Prescription Versus OTC Hearing Aids: What’s the Difference, and What’s Right For Me?

When it comes to prescription versus OTC hearing aids, there’s more to making the decision than cost alone.‍

March 14, 2023

In October of 2022, the FDA officially made it possible to purchase over the counter hearing aids in the U.S. This policy change aims to decrease the financial barrier for hearing loss treatment by eliminating the requirement of professional evaluation, fitting, and adjusting. But when it comes to prescription versus OTC hearing aids, there’s more to making the decision than cost alone.

What Are Over The Counter Hearing Aids?

Over the counter hearing aids (or OTC hearing aids), according to the FDA, provide hearing loss correction for adults 18 years or older with mild or moderate hearing loss. While in many cases they are functionally the same as prescription hearing aids, they do not require a comprehensive hearing evaluation, prescription, or professional consultation to purchase.

Prescription Versus OTC Hearing Aids: What Makes Them Different?

Prescription versus OTC hearing aids is less about the manufacturing of the hearing aids than it is about how they’re used. Today, most of the prescription and OTC devices are identical in terms of design and hardware. What makes them different falls into four key categories: programming, follow-up care, convenience, and cost. These differences make the application of the technology vastly different, as well as the process of getting hearing aids.

Prescription Hearing Aids: Benefits and Drawbacks

Prescription hearing aids are designed to correct hearing loss in all ages, from children to seniors. That flexibility comes from their customizable programming options. A licensed audiologist will adjust frequency-specific amplification, as well as other key programs, to correct any issues that are uncovered during the evaluation process.

Along with advanced programming, prescription hearing aids often include service plans through the audiologist, follow-up adjustments to improve their corrective programming, and custom fitting. Many audiologists also offer help installing smartphone apps that connect to the hearing aids, as well as help learning to use all the features of your hearing aids.

While the big advantages are the personalized programming and patient care, the biggest drawbacks come in the form of time and cost. Prescription hearing aids require a diagnosis and script from a licensed professional. And these hearing aids cost around $4,600 on average. These two barriers often result in people suffering hearing loss waiting up to 10 years on average to actually get the prescription and purchase the hearing aids.

Over the Counter Hearing Aids: Benefits and Drawbacks

Over the counter hearing aids offer a more affordable option for hearing correction, with some estimates of around $2,000 in savings per pair. The new FDA approval also opened up purchasing these OTC hearing aids possible through any retailer, rather than through a licensed professional alone.

But despite the expanded availability, lower cost, and bypass of prescription and evaluation, not everyone will benefit from over the counter hearing aids.

OTC hearing aids may be available without office visits, but that means that any fitting or adjustment processes are completely based on self perception. Custom programming won’t be possible, although users can make some small adjustments with smartphone apps. And many audiology offices provide service and warranty care, something OTC hearing aids will lack in most cases.

The limited programming also restricts over the counter hearing aids to adults 18 years or older. There is no correction for more advanced hearing loss, hearing complications, or tinnitus. Instead, these devices are intended only for mild to moderate hearing loss.

Prescription versus OTC Hearing Aids: Benefits and Drawbacks


*Cost estimate for OTC hearing aids in August 2022 according to federal statements of $3,000 estimated savings per pair under new FDA policies.

**Cost estimate for prescription hearing aids in October 2022 according to the National Council On Aging.

Hearing Aid Selection Guide: Which Hearing Aids Do I Need?

Let’s run through a simple series of questions to compare prescription versus OTC hearing aids for your needs. As you answer the questions, you’ll be able to determine if you would benefit from over the counter hearing correction or if prescription solutions to hearing loss would be better.

How Severe Is Your Hearing Loss?

If you have mild to moderate hearing loss, move to the next question. If your hearing loss is moderate to severe (you have trouble hearing people in quiet situations, for example), you should consider prescription hearing aids.

Are You Under the Age of 18?

OTC hearing aids are not intended for use in children. If you’re over 18, keep going.

What Caused Your Hearing Loss?

If you’ve lost your hearing gradually, specifically as you age, keep going. Most other causes of hearing loss need more professional attention. If you’ve suffered damage to your hearing through exposure to loud sounds, or if your hearing loss was caused by medications or medical treatments (such as chemotherapy), professional treatment is your best route.

Do You Suffer From Any Other Hearing Complications?

Tinnitus, unilateral hearing loss, and vertigo or dizziness all require more advanced prescription hearing aids for treatment. But if you’re simply experiencing mild hearing loss, you can move on to the next question.

Have You Made It to This Point?

If you’ve gotten this far, then you have simple hearing loss at a mild or moderate level, are 18 years or older, and have no other complications. You’re a possible candidate for over the counter hearing aids.

If you had to stop at any point prior to this, the FDA states that prescription hearing aids are the right path for your needs. Simply put, in a comparison between prescription versus OTC hearing aids, only a few situations will benefit from over the counter treatment options.

Do I Need to See an Audiologist to Diagnose Hearing Loss?

While you may not need a prescription to purchase over the counter hearing aids, a comprehensive hearing evaluation is still crucial to getting the hearing loss correction you need. Only trained and licensed audiologists can fully diagnose hearing loss. In fact, you could easily miss other important issues that contribute to changes in your hearing such as acoustic neuromas, schwannomas, impacted cerumen, and otitis media (middle ear infection) cause hearing loss. These conditions range from serious to common, and each requires a specific treatment and intervention.  

Acoustic neuromas, or, more accurately, vestibular schwannomas, are particularly concerning and are more common than you think. An undiagnosed vestibular schwannoma can cause a variety of symptoms. Hearing loss, tinnitus (ringing in the ears), balance issues, vertigo, and facial numbness can all stem from these benign tumors. Complications of this condition include further hearing loss, facial paralysis, neurological deficits, and even death. A hearing evaluation by a licensed professional will uncover these types of conditions and help you take the next steps to better hearing and better health.

Fortunately, comprehensive hearing evaluations are covered through most insurance policies. And seeing a hearing healthcare professional is always recommended for the best outcome measures for hearing aids. We encourage you to get your hearing evaluation before you spend your money on over the counter hearing aids. In the contest of prescription versus OTC hearing aids, undiagnosed hearing issues could cost you more than just frustration.

Schedule your evaluation with us today so you can get back to building memories with the people you love as soon as possible, whether or not you need prescription hearing aids.

Written by
Reviewed by
Mandy Rounseville-Norgaard Au.D.
Audiologist
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Dr. Norgaard has over 15 years of experience in practicing audiology, and a lifetime of experience wearing hearing aids. Dr. Norgaard was born with significant hearing loss in both ears and has worn hearing devices since the age of 3.

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