The Hearing Loss Association of America expects that by the end of the year, the Food and Drug Administration will allow sales of over-the-counter hearing aids. Adults with mild to moderate hearing loss will be able to buy hearing aids without going to a hearing professional.

OTC hearing aids should be mostly a good thing for people who don’t have the $4,000 that an average pair of prescription hearing aids costs — a price that includes appointments with hearing professionals to test hearing and, if hearing aids are needed, to choose, fit, and adjust them.

Not surprisingly, many hearing professional associations oppose OTC sales, and many potential hearing aid wearers may feel overwhelmed without expert help. I understand wanting help, as long as you can trust the specialist to not pressure you to spend more than necessary.

In the six years I’ve worn hearing aids because of age-related hearing loss, I’ve dealt with two providers. Both implied that the more you spend, the better for your hearing. Cost differences, however, are related not just to performance but also to nonessential features such as rechargeability and Bluetooth connectivity to adjust settings with a smartphone. But hearing aids automatically adjust to different settings, and I have never found the need to adjust them.

“Bluetooth capability is a convenient extra, but it can add hundreds of dollars to your bill,” Consumer Reports says. “If you don’t think you’ll use it, skip it. Economy hearing aids may provide what you need.”

I’ve also been urged to replace hearing aids well before the five-year life expectancy. At the place I bought my first hearing aids, the audiologist became testy when I said I planned to keep three-year-old devices for another two years. She couldn’t understand why someone with an insurance benefit would not use it to get a new model. The technology improves constantly, she said. By her reasoning, I’d get replacements every year.

I was able to resist her but not the hearing aid specialist who dispensed my second pair of hearing aids. I had not had a hearing test since I got them in summer 2020, so I recently went in for the overdue test and possible adjustment of the hearing aids. I left with an order for new hearing aids.

The selling point was that the test showed that my hearing had declined. He said that with my Medicare Advantage insurance, for a copay of $398 I could get “advanced” hearing aids, two levels above my basic ones, that have better clarity because they have 32 channels compared with the previous devices’ 10. Channels are the regions into which hearing aids divide sound frequencies. The more channels, the fewer the frequencies in each and thus the more precise sounds.

With more than three times the channels of my old hearing aids, the new ones should make sounds super clear. They do, but I haven’t been in an environment yet where I’ve noticed that they’re better than the old ones. Since buying them, I’ve read that studies have found that above 8 channels, most people don’t detect an improvement. Maybe I didn’t need to replace hearing aids not yet two years old. 

Most people don’t have insurance for hearing aids, including most people on Medicare. Traditional Medicare doesn’t pay for them; I’m fortunate that my Medicare Advantage insurance is generous. The HLAA supports OTC hearing aids to improve accessibility and affordability for the millions of people who might otherwise not seek help for their hearing loss.

According to the National Institutes of Health, nearly one-quarter of Americans ages 65 to 74 and one-half of those over 75 have a disabling hearing loss. Only 30 percent of older adults who could benefit from hearing aids have ever used them. Cost is a major drawback.

There are already OTC devices being marketed illegally as hearing aids prior to FDA approval of the new product category. They use the same fundamental technology as prescription hearing aids and advertise features such as rechargeability, noise reduction, volume control, Bluetooth capability, online and phone support, and warranties. 

It is advisable to delay buying OTC hearing aids until FDA regulations set quality standards. In the meantime, potential users may want to educate themselves about types and features.

It’s helpful to remember that no hearing aid can reverse hearing loss or stop its progression. The purpose of hearing aids is to help people hear better, so the test of a hearing aid, whether prescription or OTC, is how well it does that.

Fortunately, hearing aids come with trial periods. Those who think they have a hearing loss but are put off by the cost of prescription hearing aids might want to try out OTC hearing aids after the FDA issues the regulations. If you find self-service hearing aids that work for you, great. If not, you can return them and go to an in-person provider.