2/20/2024 | By Kari Smith

Finally, hearing aids have become more affordable. Seniors Guide looks at the advent of over-the-counter hearing aids.

There is no way to reverse hearing loss, but hearing aids can improve the wearer’s ability to hear and communicate with others. It may also help slow cognitive decline.

The impact of hearing impairment on cognitive decline has been acknowledged for at least a decade, but recent scientific testing demonstrates that older, less healthy participants in the study had a shocking almost 50% less cognitive decline if they were using hearing aids.

Despite the proven benefits, many seniors have not been able to afford traditional hearing aids. Seniors with mobility or other restrictive issues struggle with the multiple appointments required to visit an audiologist, and have hearing aids ordered, fitted and adjusted. Fortunately, people can now purchase less expensive over-the-counter hearing aids.

Over-the-counter hearing aids

In 2022, the Federal Drug Administration (FDA) approved over-the-counter devices. No longer must a user go through an audiologist or other professional for the product. Instead, OTC hearing aids may be purchased from a retail store or online retailer. Although there are still benefits to working with a trained professional, users who cannot afford fittings and expensive products – or who choose not to – have options.

What to look for in OTC hearing aids

Before choosing over-the-counter hearing aids, consider:


Buying an over-the-counter hearing aid means you are buying it outside of the support of an audiologist. Be sure that your device brand offers sufficient telephone-based customer support in case of any issues that arise, especially for setup and adjusting the device when you first purchase it.

Personalization / customization

Pricier self-fitting hearing aids can be more precisely customized than preset hearing aids, typically using a smartphone app. They are also more heavily governed by the FDA, offering more peace of mind regarding their effectiveness. Though you may save money on a preset hearing aid, you won’t have the ability to make adjustments to the device that address your specific problems, such as the ability to adjust specific high or low frequencies that you struggle with hearing.

If finances are an issue – or even comfortability with using a smartphone app – more cost-efficient preset hearing aids can still be a good option. Although customization options are more limited, preset hearing aids do offer a range of set programs that you can choose from to address your specific hearing needs.


over-the-counter hearing aids combined in the shape of a heart. Image by Jovanmandic

When choosing a hearing aid, you will need to determine if you prefer a device that fits in the ear, or sits behind the ear. For some, this choice is based on a preference for hearing better, and for some, to not be as visible. For either option, choose a device that you can take in and out, and clean without issue, especially if you have mobility issues in your hands.

Warranty and returns

Before purchasing, be sure that your hearing aids offer a sufficient window of time to figure out whether or not the device works for you. It’s also important to ensure that your product has a warranty – and know its terms – before purchasing.


One model we examined, Lexie B1, is powered by the popular Bose technology that you have probably heard of (or have in your own home) for speakers, headphones, and more. They are personalized to the needs of the wearer without the intervention of an audiologist. By using Bluetooth technology, the aids can be paired with a self-tuning mobile app with support available 7 days a week for usage and adjustment.

These are true hearing aids, with functions such as background noise reduction, feedback cancellation, and your typical receiver-in-canal design. This particular model is not designed to stream music or answer calls.

A brief clinical study funded by Lexie’s maker tested 68 adults who reported mild to moderate hearing loss. Some were sent to an audiologist to have traditional hearing aids fitted, and some were given self-fitting hearing aids. Six weeks later, both groups performed similarly on hearing tests. Another small clinical trial that compared self-fitted and audiologist-fitted hearing aids (another Lexie product, the Lumen) demonstrated that self-fitted devices performed as well as those fitted by an audiologist.

Effective use by the consumer depends on the user carefully following the instructional materials provided and using the associated phone app to fit the device. Seniors who struggle with smartphone apps may seek help from a tech-savvy smartphone user to set up the device and app for best results.

On the way: glasses with built-in hearing aids

I am my Dad’s barber. For as long as I have cut his hair, he has worn it long on top, short on the sides, and sported a clean-shaven face. He recently began wearing hearing aids, something he likely should have done many years before. Since that time, he goes much longer between haircuts, asks for the sides to be kept long, and has grown a full beard that helps hide the hearing aids he so desperately needs. My father is not a vain guy – and neither are many seniors who feel uncomfortable wearing visible hearing aids.

A new option is coming soon for those who are uncomfortable with the optics or stigma of wearing traditional hearing aids: glasses with onboard, hidden hearing aids.

Although a quick internet search may reveal that hearing aids attached to glasses were around as early as the 1970s, they have come a long way in terms of reliability and effectiveness. Audio-connected and smart glasses are already on the market, and businesses have begun adding hearing aids to their products.

At the Consumer Electronics Show In January 2024, EssilorLuxottica vision care and eyewear company showcased Nuance Audio, its hearing aided eyewear for consumers with mild to moderate hearing loss. Nuance Audio combines proprietary open-ear hearing technology with fashionable eyeglasses – especially useful for consumers who want to avoid the look of traditional hearing aids. Nuance Audio is expected to launch in the market starting with North America in the second half of 2024.

Hearing aid glasses aren’t for everyone. Children with hearing loss are advised to visit audiologist to discuss the particular needs of their developing ear. They are not recommended for those with severe hearing loss. Adults with mild to moderate hearing loss who struggle to hear in noisy environments (like a restaurant, a loud family dinner, or a crowded store) will be best helped by this product.

While they wait for subtlety of audio devices hidden in their glasses, price-conscious consumers looking for reasonably priced OTC hearing aids have plenty of other options.

Kari Smith

Kari Smith is a frequent contributor to Seniors Guide, helping to keep those in the senior industry informed and up-to-date. She's a Virginia native whose love of writing began as a songwriter recording her own music. In addition to teaching music and performing in the Richmond area, Kari also enjoys riding horses and farming.

Kari Smith