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Should you choose prescription hearing aids? Or should you opt for newer, more accessible, and affordable over-the-counter hearing aids? Here are expert tips to help you decide.
People with hearing loss often take up to a decade to decide whether to seek help, and the cost of hearing aids—up to $7,000 a pair—has long been a major factor in their decision-making.
Another obstacle: the growing number and variety of prescription and over-the-counter (OTC) hearing aids, leading to market saturation. The Amazon search results page for “OTC hearing aids,” the first stop for many seeking help, displays hearing aids costing over $2,000 alongside those for $50. Product descriptions also don’t always make it easy to distinguish between them.
If this expensive and confusing marketplace has you hesitating, know that hesitation can be costly. Addressing hearing issues early can reduce the risk of related problems, such as loneliness and depression. Prompt action is also crucial for preserving any remaining hearing skills, says Michelle DiStefano, MD, an audiologist at the nonprofit Hearing and Communication Center in New York City. “The longer your ears are irritated, the more likely you are to lose the ability to hear clearly,” she says.
But how do you know if over-the-counter or prescription hearing aids are right for you? Here are some tips to help you better understand your hearing loss and determine which hearing aids are right for you, as well as how to make an informed hearing aid purchase (whether you choose over-the-counter or prescription).
Sometimes it’s difficult for people to recognize they have hearing loss. Early signs, such as difficulty speaking on the phone or in a group, can be subtle. “Often you don’t realize what you’re losing,” DiStefano said.
Some signs: You may notice that it’s becoming increasingly difficult to hear people in noisy places, or that you frequently ask them to repeat themselves. You may also frequently need to turn up the volume on the TV or radio to a level that others consider too loud.
If any of these situations apply to you, free online tools can provide helpful information, says Larry Humes, PhD, professor emeritus in the Department of Speech, Language, and Hearing Sciences at Indiana University Bloomington. He recommends starting with a version of the Hearing Impairment Assessment Questionnaire (available for different age groups; a simplified version is available here). This will help you determine whether you have a hearing problem and how severe it is.
The next step is to take the Consumer Ear Disease Risk Assessment (CEDRA). This research-based online tool will help you determine whether your hearing loss is due to a medical condition requiring treatment, rather than hearing aid use.
Of course, you can also see a specialist for a hearing test. An otolaryngologist (also known as an ENT, a doctor who specializes in the treatment of the ears, nose, and throat) or an audiologist (a licensed healthcare professional who evaluates hearing problems and prescribes hearing aids) can perform a hearing test, which is usually covered by insurance. These specialists can determine the extent of your hearing loss and identify treatable conditions, such as earwax buildup or infection, that may be affecting your hearing.
While some hearing aids have long been sold online or by mail without a prescription, they were loosely regulated, with few guarantees of their effectiveness. However, thanks to a 2017 law aimed at reducing prices and increasing accessibility, the sale of over-the-counter hearing aids is now strictly regulated. These regulations, which take effect in the fall of 2022, require hearing aids sold over-the-counter to meet certain safety and effectiveness standards. Furthermore, these hearing aids cannot be sold to children.
Over-the-counter hearing aids must also meet certain technical requirements, including gain limits, designed to protect users from hearing damage. However, these limits make over-the-counter hearing aids unsuitable for people with severe hearing loss. (Symptoms of severe hearing loss include difficulty understanding speech even in a quiet room, difficulty hearing loud music, or difficulty operating power tools.) Therefore, over-the-counter hearing aids are specifically designed for people who consider themselves to have mild to moderate hearing loss. (Symptoms of mild to moderate hearing loss include difficulty understanding speech in noisy environments, in groups, and during telephone conversations.)
Prescription and over-the-counter hearing aids work essentially the same way. They capture sound through tiny microphones, amplify it, and then transmit it to the ears through speakers. They also use similar technology.
Perhaps the most significant difference between OTS and traditional assistive devices is not the technology they use, but how they are accessed and, in some cases, how they are configured.
If you choose prescription hearing aids, you should consult with a healthcare professional, such as an audiologist, otolaryngologist, or licensed hearing care professional. These professionals will test your hearing, assess your needs, and help you choose the best hearing aids for you. They will also program your chosen hearing aids to suit your hearing condition (this is called “fitting”) and perform subsequent adjustments as needed.
With over-the-counter hearing aids, you don’t need to visit a retailer or even undergo a hearing test for the final fitting. While some companies selling over-the-counter hearing aids offer excellent customer support, fitting and adjustments are usually handled independently.
Most patients with hearing loss experience mild to moderate hearing loss, and over-the-counter medications are specifically designed to treat these conditions. So, how do you choose between prescription and over-the-counter medications?
Even if over-the-counter hearing aids are appropriate for your level of hearing loss, you should consider whether you can choose and maintain them without professional help. “If you want someone to advise and assist you, I recommend seeing an audiologist or hearing aid specialist,” says Dr. Jasleen Singh, assistant professor of speech, language, and hearing sciences at the University of Massachusetts Amherst. (A hearing aid specialist is a licensed professional who dispenses prescription hearing aids.)
Moreover, even if your hearing loss is mild, you may need professional help if you have complex hearing issues, such as working in a classroom full of children surrounded by sounds, says Sumit Dhar, PhD, professor in the department of communication sciences and disorders at Northwestern University.
When choosing over-the-counter hearing aids, it’s important to take the time to determine the best model for you. Nicholas Reed, PhD, an audiologist at the Institute for Optimal Aging at NYU Langone Health, says that buying over-the-counter hearing aids that don’t work for you can discourage you from trying more effective hearing aids in the future. CR’s hearing aid brand ratings and our reviews of eight over-the-counter hearing aids can be helpful resources. Some experts we contacted also recommended HearingTracker and HearAdvisor, which test both over-the-counter and prescription hearing aids. Read on for four important points.
Self-adapting or pre-fitted: Over-the-counter hearing aids fall into two categories: self-adapting and pre-fitted. Self-adapting over-the-counter hearing aids are designed to be used with a smartphone app that includes a feature (usually a brief hearing test) that adjusts the device to your hearing loss.
Preset hearing aids sold over-the-counter typically offer only a few basic settings tailored to varying degrees of hearing loss (from mild to moderate) or to address common issues, such as difficulty hearing in noisy environments. However, their features vary greatly: some high-end models offer more extensive adjustment options, while the least expensive models offer only volume control.
Both types of over-the-counter hearing aids are generally less expensive than prescription hearing aids. For example, some pre-fitted hearing aids cost around $100 each, while over-the-counter auto-fitting hearing aids start at $500.
However, some hearing aids in each category cost nearly $2,000 or more. For example, Eargo self-fitting hearing aids, which are so small they’re barely noticeable when worn, can cost up to $2,500 per pair. (By comparison, prescription hearing aids at Costco start at $1,500.)
Several experts we interviewed generally recommend plug-and-play hearing aids over pre-fitted ones, as the latter must be approved by the U.S. Food and Drug Administration (FDA) for safety, usability, and effectiveness before being marketed. Dr. Vinaya Manchaya, chief of the department of audiology at the University of Colorado Hospital in Aurora, notes that because over-the-counter pre-fitted hearing aids do not require FDA approval, their quality can vary significantly. For example, some hearing aids, especially budget models, may have inferior sound quality.
Form Factor: Like prescription hearing aids, over-the-counter hearing aids come in two main styles: in-the-ear (ITE) and behind-the-ear (BTE). ITE hearing aids are typically smaller, sometimes so small that they fit entirely within the ear canal. Behind-the-ear (BTE) hearing aids consist of connected parts: a housing, which fits behind the ear and contains the hardware, and a receiver, which fits in the ear canal or earbud.
Which hearing aid style is best? “I generally believe you should choose what you want to wear, what you want to wear most, and what you enjoy wearing,” said Laura Coco, an associate professor in the School of Speech, Language, and Hearing Sciences at San Diego State University. However, she notes that behind-the-ear hearing aids tend to filter out background noise a little better.
Smaller devices tend to be more difficult to use and clean, and they may have fewer options for features like wireless audio streaming, says Anna Gilla, an assistant professor of audiology at Lamar University in Beaumont, Texas.
Customer Service: Self-fitting and pre-installed OTC hearing aids are designed so you can adjust them yourself. However, you may need assistance learning how to use them or troubleshooting any issues that arise. To evaluate the level of customer service offered by different OTC brands, visit their websites and find out if they offer assistance with fitting and using OTC hearing aids. Companies like Jabra and Lexie offer audiologist support, but the higher the level of service, the higher the cost. Audiologists in your area can also help with the cost of OTC hearing aids, so if this service interests you, consider contacting several of them.
Return Policy: Allow at least several weeks for your return to allow you to fully try out your hearing aids and get used to them before returning them if you’re not satisfied. Most states require a 30-day trial period for prescription hearing aids and a 30-day return period for over-the-counter hearing aids.
Prescription hearing aids can help with any degree of hearing loss, but they are the only option for people with severe or profound hearing loss—a problem that cannot be addressed with over-the-counter medications.
With prescription hearing aids, you get more than just the device itself. You also receive support from an audiologist, including on-site hearing testing, model selection recommendations, and numerous adjustments and adjustments.
Prices range from $1,500 to over $7,000 per pair. In our recent survey, CR members who purchased prescription hearing aids reported that the average price per pair after insurance was $2,592.
While insurance coverage for hearing aids isn’t yet uniform, it’s becoming more common. Therefore, before purchasing, check with your insurance company to make sure it covers hearing aids. Audiologist Michelle DiStefano says she encounters patients who aren’t aware that their private insurance covers hearing aids.
Shopping wisely also ensures you get the help you need at a fair price. The Department of Veterans Affairs (VA) received the highest overall rating in Consumer Reports’ ranking of hearing aid retailers. If you’re a veteran, you can receive full reimbursement for hearing aids purchased through the VA.
CR members also report high satisfaction with wholesale clubs, partly due to price variety and transparency. Costco ranked second in our rankings, and Sam’s Club also received high marks. Hearing aid chains Audibel and Connect Hearing also received high marks. Hospitals, clinics, and ENT clinics also received high marks, so consider purchasing hearing aids at your nearest medical facility or ENT clinic.
Editor’s note: A version of this article also appeared in the May/June 2023 issue of Consumer Reports magazine. This version has been significantly updated and supplemented with information from the July/August 2025 issue.
Katherine Roberts is a health and science reporter at Consumer Reports. She has worked for the publication since 2016, covering topics such as infectious diseases, germs and pesticides, consumer medical devices such as hearing aids and blood pressure monitors, and health privacy. Her regular interests include cycling, horror films and novels, and rabbit hole research. Follow her on Facebook: @catharob.
Post time: Oct-25-2025