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My Perspective on Over-the-Counter Hearing Aids

A silver cochlear implant BTE, a beige hearing aid BTE, old white iPhone earbuds with wires.

There is recent news that the FDA issued a proposal to “make hearing aids available without a medical exam, prescription, or fitting.” What is my take on it? I would say yes and no – it depends.

Before going further, I would like to state that I’m not a medical professional and do not offer medical advice. I share only my personal experience as a deaf person and my knowledge and understanding about deafness and hearing devices.

I have been profoundly deaf since I contracted meningitis at the age 2. I am a former hearing aid user and a current cochlear implant user. I’ve visited many ENTs and audiologists throughout my life – both in Russia and here in the USA. 

There are 48 million deaf and hard of hearing people in the USA and 466 million in the world. 

Deafness is a spectrum. There are various types of deafness from mild to moderate to profound hearing loss. Therefore, there’s no one size solution for everyone. 

So it means that OTC hearing aids are not for everyone.

They are meant only for people with mild to moderate hearing loss. They have more limitations than prescribed hearing aids that have more functions and therefore cost more to manufacture. 

For example, OTC hearing aids are useless to me as I have profound hearing loss. Even the most powerful prescribed hearing aids on the market are no longer useful to me. That’s why I have a cochlear implant. Hearing devices just amplify sounds while cochlear implants bypass hair cells in cochleas.

Healthy Hearing explains:

Prescribed hearing aids cost an average of $1,000-6,000 per one ear. The cost depends on a level of hearing loss and hearing aid customization. The more severe the loss and the more customization is needed, the more expensive the device becomes. Most people need two aids.

Also consider the cost of an audiology visit for hearing test, hearing aid customization, hearing aid molds, hearing aid batteries, and so on. All this is not cheap. 

Hearing aids are sadly not covered by many health insurance companies. The reason? Many health insurance companies consider hearing aids cosmetic!

However, the high cost is not the main reason why people would not wear hearing aids. Other countries with universal healthcare offer hearing aids for free. Yet, 65% of Europeans with hearing loss do not use hearing aids

Why do many people that benefit from hearing aids not wear them?

To my knowledge, stigma associated with hearing loss is a bigger problem than the cost of healing loss. Sadly, hearing aids are much more stigmatized than eyeglasses. It takes on average 7 years for people to do something about their hearing loss.

Many people, especially late deafened adults, feel uncomfortable wearing hearing devices. They feel those devices make them look old. So they would either try to hide them or not wear them at all. John Hopkins lists myths that hold those people back.

But hey, I had worn hearing aids from age 3 until age 20. I’m not even that old yet! 

Sadly, hearing is often taken for granted until it gets worse. More young people are losing hearing as they listen to loud music with their earbuds on or at concerts. The number one cause of hearing loss is the constant exposure to loud noises. Age is only number two.

Even if you have mild hearing loss, you may not be aware of 3 things:

  • Conductive hearing loss caused by wax or ear infections, for example, can be treated. For that you would need to see an ENT.
  • certain medical issues that may cause hearing loss. For example, acoustic neuroma. If left untreated, it can become life threatening.
  • the severity of your hearing loss. It can be determined only during a hearing test.

Some people compare OTC hearing aids with reading glasses. I personally disagree. Reading glasses are meant to read small print. Even if you have any slight vision problems, it would be a good idea to visit a doctor. There may be a medical issue that may cause vision problems.

In addition to deafness, I also have had mild vision loss since I was in high school and visited an eye doctor regularly. I have prescribed eyeglasses. Lately, I started using reading glasses due to age. I remember seeing floaters and asking a doctor if it was a problem. The doctor said it’s usually not a concern but I would need eye ultrasound to make sure that they do not pull a retina. Fortunately, tests showed no issues.

My opinion is that while it’s great to see more OTC hearing aids in stores, it’s better to have all insurance companies cover expenses on hearing devices in full. Also to reduce the stigma of deafness and hearing devices and to encourage more people to do annual hearing tests.


My advice as a deaf person is to speak to a qualified ENT and a qualified audiologist first. They can determine the severity of your hearing loss and whether there are any medical issues that cause it. Only then they can tell you if OTC hearing aids may be the right solution for you. Better yet, visit an audiologist regularly the same way you visit an eye doctor. 

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