Yes, you can. Since October 2022, over-the-counter (OTC) hearing aids have been available in the United States without a prescription, a hearing exam, or any involvement from an audiologist. The FDA created this category specifically for adults 18 and older with mild to moderate hearing loss, and you can buy these devices at pharmacies, electronics stores, and online retailers just like you’d buy reading glasses.
That said, skipping the audiologist works well for some people and poorly for others. The answer depends on your age, the severity of your hearing loss, and whether anything else is going on with your ears.
Who Qualifies for OTC Hearing Aids
OTC hearing aids are designed for a specific group: adults 18 or older who have perceived mild to moderate hearing loss. “Perceived” is the key word. You don’t need a formal diagnosis. If you find yourself turning up the TV, asking people to repeat themselves, or struggling to follow conversations in noisy restaurants, you likely fall into this range.
The devices have a cap on their maximum sound output, which means they physically cannot amplify sound enough for someone with severe or profound hearing loss. If you can barely hear someone speaking directly to you in a quiet room, or if you rely heavily on lip reading, OTC aids probably won’t give you enough amplification. Prescription hearing aids, fitted by an audiologist, remain the only option for more significant hearing loss.
Children under 18 are excluded entirely. Both FDA regulations and the American Academy of Audiology maintain that OTC hearing aids are not approved for minors. Kids with hearing concerns need a diagnostic evaluation from a pediatric audiologist, who can identify the type and degree of loss, coordinate with other specialists like ENT physicians, and select technology appropriate for a child’s developing speech and language needs.
What OTC Hearing Aids Actually Offer
OTC devices come in two broad types. Basic models work like traditional hearing aids with volume control and preset programs. Self-fitting models go further, using a smartphone app to run a hearing test through the devices themselves, then adjusting amplification across different frequencies based on your results. Some use built-in algorithms that measure how sound reaches your eardrum and tailor the settings automatically.
The self-fitting process typically involves downloading an app, pairing the hearing aids via Bluetooth, and following on-screen instructions. In practice, this doesn’t always go smoothly. A study published in the Journal of the American Academy of Audiology found that 18 out of roughly 40 participants struggled with Bluetooth pairing alone. Researchers also documented app malfunctions, offline servers, and cases where the app only recorded test results for one ear. One participant couldn’t complete the self-fitting process at all because the app determined their hearing loss was too severe for the device.
These aren’t dealbreakers, but they’re worth knowing about. If you’re comfortable troubleshooting technology, self-fitting OTC aids can work well. If smartphones frustrate you, expect a learning curve or consider asking a tech-savvy friend or family member to help with the initial setup.
The Cost Difference Is Significant
Price is often the main reason people look into skipping the audiologist. Data from the MarkeTrak 25 survey, one of the largest hearing aid market studies, found the median cost of a prescription hearing aid is $1,560 per ear. Since 83% of prescription hearing aid owners wear them in both ears, the typical total lands above $3,000. An affordability analysis found that $1,500 in out-of-pocket hearing aid costs would be a catastrophic expense for more than half of American adults.
OTC hearing aids come in at a median price of $150 per device. At that price point, even a pair would be affordable for more than 90% of Americans with hearing loss. The gap between $300 and $3,000 is enormous, and it’s a big part of why the FDA created the OTC category in the first place.
One thing to factor in: Medicare does not cover hearing aids or hearing aid fitting exams under Original Medicare. Some Medicare Advantage plans (Part C) include hearing benefits, but coverage varies by plan. If you have no hearing aid coverage, the financial case for trying OTC first is strong.
What You Miss Without an Audiologist
An audiologist does more than sell you a device. The most concrete thing you lose by going OTC is a procedure called real ear measurement. During this process, the audiologist places a tiny probe microphone in your ear canal alongside the hearing aid and measures exactly what sound reaches your eardrum. They then adjust the hearing aid’s programming until the amplification matches a target prescription specific to your hearing loss pattern. This is an objective measurement, not based on your subjective impression of “does this sound better or worse,” and it can be done on day one without any adjustment period.
This matters because hearing loss is rarely uniform across all pitches. You might hear low-frequency sounds fine but miss high-frequency consonants like “s” and “f,” which is what makes speech sound mumbled. A professionally fitted hearing aid can boost specific frequency ranges precisely. OTC self-fitting apps attempt this too, but the accuracy depends on how quiet your testing environment is, how well-calibrated your earbuds are, and how reliably the app’s algorithm works.
You also miss a diagnostic evaluation that can catch medical problems. Not all hearing loss is the kind a hearing aid can fix.
Signs You Should See a Professional First
Certain symptoms suggest your hearing loss may have a medical cause that needs treatment, not just amplification. The FDA established a set of warning signs that warrant a full medical evaluation before using any hearing aid:
- Sudden or rapid hearing loss that developed within the past 90 days
- Hearing loss in only one ear that appeared recently
- Ear drainage, bleeding, or pus within the past 90 days
- Dizziness or vertigo, whether occasional or ongoing
- Ear pain, pressure, or a feeling of fullness
- Visible deformity of the outer ear, whether from birth or injury
- Significant earwax buildup or a foreign object in the ear canal
Some of these point to conditions like infections, tumors on the hearing nerve, or inner ear disorders that require medical treatment. Sudden hearing loss in one ear, for example, is sometimes treated as a medical emergency. Buying an OTC hearing aid and hoping for the best in these situations can delay treatment that works best when caught early.
How Reliable Are Online Hearing Tests
If you’re skipping the audiologist, you’ll likely rely on an app or website to gauge your hearing level. These tools vary wildly in accuracy. A systematic review of 15 audiometric apps and web tools found that sensitivity (the ability to correctly identify hearing loss) ranged from 18% to 100%, and overall accuracy ranged from 14% to 97.4%. A couple of well-validated apps performed consistently well, but many showed unreliable results across different studies.
The biggest problem is the testing environment. Two-thirds of the studies evaluated these apps in non-soundproof settings, which is exactly how you’d use them at home. Background noise, uncalibrated headphones, and differences between phone models all introduce error. A clinical audiogram, by contrast, is performed in a soundproof booth with calibrated equipment.
Online tests are reasonable as a first step to confirm you probably have some degree of hearing loss. They’re not reliable enough to determine exactly how much loss you have or whether it’s the type an OTC device can help with. If an app says your hearing is fine but you’re still struggling, or if it suggests severe loss, those results deserve a professional follow-up.
A Practical Approach
For a straightforward case, gradual hearing loss in both ears over months or years, no ear pain or drainage, no dizziness, and you’re over 18, trying an OTC hearing aid is a reasonable and far more affordable first step. Many retailers offer return windows of 30 to 60 days, so you can test the device in your daily life before committing.
If the OTC device doesn’t help enough, or if you’re unsure whether your hearing loss is mild, moderate, or something more, an audiologist visit fills in the gaps. You don’t have to choose one path permanently. Some people start with OTC, find it insufficient, and move to prescription devices. Others get a baseline audiogram from a professional, confirm they’re in the mild-to-moderate range, and then buy OTC with confidence. The regulatory barrier between you and a hearing aid is gone. What remains is figuring out which level of support your particular ears need.