An audiologist’s thoughts on over-the-counter (OTC) hearing aids


The Over-the-Counter Hearing Aid Act bill was signed into law in 2017. This law will allow certain hearing aids to be sold over-the-counter, in an attempt to reduce the cost of hearing aids. The rules for OTC hearing aids are supposed to be completed by August of 2020. However, there appears to have been little progress made on creating the rules regarding OTC hearing aids. Despite this, there is a lot of interest in the community for over-the-counter hearing aids. We wrote this blog post to give an audiologist’s thoughts on OTC hearing aids, since an audiologist has specialized knowledge about the potential pro’s and con’s.

When I founded Merit Hearing in 2016, my initial goal was to make premium level hearing aid technology affordable. Even though we sell hearing aids at wholesale prices, I realize that spending two or three thousand dollars for hearing aids is not in everyone’s budget. For this reason, Merit Hearing’s official stance on OTC personal amplification devices and OTC hearing aids is hopeful. Though the market is relatively new and there are many players, we are not opposed to offering affordable amplification options to patients who are not ready to make significant or serious investment into their hearing health.

Merit Hearing’s official stance on OTC personal amplification devices and OTC hearing aids is hopeful.


To this point, we have not offered any OTC hearing aids for a variety of reasons:

  1. There are many brands to choose from and almost all are relatively unknown companies. Quality and durability are major issues in hearing healthcare. Even premium hearing aids from major manufacturers will break down and require service eventually. It is difficult to recommend a product when we don’t know its durability or the customer service ability of the manufacturer.
  2. Many OTC hearing device manufacturers will only market directly to consumers. Our clinic has inquired about several products in an attempt to learn more and to evaluate if we could offer them to our patients. Regrettably, the companies were unwilling to share any information with us. While a direct-to-consumer idea is not inherently bad, it does draw some concerns in the area of hearing health. The audiologist is a manager of the patient’s hearing, and outcomes are dependent on a team approach. The provider needs to be able to make appropriate referral to specialized medical care when necessary. Each individual’s hearing loss and physiology will require large variability in how the hearing device is fit. This care can only come from experience. Most notably, the hearing healthcare provider must be able to verify that the hearing aid is doing what it is supposed to be doing. This is currently not possible in a direct-to-consumer strategy. If a company withholds its devices for clinic availability – it calls into question the ability of the devices to do what they are actually marketed to do. It not as simple as relying on online reviews. As any clinician will tell you, many new hearing aid users are most pleased with the sound of their new hearing aids when the hearing aids are turned down and barely doing work for the patient. This is because it most closely resembles the hearing profile they are used to – hearing impairment.
  3. As noted in the previous paragraph – verification and customization is vital for hearing aids to work well. Hearing aids come in all shapes and sizes and need to be customized based on the individual’s hearing loss and their anatomy/physiology. Many OTC hearing aids offer little in terms of customization. Having a one-size-fits-some approach can benefit many people, but when it doesn’t work, it can be very damaging. The patient’s trust in hearing healthcare might become damaged. Their outlook on quality of life may be impacted if they become even more pessimistic about their communication abilities and may result in further social withdrawal.
  4. Finally, of course, there is the financial burden of choosing to purchase a product that does not work for them. Not everyone is a good candidate for hearing aids in general. An audiologist is able to conduct a hearing aid assessment to determine if a specific patient is likely to be successful with hearing aids based on their hearing loss.

Bottom line:

Until there are OTC hearing aid manufacturers that are willing to work as partners with hearing health providers, we will not be comfortable recommending them to our patients. Instead, for our patients requesting ultra low-cost hearing aids, please take a look at our selection of economy hearing aids. As always, we share the cost of the hearing aids right on our website. We are hopeful that we will be able to offer OTC personal amplification devices and OTC hearing aids in the future.

If you’d like to read more about economy hearing aids, check out our latest blog post.

Written by: Dr. Andrew Keiner, AuD

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