In August, a Food and Drug Administration (FDA) policy change opened the door to over-the-counter (OTC) sales of hearing aids. As of October 17, 2022, consumers can now buy hearing aids directly without consulting a healthcare provider.
The Biden-Harris administration said the move will reduce healthcare costs for consumers. Medicare does not provide coverage for the devices, and because prescription hearing aids can cost thousands of dollars, it is estimated that only 14% of older adults with hearing loss who could benefit from hearing aids actually use them. Overall, nearly 30 million people in the US are expected to benefit from increased access to over-the-counter hearing aids
We spoke to Baltimore-based audiologist Rachel Raphael and Hearing and Speech Agency (HASA) CEO Erin Stauder, who discussed the pros and cons of over-the-counter hearing aids and what women should know before buying one for themselves or for loved ones.
Set realistic expectations
Raphael compared over-the-counter hearing aids to being able to buy reading glasses at a drugstore. “Reading glasses are great — they’re cheap and I have them all over the house,” she said. But according to Raphael, they don’t offer a solution to more complicated vision problems. “If you need glasses that are tailored to your specific vision needs, you need to see a doctor.”
Stauder said she often heard the analogy to reading glasses with this rule change. “This analogy is good, but it has limitations. HASA supports affordable options, but we strongly believe that an audiologist or healthcare professional needs to be part of the conversation. Here there is a chance that you will not get what you need and in some cases even damage the hearing system. We support more accessible products, but there are limitations to what you can achieve with just one product.”
Most people don’t realize that there’s an adjustment period to using hearing aids, Stauder said. “People think you put the hearing aids in and it’s like, ‘Oh, I hear better now.’ It’s not like that, and in some cases it still has to be programmed.”
You get what you pay for
While “over-the-counter” hearing aids typically mean cost savings for the consumer, Stauder cautioned that these hearing aids cannot be described as cheap. “These devices will still cost hundreds of dollars to consumers,” Stauder said. “And they won’t be on a shelf. You’ll likely be behind the counter, and you’ll need to speak to someone to access it. That someone might as well be a medical doctor.”
Raphael warned against trying to save money by not seeing a doctor first to rule out possible, treatable causes of hearing loss. “You could spend all this money on a hearing aid that doesn’t help because you have earwax or an otitis media,” Raphael said.
For some people with uncomplicated, mild to moderate hearing loss, Raphael said an over-the-counter hearing aid is fine. But hearing loss can be complicated, and it’s difficult for a layperson to know if their hearing loss is simple or complex, or even mild, moderate, or severe.
Hearing aids generally come in three or four different tiers — entry-level, basic, mid-range, and premium — depending on the manufacturer, and the higher tiers are more expensive, Raphael said. “The levels make a difference. You could start with an “entry-level” hearing aid that only amplifies background noise. Mid-level and premium options are far more complex, processing speech, locating speech direction, and detecting background noise.”
Some insurance plans cover more complex prescription hearing aids. “If you have insurance that covers hearing aids, they generally offer a price cap on the coverage, paying every three to five years for a base pair, with the option to pay for the upgrade out of pocket,” Raphael said.
Hearing aids are not “plug and play”
Hearing aids may not be the giant, visible, squeaky devices of the last century, but they are high-tech, and that can be both an advantage and a disadvantage for the consumer.
Raphael said a big part of her job as an audiologist is fixing hearing aid problems. “There are so many ways technology breaks down and so many reasons why,” Raphael said. “I fix problems that the average person would have no idea how to fix. Now that hearing aids are Bluetooth compatible I can’t tell you how much time I spend troubleshooting.”
If you’re considering buying an OTC hearing aid, Raphael said, read the warranty to find out what parts are included and how to get service if something goes wrong. “Something may look cheap on the shelf, but you’ll get it for free in the end,” Raphael said.
Don’t be discouraged, get tested
While some audiologists worry that selling over-the-counter hearing aids will negatively impact their business, Raphael believes the opposite will happen. “I think audiologists will see a lot of people who aren’t happy with their results from over-the-counter hearing aids,” she said. “I hope that they will not give up getting help, but will contact a doctor and get a detailed analysis of the situation. Generally, people wait five to seven years before seeking help for hearing loss. Hearing is so important to overall health. Dementia, depression and anxiety have been linked to hearing loss. Over-the-counter hearing aids may not provide the best fit for everyone, but they could offer a path to better hearing care.”
American Academy of Audiology
American Speech Language Hearing Association
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