiologist, which can result in better continuity of care. In addition, audiologists alert patients to larger hearing issues that require medical attention. “A number of different conditions can cause hearing loss, and often people cannot differentiate the cause without an evaluation,” Dr. Naples says.
The verdict
OTC hearing aids vary widely by price and quality. There are fewer choices for those with severe hearing loss, and they often don’t offer many models. The tips are also not customized, so there is the possibility of increased feedback. However, if one is on a strict budget and only needs to use a hearing aid to amplify sound in social situations, OTC aids will do the trick. It is important to remember, though, that sometimes OTC hearing aids cost just as much as prescription aids, so it is important for the consumer to educate themselves about available hearing aid models.
About the Author: Taylor Hamilton is a fellow with The Loreen Arbus Accessibility is Fundamental Program, a fellowship created with Women’s eNews to train women with disabilities as professional journalists so that they may write, research and report on the most crucial issues impacting the disabilities community.
