Know Your Audiology Options

Consumers need to be all ears about over-the-counter hearing aids - Get a full audiology exam before buying new devices coming to market this year
By Alice Bassen and Pamela O’Bert

A new class of hearing aids, available over the counter without a prescription or any professional consultation required, is expected to come to market throughout the U.S. later this year. While that sounds like good news for people with mild to moderate hearing loss seeking a more affordable alternative to traditional prescription hearing aids, many audiologists are concerned about patients self-diagnosing and are urging consumers to get comprehensive hearing examinations before purchasing such devices. 

It’s understandable consumers want the option of buying over-the-counter (OTC) hearing aids.  Traditional hearing aids can be very expensive, as much as $3-$5,000 a pair or more, usually with zero coverage by insurance and Medicare plans. While pricing isn’t clear yet, OTC hearing aids may cost well under half that amount. Making hearing aids more affordable and readily available to more people is certainly a positive thing, and that’s why Congress in 2017 authorized the FDA to create this new category of OTC devices. The federal guidelines necessary for bringing them to market are supposed to be published by August. 

OTC hearing aids will be self-programmable, which means the user can select, fit, program and control the device (usually with a cell phone) without the assistance of a professional. What concerns audiologists is that many consumers will think it’s ok to skip the comprehensive audiology exam that determines the type and degree of hearing loss a patient has.  Everyone’s auditory system is different. It’s important to know what you’re trying to correct in order to do it correctly. Relying on consumers to diagnose themselves can leave significant room for error. They may overestimate or underestimate their level of hearing loss or miss underlying medical conditions causing their hearing loss. There’s also the issue of proper fitting and calibration. The wrong fit and programming won’t solve your hearing problem and may even do more harm than good.

In other words, selecting the right hearing aids is not the same as buying a cheap pair of reading glasses off the rack. With readers, if they’re the right magnification, you see it right away. With hearing aids, you don’t know what you’re not hearing. That’s why it’s so important to get an accurate evaluation, and only a licensed audiologist is fully qualified to do so. While audiologist may not be able to program the hearing aids a patient buys over the counter or online, they can still help people identify the right type of device for their particular needs.

Another point for clarity: OTC hearing aids aren’t to be confused with personal sound amplification products or PSAPs, which already are available over the counter and online, and which simply amplify all sounds, even those you don't want to hear – unlike hearing aids, which filter out background sounds and selectively amplify what you need to hear.

Nearly 50 million Americans have some form of hearing loss, including 40 percent of all people between the ages of 55 and 74. And yet, only one in three people over the age of 70 who would benefit from the use of hearing aids actually use them. The remaining 70 percent go without treatment. Many cite the cost. Some are embarrassed to wear them. But most aren’t using hearing aids because they haven’t been tested or have wrongly convinced themselves they don’t need them.

People often are surprised when their hearing capability increases 50 percent or more by having hearing aids that are appropriate for them. Whether you’re choosing traditional hearing aids or the new over-the-counter devices coming to market later this year, it’s important to know the best results can only be achieved by getting a thorough hearing evaluation by a licensed audiologist.

Alice Bassen, Au.D, CCC-A and Pamela O’Bert, MA,CCC-A are audiologists with Berkshire Health Systems.