Since October 2022, U.S. adults with self-perceived mild-to-moderate hearing loss have been able to buy in-ear hearing aids without a prescription. The rule did not, however, abolish the audiologist — and for many seniors, the clinic still belongs in the picture.
Three questions, in order
- 1. Is the loss mild or worse? If conversation in a quiet room is fine but TV is hard, OTC is reasonable. If you cannot follow a one-on-one conversation, see an audiologist.
- 2. Any red flags? Sudden loss, dizziness, ear pain, drainage, or one-sided loss require a medical exam first — these are not OTC situations.
- 3. How comfortable are you with apps? Most OTC devices self-fit through a smartphone. If that is a barrier, a prescription fitting is worth the cost.
| Factor | OTC | Prescription |
|---|---|---|
| Typical price (pair) | $200–$1,500 | $2,000–$6,000 |
| Severe loss | Not suitable | Yes |
| Custom-molded shell | Rare | Standard |
| Follow-up care | Self-serve | Included |
A reasonable hybrid path: pay $50–$150 for a baseline audiogram at a Costco or VA clinic, then decide. The exam is yours to keep regardless of where you eventually buy.
