Over-The-Counter Hearing Aids Vs. Prescription Hearing Aids: What To Expect

Written by the Nano Hearing Aids Team
Reviewed for Accuracy by Lindsay Roberts, AuD.

Lindsay Roberts
Over-The-Counter Hearing Aids Vs. Prescription Hearing Aids: What To Expect

As someone with hearing loss, you want the best results from your hearing aids. Luckily, there’s more available to you than just expensive prescription options. You can save thousands by choosing over-the-counter (OTC) hearing aids.

Understanding the differences between OTC and prescription hearing aids is key to choosing which one is right for you. Our experts at Nano Hearing Aids have extensive knowledge of hearing aids. We’ll tell you everything you need to know about what to expect from OTC and prescription hearing aids.

1. Degree of Hearing Loss

Both OTC and prescription hearing aids address hearing loss, but your current stage of hearing loss will have an impact on the options available to you. For reference, the stages are:

  • Mild: Difficulty hearing soft or faint sounds, making conversations difficult in the presence of background noise.
  • Moderate: Soft and moderately loud sounds are difficult to hear. You may turn up the volume often or withdraw from social interactions.
  • Severe: Hearing sounds of various loudness and frequency is difficult. You may start to rely on lip-reading and visual cues.
  • Profound: Very limited to no hearing, relying primarily on sign language, lip-reading, or cochlear implants

OTC Hearing Aids For Perceived Mild To Moderate Hearing Loss

OTC hearing aids are one of the best options for perceived mild to moderate stages of hearing loss. The American Speech Language and Hearing Association defines mild to moderate hearing loss as anywhere from 25 dB HL and 55 dB HL hearing thresholds on an audiogram. However, you don’t need to know your exact hearing loss level or even take a hearing test to try OTC hearing aids.

If you can hear, but regularly ask others to speak louder, perceive speech as muddled, regularly turn up the volume on the TV, or struggle to understand conversations in noisy environments, you can likely benefit from OTC hearing aids.

Prescription Hearing Aids Are Best For Severe and Profound Hearing Loss

Prescription hearing aids can be useful for people with perceived mild to moderate hearing loss, but are necessary if you have severe hearing loss. These devices are designed for your specific hearing challenges, allowing you to hear once again even in the late stages of hearing loss.

Severe hearing loss requires precise calibration to ensure you’re able to hear without discomfort. Along with the device itself, the expertise of a hearing healthcare professional is crucial in assessing severe hearing loss, conducting comprehensive evaluations, and determining the best prescription device for you.

2. Availability

Lack of availability can be a huge hassle when you’re seeking out hearing aids. Prescription and OTC hearing aids are acquired differently, with the former being harder to acquire and taking longer to acquire than the latter. Here are the details:

OTC Hearing Aids Are Available Online And In-Store

As of October 2022, OTC hearing aids following FDA quality standards are now available for purchase. You can buy them at pharmacies, in stores, and online without needing a medical exam or a specialized fitting.

This impressive availability makes shopping for hearing aids as easy as visiting a reliable website where you can find several affordable options to choose from. 

Prescription Hearing Aids Must Be Ordered From A Hearing Professional

While prescription hearing aids are a necessity for those with severe hearing loss, their lack of availability can make them an unideal option for those with perceived mild or moderate hearing loss. 

Lack of availability results from regulatory restrictions and the need for professional oversight. Unlike over-the-counter hearing aids, prescription devices are ordered by your hearing professional following a hearing test. The devices are then customized for your specific hearing challenges. 

This level of customization, combined with the need to address more advanced degrees of hearing loss, limits their availability.


3. Affordability

Affordability is crucial in determining which hearing aid is right for you, especially if you lack insurance or have financial concerns. Here’s what you can expect:

OTC Hearing Aids Are Less Expensive

OTC hearing aids cost significantly less than prescription hearing aids, with the average cost estimated to be anywhere from $1,000-$3,000, with the average being $2,500. Compared to prescription options, you’ll save up to $3,000 per purchase.

High-quality hearing aids provided by Nano Hearing Aids are even more affordable, with pairs starting as low as $297. If you’re on a budget, OTC hearing aids are by far the most cost-effective option for you.

However, do keep in mind that most private insurance plans and Medicare do not cover expenses associated with these devices. Some may, but relying on either can be a risky safety net.

Prescription Hearing Are More Expensive

Prescription hearing aids are the more expensive option, costing around $4,600 per pair on average. Premium models can cost as much as $12,000. While these estimates do factor in professional fitting, ongoing treatment, and maintenance, it’s still a large sum of money for most households.

Further, not every insurance plan will cover prescription hearing aids, meaning you might have to pay the entire price out of pocket.

4. Variety

Both prescription and OTC hearing aids come in different styles suited for different ear sizes, ear types, and degrees of hearing loss. There are many common styles of hearing aids that all serve different purposes. For example:

Nano’s OTC Hearing Aids Offer Variety

OTC hearing aids offer a wide variety of options and sizes to fit anyone, even if they won’t be customized specifically to your ears. 

Here are some examples of OTC hearing aid styles:

  • Behind-the-Ear (BTE): This hearing aid rests behind the ear, with a tube or wire connecting to an earpiece.
  • Bluetooth BTE: This option also rests behind the ear with the added benefit of Bluetooth capabilities. The Sigma Plus app is used to control the volume and program settings of the hearing aids directly, allowing for hearing preference customization. 
  • Completely-in-the-Canal (CIC): Fitting inside the ear, this style is nearly invisible and is available with a variety of dome sizes. 

Overall, one of the most exciting aspects of OTC hearing aids is their effect on the market. Now that hearing aids are open to sellers outside the doctor’s office, the competition will spur innovations. Over the next 10 years, we can expect an exciting new array of OTC hearing aids to choose from. 

Prescription Hearing Aids Are Customized

As mentioned previously, the variety of prescription hearing aids is less important than their personalization. Your hearing healthcare professional can match you with a fully customized prescription hearing aid. 

However, besides BTE and ITE options, here are some examples of prescription hearing aids styles: 

  • In-the-Canal (ITC): Smaller than ITE aids, sitting partly in the ear canal.
  • Completely-in-the-Canal (CIC): Fitting deep inside the ear canal, this option offers a nearly invisible look.
  • Receiver-in-Canal (RIC): Similar to BTE but with a receiver in the ear canal for a more natural sound.
  • Invisible-in-Canal (IIC): This variety is placed deep in the ear canal, making it almost invisible.
  • Bone-Anchored Hearing Aids (BAHA): Surgically implanted devices for those with conductive hearing loss.
Fitting and Adjustment Process

5. Fitting and Adjustment Process

If you’re short on time and want fast hearing improvement, OTC hearing aids are the best option for you. Prescription hearing aids take a while to be fitted and adjusted, prolonging the time you have to spend struggling with hearing loss.

OTC Hearing Aids Are Fast And Easy

OTC hearing aids have a much faster and easier fitting and adjustment process.

With OTC hearing aids, you’ll receive ear-domes of different types and sizes that help you choose the best fit. Over 95% of people can find the right fit, allowing you to save time and money while still receiving optimal results. 

Just keep in mind that it takes a few days to months for your brain to adjust to the new sounds, and you'll need some time to learn how to use the hearing aids properly. During this time, you can easily reach out to your OTC hearing aid provider with questions and concerns.

Prescription Hearing Aids Require An Extensive Process

The fitting and adjustment process is lengthy for prescription hearing aids. First, you’ll need to undergo a hearing test with a hearing healthcare professional and attend a pre-fitting evaluation appointment. After these steps are complete, you’ll start the fitting process. 

An appointment will be made to have your hearing aids fitted. This appointment typically takes an hour, as the hearing professional may need to create custom molds of your ear canal and outer ear. Even after your new hearing aids are ordered, you can expect to attend a final fitting.

The benefit of this long process is receiving a custom fit and adjustments along the way, but it’s still a very time-consuming commitment.

Nano Hearing Aids

OTC Vs. Prescription Hearing Aid FAQ

What are the disadvantages of a hearing professional?

Hearing professionals are useful, but getting prescription hearing aids from them isn’t the answer for everyone. Here are some disadvantages of working with a hearing professional:

  • High Costs: Services and comprehensive hearing evaluations can be costly, potentially making the process of getting hearing aids unaffordable.
  • Time-Consuming: The process of obtaining hearing aids through a hearing professional may involve multiple appointments, potentially extending the time before you receive your devices.
  • Appointment Dependency: Regular follow-up appointments for adjustments and maintenance may be necessary, requiring ongoing time commitments.
  • Limited Accessibility: Hearing professionals aren’t available everywhere, leading to challenges in obtaining timely assistance in rural or underserved areas

It's crucial to weigh these disadvantages against the potential benefits of hearing professionals, as you may require their personalized care when you struggle with severe hearing loss.

How do I ensure my OTC hearing aids are fitted?

You can ensure your OTC hearing aids are fitted by trying out different sizes. Luckily, OTC hearing aids allow you to have easy access to different devices.

First and foremost, finding the right OTC hearing aid fit is all about having the correct hearing aid ear dome. An ear dome is a small detachable component at the end of your hearing aid that channels sound directly into your ear canal. When looking for the correct fit, you should try different ear domes to see what works for you. Sometimes, using no dome at all provides the best fit and comfort.

Here are some additional tips for fitting your OTC hearing aid:

  • You shouldn’t feel pain or discomfort
  • Test the volume of the device
  • See if the device stays in place while you move
  • Look out for any whistling or buzzing

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