The market for hearing aids is huge, and navigating the hearing-health care system requires ingenuity and patience, not to mention often-exorbitant amounts of money. Almost 30 million Americans of all ages would benefit from hearing aids, according to the National Institutes of Health, including a disproportionate number of those over 70. Among septuagenarians, 55 per cent of those 75 and older would benefit from hearing aids, but only one in three have even tried them.
Under-use of hearing aids has many causes, including cost, difficulty of access to audiologists, and stigma. Over-the-counter hearing aids – hearing aids you buy and adjust without an audiologist’s input – were approved for sale by the Food and Drug Administration in 2022.
Hearing-health advocates hoped that with cheaper, more accessible hearing aids, the barriers of cost and access would disappear. And as more people wore hearing aids, stigma would drop away. But the expected revolution in hearing-health care is arriving more slowly than some expected.
OTC aids will not replace prescription hearing aids or the need for audiologists, and they are not for everyone. Candidates for OTC’s are adults with self-perceived mild to moderate hearing loss. They are not for:
- People with more than a moderate loss
- Children under 18
- People with any pain or discomfort in the ear, dizziness, sudden hearing loss, loss in only one ear, ringing or buzzing in the ear
These latter conditions are considered red flags, and you should not try an OTC aid without seeing a doctor.
(Editor’s note: In a 2013 series, well before the OTC aids became available, we discussed issues of cost, efficacy, stigma and usefulness for hearing aids broadly. Read the series here: Part 1, Part 2 and Part 3.)
Upsides and downsides
One factor delaying the revolution is that three years after FDA approval, quality OTC’s are sometimes as expensive as a prescription hearing aid. Those that are inexpensive are not always safe, with no cap on volume control (even though volume control is an FDA requirement), and they don’t work as well as the more expensive products.
The OTC market is big and confusing, and getting bigger. As of last fall, there were at least 40 companies selling OTC devices and 80 more had filed applications for approval, according to Thomas Powers, whose eponymous consulting firm works with the hearing-health industry.
The new OTC hearing aids muddy the waters rather than clearing them. How do you choose from what looks like a vast number of offerings? This is hard with prescription aids as well, but you usually have a hearing professional as a guide (for better and sometimes for worse).
An audiologist can help with choosing an OTC aid, but it’s not easy to find an audiologist period, not to mention one who will help you with an OTC hearing aid. Nearly two-thirds of U.S. counties lack audiology services, according to a December 2024 report, disproportionately affecting rural communities.
As of January 2025, Medicare disallowed coverage for telehealth visits with audiologists, making access to an audiologist even more of a barrier. You should have an audiologist test your hearing, but if you can’t, take an online or telephone test, and try one of the new hearing aids. The CEDRA (Consumer Ear Disease Risk Assessment) screening test is also a way to see if OTC aids are right for you.
One popular choice
One of the most popular OTC hearing aids on the market is the Jabra Enhance Select, which remains at the top of most lists of best OTC hearing aids. Michelle Holcomb, a 50-something Boston fundraiser for small nonprofits, was one of the early users of the Jabra. She bought hers in 2022, online, after taking Jabra’s online hearing test. (She had seen a doctor a few years before, who ruled out any serious issues.)
With a few modifications and one or two follow-ups, they have worked well for her. Holcomb uses hers primarily for work or in noisy group settings. She paid around $1,300 for the pair. The newer top of the line Jabra Enhance Select retails for $1,995 and includes three years of hearing care, warranty, and loss and damage protection.
Hearing Tracker and its testing partner Hear Advisor are the source that most people look to for information about hearing-aid quality. Hearing Tracker put the Jabra, at $1,995, in the top spot on its 2025 best list, which included nine OTC aids with costs ranging from $1,995 down to $99.
The Jabra list price is $1,795-$1,995, The higher-price premium includes three years of hearing care, warranty, and loss and damage protection.
Basic vs. premium
Hearing Tracker advises: “Whichever Jabra Enhance product you pick, we highly recommend opting for the premium package ($1,995 versus the basic package at $1,795). The custom programming to your unique hearing profile and the three years of professional hearing care — which includes unlimited remote adjustments — can make all the difference. You’ll also receive three years of warranty and loss & damage protection, instead of just one year.”
Almost all hearing aids, prescription or OTC, come in a range of prices. The more you pay, in general, the more you get.
The Audicus Omni Series 2, at $1,898, came in second. Third overall was the Lexie B2Plus Powered by Bose at $999. The Sony CRE 10, #4, is $1,299 and others are $999 or below. The recently issued Apple AirPodPro 2 is $249. The least expensive, the JLab Hear OTC, at $99, is understandably pretty basic, but Hearing Tracker gave it a B for sound quality (with the caveat that “most devices in this price range are awful”.) The Elehear Beyond hearing aid was cited as the “Best Budget Under $400” hearing aid and received an A Sound Grade from the Hear Advisor lab.
Most of these OTC aids include noise cancellation, directional hearing and other features found on expensive prescription aids. A self-hearing test is usually included. The prices will vary according to where you buy them and what grade package you choose.
Different features
Features differ as well. Some have rechargeable batteries, and some use the one-time-use batteries that conventional hearing aids usually use. (I use regular hearing aid batteries, and they last about a week with full-time use.) Some of the hearing aids on Hearing Tracker’s list do better in the speech-in-noise area and others do better for music and other audio streaming. For details among Hearing Tracker’s top nine, this link takes you to full descriptions of each.
The announcement of Apple’s new hearing system, in September, generated a lot of media interest, despite the fact that the software was not yet available. If you already owned the AirPod2 you’d just need to download the new free software. If you bought a new AirPodPro 2 with the hearing aid software installed, the list price was $249. Apple’s standard 14-day return policy applied. (This is a short return window for hearing aids, which take time to get used to. Most return policies are 30 to 45 days.)
When the software became available a couple of months later, it arrived without much fanfare. I couldn’t find anyone who has used them, and I can’t try them out myself, because my hearing loss is severe to profound.
One friend tried to connect via her existing AirPods but she didn’t have a new enough iPhone. You need IOS 18.1 or higher, and she didn’t want to buy a new phone. Hearing Tracker published a detailed review of the Apple in November, updated in January, with tepid findings in all but the audio streaming category.
Deterrents
Stigma is perhaps the biggest deterrent to buying and wearing hearing aids. The stigma of hearing aids is entangled with the stigma of age, reinforced by the fact that the elderly are more likely to have hearing aids than younger people. Their hearing loss might have started when they were younger, but the combination of delay in getting hearing aids and the fact that most hearing loss is progressive means that we see more older people with hearing aids.
If enough people start wearing hearing aids because of OTC availability, and if enough of them are young (attracted by the Apple, for instance), will stigma begin to drop away? Abram Bailey AuD., the founder and president of Hearing Tracker, notes that denial also plays a major role – “My hearing isn’t bad enough” or “hearing aids won’t help.”
This is where Airpods could play a crucial role, despite their less than stellar ratings. They are accessible and inexpensive, and Apple is a trusted name. AirPods give people an easy way to see if amplification helps.
Traditional aids
Traditional prescription hearing aids go for $7,000 and more per pair, often with little to no insurance coverage. Medicare does not cover hearing aids, though some Medicare Advantage plans do. But there are good alternatives.
Costco offers brand-name prescription hearing aids at a big discount, often around the same price as the better OTC’s. It also sells OTC’s. Costco has its own audiologists and hearing-aid specialists, so the audiologist shortage is not an issue.
Users I spoke to are happy with the experience, buying name-brand aids like Oticon and Phonak at a big discount. If you are a veteran, hearing aids are free through the Veterans Administration, which is the country’s largest supplier of hearing aids. Costco is second.
It’s still early days for over-the-counter hearing aids. The revolution may not be coming as quickly as hoped, but most think we are off to a good start.
Katherine Bouton is the author of the books Shouting Won’t Help and Smart Hearing, and she blogs at Smart Hearing. She is president of the New York City chapter of the Hearing Loss Association of America.
