OTC vs Prescription Hearing Aids: What's the Difference?
Hearing loss can be isolating and frustrating. However, there are many hearing aid devices available that may help. Some are available through a prescription, while over-the-counter (OTC) hearing aids are also an option.
Understanding the differences between prescription and OTC hearing aids is important in making the decision on which is best for you. In this guide, we’ll walk you through the differences, benefits, and disadvantages of each in the hopes that you can choose the best fit for your hearing needs.
Key Takeaways
Over-the-counter (OTC) hearing aids are generally more affordable and accessible compared to prescription hearing aids.
Medicare does not cover the cost of hearing aids. However, some parts of Medicare Advantage (Part C) and some private insurance policies may offer partial coverage.
Doing a hearing test, either an online assessment or one with a professional, can help you determine whether you need an OTC hearing aid or a prescription.
What are OTC hearing aids and prescription hearing aids?
In 2022, the Food and Drug Administration (FDA) approved OTC hearing aids. These are hearing aids that are available directly to you without a prescription. They are designed for individuals aged 18 and above with mild to moderate hearing loss.
Prescription hearing aids are custom-fitted and programmed devices that a licensed audiologist or an ear-nose-throat (ENT) specialist prescribes. They are best for individuals under the age of 18 or those with severe or varying degrees of hearing loss.
Why choose OTC hearing aids vs prescription hearing aids?
Choosing between OTC and prescription hearing aids depends on several factors, including the severity of your hearing loss, budget, and personal preferences.
Benefits of OTC hearing aids
OTC hearing aids have opened up a world of possibilities for people with mild to moderate hearing loss.
Cost advantages
One of the biggest benefits of OTC hearing aids is the price. While traditional prescription hearing aids often cost around $4,000, OTC hearing aids typically range from just $200 to $1,400 per pair.
They also don’t require professional exams, fittings, and follow-up visits, which can add to the overall cost.
Convenience and accessibility
You can purchase OTC hearing aids online or at local retailers like pharmacies, big-box stores, or even warehouse clubs. There’s no need to wait weeks for appointments or insurance approvals.
Online retailers often provide video tutorials, setup guides, and customer service chats to help you get started. Purchasing in-store gives you the option for hands-on comparison before making a purchase.
Personal privacy
Hearing loss can feel personal or even embarrassing for many individuals. OTC hearing aids allow you to address your hearing needs privately, without having to schedule medical visits or share your situation with others.
Many OTC hearing aids are designed with slim, stylish profiles that fit comfortably and discreetly behind or inside the ear. Some models even resemble wireless earbuds, blending seamlessly into everyday life.
Benefits of prescription hearing aids
While OTC hearing aids have made hearing support more accessible, prescription hearing aids still offer unmatched customization and professional care.
Customization and support
Prescription hearing aids are custom-fit to your needs. An audiologist performs a detailed hearing test to map out exactly which sounds you struggle to hear. Based on that information, they program your devices to enhance the frequencies you need most.
Your audiologist can fine-tune them over time, ensuring you are getting the most out of your hearing device.
Advanced technology options
Prescription hearing aids often include advanced technology that goes beyond what most OTC devices can offer. They use powerful sound processors that automatically adjust to your environment. For example, they can detect background noise and focus on speech, making conversations easier to follow even in crowded places.
Modern prescription hearing aids often connect to smartphones, TVs, and tablets via Bluetooth. You can stream phone calls, music, and even GPS directions directly to your hearing aids.
Comprehensive hearing health care
When you choose prescription hearing aids, you’re not just getting a device. You’re also gaining ongoing monitoring with your healthcare provider.
Ear canals can often become clogged with earwax, which can worsen hearing loss. Audiologists have specialized tools to safely remove blockages and check for ear health issues. Regular cleanings and checkups ensure your hearing aids function properly and your ears stay healthy.
Hearing loss is often a gradual process. With professional care, you’ll receive ongoing monitoring to track changes in your hearing over time.
OTC hearing aids vs prescription hearing aids
Choosing between OTC and prescription hearing aids can feel overwhelming at first. Here’s a comparison to help you see the differences between the two options.
Cost and insurance soverage
OTC hearing aids are generally much more affordable, typically ranging from $200 to $1,400 per pair, depending on the brand and technology level. Prescription hearing aids, on the other hand, average around $4,000.
At this time, Original Medicare does not cover hearing aids of any kind, OTC, or prescription. However, some Medicare Advantage (Part C) and private insurance plans may offer partial coverage for prescription hearing aids, including fittings and follow-up visits.
OTC hearing aids are usually purchased out-of-pocket. Some people use their flexible spending accounts (FSAs) or health savings accounts (HSAs) to help offset the cost. It’s a good idea to check your specific plan for hearing benefits before making a purchase.
Although prescription hearing aids cost more upfront, they often include warranties, professional cleaning, and repair services that extend their lifespan. OTC hearing aids may include shorter warranties or require users to troubleshoot on their own.
Effectiveness and performance
Recent studies have shown that OTC hearing aids’ effectiveness can be similar to prescription devices for adults with mild to moderate hearing loss. A 2024 study published in JAMA Network Open found that participants who used self-fitting OTC hearing aids reported hearing improvements similar to those fitted by audiologists. However, for people with more complex or severe hearing loss, prescription hearing aids consistently provided better speech understanding and comfort.
Prescription hearing aids are finely tuned to match your unique hearing loss pattern, which results in clearer sound and better speech recognition, especially in noisy environments. For those who mostly struggle in quiet settings, OTC devices can be an excellent solution. But for busy or social environments, prescription devices tend to perform better.
Both OTC and prescription hearing aids have high satisfaction rates among users; however, individual expectations play a significant role. Many people appreciate the immediate access and affordability of OTC options, while others prefer the personalized care and advanced features of prescription models.
Most OTC brands offer 30- to 60-day return policies, while prescription hearing aids typically come with professional trial periods, giving you time to adjust or request modifications if needed.
Ideal candidates for each
If you find yourself turning up the TV, asking people to repeat themselves, or struggling in small group conversations, but can still hear in quiet environments, OTC hearing aids may be perfect for you.
For people with severe or complex hearing loss, prescription hearing aids are essential. They deliver stronger amplification and are professionally adjusted to handle a wider range of hearing challenges.
First-time users may appreciate the low cost and simplicity of OTC hearing aids, as they can try hearing support without a large investment. However, experienced hearing aid users, especially those familiar with professional fittings, often prefer prescription devices.
How to choose between OTC and prescription hearing aids
Deciding between OTC and prescription hearing aids depends on your unique hearing needs, lifestyle, and comfort level with technology.
Assessing your hearing
Online hearing tests can be a quick and easy way to decide if you may benefit from a hearing aid. However, a professional audiogram performed by an audiologist provides a much more precise assessment.
If you frequently struggle to hear conversations even in quiet settings, experience ringing in your ears, or notice that sounds seem distorted rather than just soft, it may indicate more significant hearing loss.
It’s always wise to consult an audiologist if you have sudden hearing loss, pain, drainage, dizziness, or hearing that differs between ears. These symptoms can signal an underlying medical condition that requires professional evaluation.
Important factors to consider
Think about where you spend most of your time. If you’re often in quiet environments, an OTC hearing aid may work well. However, if you attend meetings, social events, or noisy restaurants, a prescription hearing aid with advanced noise filtering and directional microphones may provide better clarity.
OTC hearing aids often rely on smartphone apps for setup and adjustments, making them ideal for tech-savvy users comfortable managing settings on their own. If you prefer hands-on guidance or struggle with technology, you may find it easier to work with an audiologist who can fine-tune your prescription hearing aids and provide in-person support.
Budget is an important factor for many users. OTC hearing aids are more affordable upfront, but prescription hearing aids may offer longer warranties, professional maintenance, and better long-term reliability.
Step-by-step decision process
Begin with a hearing test, either an online assessment or one conducted by a professional, to determine your current hearing level.
If you have mild to moderate hearing loss, starting with an OTC hearing aid can be an affordable way to trial hearing aids. Many brands offer generous return policies, allowing you to test the devices in your daily life before making a larger investment.
If OTC hearing aids don’t provide enough clarity, comfort, or improvement in daily communication, it may be time to consider a prescription option.
Adjusting to hearing aids, whether they be OTC or prescription, can take several weeks. The brain needs time to adapt to amplified sounds, so gradual, consistent use is important.
Bottom line
OTC and prescription hearing aids both offer valuable ways to improve hearing, but they serve different needs. OTC hearing aids are affordable, convenient, and ideal for mild to moderate hearing loss, while prescription hearing aids provide advanced technology, personalized programming, and professional support for more complex or severe hearing loss.
The best first step is always a professional hearing evaluation. An audiologist can help you understand the extent of your hearing loss and guide you toward the solution that fits your lifestyle, budget, and hearing goals. From there, you can try an OTC hearing aid if appropriate, or move directly to a prescription device for customized support.
FAQs
What's the main difference between OTC and prescription hearing aids?
The main differences are the type of hearing loss they are intended for, the cost, and the level of professional support. OTC hearing aids are designed for mild to moderate hearing loss and can be purchased directly without a prescription. Prescription hearing aids are tailored to your exact hearing profile and include professional fitting, follow-ups, and advanced technology.
Are OTC hearing aids as effective as prescription hearing aids?
For mild to moderate hearing loss, OTC hearing aids can be very effective and help improve speech understanding and overall hearing. However, for severe or complex hearing loss, prescription devices are usually more effective due to precise programming and advanced features.
How much do OTC hearing aids cost compared to prescription?
OTC hearing aids generally cost between $200 and $1,400 per pair, depending on the brand and features. Prescription hearing aids are more expensive, typically ranging from $4,000 or more.
Sources
Borre, E. D., Johri, M., Dubno, J. R., Myers, E. R., Emmett, S. D., Pavon, J. M., Francis, H. W., Ogbuoji, O., & Sanders Schmidler, G. D. (2023). Potential Clinical and Economic Outcomes of Over-the-Counter Hearing Aids in the US. JAMA Otolaryngology-- Head & Neck Surgery, 149(7), 607. https://doi.org/10.1001/jamaoto.2023.0949
De Sousa, K. C., Manchaiah, V., Moore, D. R., Graham, M. A., & Swanepoel, D. W. (2024). Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids. JAMA Otolaryngology-- Head & Neck Surgery, 150(9), 765. https://doi.org/10.1001/jamaoto.2024.1825
Food and Drug Administration. (2023). OTC Hearing Aids: What You Should Know. Retrieved from https://www.fda.gov/medical-devices/hearing-aids/otc-hearing-aids-what-you-should-know
Mayo Clinic. (2023). Hearing Loss. Retrieved from https://www.mayoclinic.org/diseases-conditions/hearing-loss/diagnosis-treatment/drc-20373077
Medicare. (2025). Hearing Aids. Retrieved from https://www.medicare.gov/coverage/hearing-aids
National Council on Aging. (2025). Medicare and Hearing Health For Seniors. Retrieved from https://www.ncoa.org/article/medicare-and-hearing/