OTC vs Prescription Hearing Aids - What You Need to Know

Updated August 7, 2025 | Lisbeth Cano

Choosing a hearing aid for an aging parent can feel overwhelming. Many options are available, and it's essential to understand your choices.

Understanding the differences between over-the-counter (OTC) and prescription hearing aids can help you make the best decision. Hearing aids can significantly improve a loved one’s communication and quality of life.

Nearly 30 million U.S. adults experience some hearing loss, yet only 1 in 5 uses hearing aids1.

What Hearing Aids Do and How They Work

Hearing aids are regulated medical devices that amplify sound to help individuals with hearing loss.

Most work through air conduction, sending amplified sound through the ear canal. A smaller subset uses bone conduction to transmit sound through vibrations in the skull.

“You don’t want to risk having a fall and being unable to get help.” — Dr. Warren Wong

It’s important to distinguish hearing aids from personal sound amplification products (PSAPs). PSAPs are designed for people without hearing loss who want amplification in specific settings (like birdwatching or lectures)2.

OTC Hearing Aids: What You Should Know

OTC hearing aids are available without a prescription and are designed for adults 18+ with perceived mild to moderate hearing loss1.

These devices can be purchased online or in stores and often include:

  • Self-fitting controls
  • Wireless connectivity
  • Smartphone app adjustments

Advantages of OTC Hearing Aids

  • Lower cost than prescription models
  • Easier access — no doctor or audiologist required
  • Good entry point for mild hearing loss

Limitations of OTC Hearing Aids

  • Not suitable for severe hearing loss
  • No professional fitting or medical diagnosis
  • Limited support if issues arise

Prescription Hearing Aids: A Professional Option

Prescription hearing aids are custom-fitted and appropriate for any age and any hearing loss level, from mild to profound3.

They must be prescribed and fitted by a licensed audiologist or ENT following a formal hearing evaluation1.

Advantages of Prescription Hearing Aids

  • Custom-programmed to exact hearing profile
  • Professional guidance on features and fit
  • More advanced models and long-term support
  • Available for children and those with complex needs

Limitations of Prescription Hearing Aids

  • Higher upfront cost
  • Requires in-person medical visits
  • Insurance coverage may vary depending on the plan

OTC vs Prescription Hearing Aids: Main Differences

Feature OTC Hearing Aids Prescription Hearing Aids
Age Requirement 18+ only Any age
Hearing Loss Level Mild to moderate Mild to profound
Professional Fitting
Access Retail or online Healthcare provider
Custom Programming Self-adjusted Clinician programmed
Price Lower Higher (includes services)

When to Consider OTC Hearing Aids

Choose OTC hearing aids if your loved one:

  • Is over 18
  • Has mild to moderate hearing loss
  • Does not have dizziness, pain, or other ear symptoms

These are a convenient and affordable first step. However, a hearing test is still recommended to rule out underlying medical issues4.

When Prescription Hearing Aids Are a Better Fit

Consider prescription hearing aids if your loved one has:

  • Severe or profound hearing loss
  • Hearing loss in one ear
  • Balance issues, dizziness, or ear pain
  • Is under 18 years old

A professional evaluation ensures the correct diagnosis and best device selection for long-term hearing support4.

How to Get Started with Hearing Aids

For OTC Devices

  • Buy online or at retail locations
  • Check return policies and warranty details
  • Follow manufacturer setup instructions
  • Monitor for hearing improvement or problems

For Prescription Devices

  • Schedule a hearing evaluation
  • Review options with a hearing care provider
  • Attend follow-up visits for fitting and adjustment
  • Return for regular maintenance

No matter the option, ensure the hearing aids are used consistently, cleaned regularly, and maintained properly. Malfunctions can be reported to the FDA via MedWatch.

Need More Help Deciding?

Explore the FDA’s OTC Hearing Aids Guide for detailed insights.

Also see our Hearing Aid Products section for reviews, guides, and comparisons.



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Lisbeth Cano Clinical Researcher and Elder Advocate

Meet the author: Lisbeth Cano earned her medical degree from Universidad de Iberoamérica in Costa Rica and worked as a doctor before becoming a clinical researcher. She now focuses on senior care, writing evidence-based guides for SeniorCanvas.com to help families make safer, smarter decisions for aging parents.