Should You Get Over-the-Counter Hearing Aids?

Millions of people live with hearing loss. But newer OTC hearing aids can save you money and make a big difference in your life, even if your hearing loss is mild.  

Sam lived with his bad hearing for some 15 years, even though his girlfriend, daughter, and caregiver all complained, loudly, that they needed to shout to talk with him. Then, at a small party to celebrate his 93^rd birthday, his friends had a lively conversation that he couldn’t follow. Every so often someone would turn to him and begin shouting.

Within the month, he took the plunge and got a new hearing aid. “I love it,” he said.

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Millions of people live with hearing loss. Nearly a quarter of people aged 65 to 74, and half of people 75 and older, have hearing loss. Younger people may have damaged their hearing listening to music too loudly on earphones.

Too many people put up with the problem for years, in part because of the cost of hearing aids. Hearing aids range in price from hundreds to thousands and often aren’t covered by insurance, including Medicare.

But the costs are coming down, with new technology and rules. The Food and Drug Administration has made it possible to sell over-the-counter (OTC) models in retail stores, designed for people with mild-to-moderate hearing loss. Many models are now available online.

There’s another reason people put this off: We’re not good at judging our own hearing. Your brain adjusts to the input it receives, and your hearing loss becomes your “new normal” — yet you still live with the consequences. Uncorrected hearing loss is linked to loneliness, hospital errors, dementia (even mild hearing loss may double dementia risk), falls, and depression, among other risks.  

The good news is that low-cost hearing aids are as good or better than the expensive models from a few years ago. Sam had two pairs he never used in a drawer. If you have tried hearing aids in the past and didn’t like them, now is a good time to try again.

A word of caution: Some research indicates that people have trouble choosing a hearing aid on their own. If your OTC pick doesn’t work for you, return it and see an audiologist, a professional hearing aid expert.  

Do I really need hearing aids?

Here are some tell-tale signs of hearing loss:

• People complain or make jokes about how loudly you play your TV.
• Your spouse and companions complain that they have to repeat themselves.
• You often find yourself asking people to repeat something, or you rely on your spouse to repeat what others say.
• You have trouble understanding conversations in groups, with background noise, or when you can’t see the speaker.
• You avoid parties in restaurants.
• You interrupt and talk too loudly, habits often related to hearing loss that bother other people.
• You go into long monologues, often because it’s easier to talk than listen.
• You get irritated by people who seem to be whispering.
• You can’t hear your grandkids or women with high voices.

If your hearing loss is sudden, see a doctor to rule out medical causes other than damage to your ears from noise or age-related decline.

How do I know if I have mild-to-moderate hearing loss?

The tips above are clues. To nail down your exact decibel numbers, a hearing test at an audiology office is the gold standard. You don’t have the buy a hearing aid there, but ask for a copy of your audiogram, a chart of how well you hear at different frequencies. You can also try online- or app-based screening tests. Hearing aids sometimes have built-in tests.

Over time, your hearing will decline, so repeat the test even if you took it within the past year.

If your hearing is very bad, you will be better off working with an audiologist, who will choose an aid and help you adjust.

How do I buy an OTC hearing aid?

No one aid works for everyone. But here are considerations:

• Hearing aids can look like earbuds, a chunk that goes in your ear. They also can attach behind your ear, connected by a wire to a tiny plastic basket that fits in your ear. Either way, most people will not notice that you’re wearing an aid.
• Choose an aid with a free trial period or money-back return policy. It takes time to adjust to an aid, so don’t rush to return it after a day.
• Most people want an aid with settings to make it work best in different circumstances, such as a setting for classrooms and another for a packed restaurant.

If you’re likely to use a smartphone app, look for an aid that allows you to adjust the settings yourself with your phone. The same goes for Bluetooth compatibility, which will allow you to feed sound from a phone or computer directly into your hearing aid.

Will you be annoyed if the battery runs out? In that case, choose a model that you can charge the way you charge a phone. If you’re worried about electrical outages, often forget to charge your phone, or lose your chargers, stick with batteries.

What are the best hearing aid brands?  

A New York Times “Wirecutter” review recommends and describes hearing devices branded as Lively, Eargo, Tweak Enhance, Jabra Enhance, and Hear.com’s Horizon. Costco has a popular line.  

Be patient

Your ears take in sound, but your brain interprets it. If you’ve had hearing loss for a long time, your brain has adjusted to that situation. When the frequency ranges you couldn’t hear before are now audible, you might be uncomfortable.

You might hear every door slam and passing garbage truck. It’s like going from hours in darkness to bright sunshine.

The adjustment can take weeks or months. Eventually your brain will adjust and filter out unimportant sounds, the same way you may have learned to sleep through familiar noises. And now you’ll hear a dog whimpering, and can get to your pet sooner.

It’s important to wear your hearing aids every day, though you can take short breaks. If you’re still not happy after regular use over a few weeks, consider the return policy. As noted earlier, you may need to work with an audiologist. But don’t give up: Give yourself the gift of better hearing.

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