Hearing Matters Podcast: Hearing Aids, Hearing Loss and Tinnitus

OTC Hearing Aids, Clearly Explained

• Hearing Matters

Share episode

Send us a text

Buying hearing help shouldn’t feel like guesswork. We break down over-the-counter hearing aids with plain talk: what they are, who they’re designed for, and how to know whether self-fit amplification is a smart starting point or a detour that delays the clarity you want. You’ll hear the critical differences between OTC and prescription devices, from diagnostic testing and individualized programming to real-ear verification and ongoing counseling that actually moves the needle in noisy, real-world settings.

We share evidence-backed criteria to decide if OTC suits your needs—perceived mild to moderate loss, comfort managing tech, and realistic expectations—and the red flags that call for a professional evaluation right away, like sudden or asymmetric changes, persistent ringing or pain, or continued trouble understanding speech even when it’s loud. Along the way, we talk through the biggest complaint users have in daily life: speech in noise. You’ll learn why clarity, not just volume, drives satisfaction, and how targeted signal processing and guided adaptation can turn “I can hear” into “I can understand.”

This conversation is about access and outcomes, not choosing sides. Used as directed, OTC devices are safe and can reduce stigma and encourage earlier engagement. The real risk is delay—waiting years to act or assuming nothing works after a poor first try. If you’re on the fence, start with our online hearing test to get a baseline, then use our provider locator to find a professional who will meet you where you are, explain your hearing test results, and map options without pressure. Subscribe, share this with someone who keeps asking for repeats, and leave a review to help more people hear life’s story with confidence.

Omega AI hearing aids don’t just keep up. They redefine what it means to be modern and discreet yet durable and comfortable for all-day wear.

They’re waterproof, everyday-proof, and designed to go the distance of your day and then some. All while tailored to your unique hearing needs.

Connect with the Hearing Matters Podcast Team

Email: hearingmatterspodcast@gmail.com

Instagram: @hearing_matters_podcast

Facebook: Hearing Matters Podcast

Blaise M. Delfino, M.S. - HIS :

You're tuned in to the Hearing Matters Podcast, the show that discusses hearing technology, best practices, and a global epidemic. Hearing loss. Before we kick this episode off, a special thank you to our partners. Care Credit. Here today to help more people here tomorrow. Fader Plugs, the world's first custom adjustable earplug. Welcome back to another episode of the Hearing Matters Podcast. I'm founder and host, Blaise Delfino, and as a friendly reminder, this podcast is separate from my work at Starkey. Welcome back to the Hearing Matters Podcast. I'm Blaise Delfino, host of the show, and today's episode is for anyone who has searched for hearing aids and recently found themselves asking a very reasonable question Should I try over-the-counter hearing aids? Now, OTC hearing aids are everywhere right now. They're talked about as more affordable, more accessible, and easier to get as compared to prescription hearing aids. And for some people, they can be helpful. But there's also a lot of confusion about what OTC hearing aids are, who they're designed for, and what they can realistically do. Now, my goal today isn't to talk you into or out of anything. It really is to give you clear, evidence-based information so that, you know, you can make a decision that actually fits your life and your hearing health care journey. Because it is, in my professional opinion, that hearing care isn't so much about products, but it really is about understanding. And as a former private practice owner and current hearing health care professional, it's very exciting to be having this conversation with you because I was able to see years back when OTC legislation was introduced, and all of the professionals got together, talked about the pros, talked about the cons. And years later, here we are. OTC hearing aids are here. They're here to stay. And as hearing care professionals, it's really important that we navigate this landscape while also continuing to help patients make an educated hearing healthcare decision. Now, this episode is for consumers. So if you are a consumer interested in hearing better, understanding speech clearer, well, we hope that this episode sheds light on what OTC hearing aids are. And OTC hearing aids, they are FDA-regulated medical devices that adults can purchase without a prescription or a diagnostic hearing test. Now, emphasis here on adults, 18 years or older, those are the people that can purchase OTC hearing aids. Now that regulation matters. OTC hearing aids are not generic sound amplifiers. They're not consumer earbuds that boost sound, and they are not personal sound amplification products marketed without medical oversight. So they are classified as medical devices and they must meet safety and performance standards set by the FDA. Again, OTC hearing aids are intended only for adults who perceive they have mild to moderate hearing loss. Now that phrase, perceived mild to moderate hearing loss, is foundational to understanding where these devices fit. Why OTC hearing aids? Why do they even exist? OTC hearing aids didn't just appear out of nowhere. I mean, even if we look back to I want to say the early 2000s, which is when Songbird was originally introduced, similar to OTC hearing aids, hearing care professionals thought that the sky was falling. It did not, in fact, fall. And they've been around for quite some time. But again, OTC hearing aids did not appear out of nowhere. Years of public health research actually show that number one, adults often wait seven to ten years before seeking hearing care. Now, as a hearing care professional, I don't want patients waiting seven to ten years to get into hearing technology because that is time that you are not allowing your brain to be reintroduced to a new hearing world. And we know that there are comorbidities linked to untreated hearing loss, like cognitive decline. Number two, cost and access are real barriers. And the third bullet point here of years of public health research showing that untreated hearing loss affects communication, participation, and quality of life. So as a hearing care professional, we know that. And as it relates to public health, we as hearing care professionals, for many years, have been raising awareness of the importance of wearing prescriptive hearing technology. OTC hearing aids were designed to really reduce barriers, increase access, and provide an entry point into hearing care. When I was running the private practice in Pennsylvania, I honestly did not see OTC as a threat. I saw it as an opportunity really for a conversation with patients because many patients would ask me, Blaze, what are OTC hearing aids? Well, they're they're a lot cheaper than the prescription hearing aids you're fitting me with. And I never answered on the defense. It was always open dialogue and opportunity to educate my patients on the differences between OTC hearing aids and prescription hearing technology. Now, from a public health perspective, that goal is evidenced aligned. The challenge isn't the existence of OTC. The real challenge today is how they're understood and used. Like, who are OTC hearing aids actually for? I mean, that's the question most individuals and prospective patients are going to ask and have asked. So based on FDA guidance and clinical standards, OTC hearing aids may be appropriate if you notice mild hearing difficulty, struggle mostly in quieter or one-on-one situations. You don't experience sudden or asymmetric hearing loss. That's an important bullet point to really emphasize. You don't experience sudden or asymmetric hearing loss. If you do, please make an appointment with your local audiologist, hearing care professional, or ENT. OTC hearing aids may be appropriate if you are comfortable managing technology independently. Again, these are devices that you purchase over the counter, so they don't require a professional's guidance. And it's important to understand that this is a starting point and not a cure. Now, OTC hearing aids are not recommended if you struggle significantly with speech clarity. They're not recommended if you have difficulty even when sound is loud. They are not recommended if you experience ringing, pain, or sudden hearing changes. They're not recommended if you have known moderate to severe hearing loss. If you have known moderate to severe hearing loss, well, OTC hearing aid devices are not going to provide you with the greatest clarity or amplification that you need based on the type and degree of hearing loss with which you have. And OTC hearing aids are not recommended if you, you know, kind of feel unsure about what level of hearing loss you have. That's why I recommend visiting Hearing Matters Podcast.com, visit our provider locator, and find a local hearing health care professional near you. If you do suspect that you have hearing loss, but you've never gotten a baseline hearing test, you can actually also visit our website. We have a hearing screener that you can go through and kind of get a baseline of where your hearing level is. Now, in the cases I just reviewed, evaluation is incredibly important. So again, feel free to visit our provider locator and find a local hearing healthcare professional near you. Now, here's what we've been talking about for many years is OTC hearing aids versus prescription hearing aids. This is the most common question. I see a lot online. I saw a lot in the clinic. And it was are OTC hearing aids as good as prescription hearing aids? Now, the evidence-based answer is this they are designed for different purposes. Let's start with prescription hearing aids. Prescription hearing aids are number one, fit using diagnostic testing. Number two, they are individually programmed. Number three, they are verified objectively, and there's different objective measures to use. The most talked about and most popular is really your measurement. And then the fourth, prescription hearing aids are supported with counseling and follow-up in partnership with your hearing care professional. Let's go on to OTC hearing aids. OTC hearing aids rely on number one, self-perceived difficulty. Do I perceive myself presenting with a decrease in hearing? And I remember one evening I was driving home during my graduate studies, and I was looking ahead and I couldn't read the sign as clear on the highway. And I was closing my left eye and I was like, man, that looks blurry. And then I closed my right eye and it was clear. And it was at that point, I was like, you know what? I probably just have dry eyes. The denial there. Well, no, I actually present and presented with a mild vision loss, unbeknownst to me. I did actually try the, you know, male order eyeglasses and didn't like it. So I actually went to the eye doctor. And personally, I preferred that model. There are individuals who don't prefer that model, and I'm not here to preach and say you should go to the X, Y, and Z model because it's better. I'm here to educate you, but I just kind of wanted to review with you my own self-perceived difficulty as it related to vision, and then eventually trying OTC eyeglasses, if you will, but then going to the eye doctor. OTC hearing aids rely on user-directed setup. So again, OTC hearing aids don't require the hearing care professional to get set up. And then third, OTC hearing aids rely on generalized amplification strategies. So again, you're not receiving that real ear measurement, that objective verification, sort of that one size fits all model. Research does show that some adults with mild tearing loss benefit from the self-fit amplification. Again, outcomes vary widely. And what research has shown is that professional counseling consistently improves satisfaction. Now, again, this is not about better or worse, it's about appropriateness. There are limitations of OTC hearing aids, and most limitations are not about loudness, they're actually about clarity and complexity. Speech understanding, especially in noise, depends on individualized signal processing, directionality, and adaptation over time. And studies consistently show that noise is the most common complaint among hearing aid users. Speech clarity predicts satisfaction more than volume, and expectations strongly influence outcomes. So OTC hearing aids can improve audibility, but they cannot fully replace diagnostic fitting and guided adaptation. Again, that doesn't make them bad. It means they have defined limits. I recently wrote an article for audiology online, and it talked about how artificial intelligence is not going to replace the hearing care professional, but it's actually going to enhance them. And I see that with OTC hearing aids as well. OTC hearing aids, they've done a great job in terms of assisting our industry and raising awareness of hearing healthcare first and foremost. Sure, they create greater accessibility from a pricing standpoint. Again, I have a biased view in that I do believe that prescription hearing aids in the hands of the professional yield the best outcomes. And here's why. Let me bring this back to the article I was talking about. I discussed theory of mind. And as humans, we have theory of mind where when you're sharing an experience with me as a patient, and you say, wow, you know, I can't really go to my favorite restaurant anymore. And it's really frustrating to me because it's so loud and I want to be able to hear my family. And I feel anxious or depressed that I really can't participate in communication like I once used to. Well, as a human, chances are I've may not have been in their exact shoes, but I've experienced situations maybe where I couldn't understand. I felt anxious, I felt depressed, I felt like I was in that grieving process. And I can tell the patient, I feel that, I can hear that. Well, AI can't necessarily do that. There are schools of thought that will say, yeah, AI actually has more empathy than physicians, but theory of mind, AI does not have. And when we talk about limitations, it's important that we discuss these limitations as we are with OTC hearing aids. You don't receive that verified objective measures, like really your measurements. So, me personally, I like going to the eye doctor to get my prescription dialed in as it should be. I also present with astigmatism. So I want to make sure that my vision loss is being treated in the hands of an eye doctor. And again, that's my own personal and professional opinion. My goal here is to read all the facts that we can about OTC hearing aids and again, sharing that information with you so you can make that educated decision about your hearing healthcare. Now, if we talk about safety and delay as it relates to OTC hearing aids, used as directed, OTC hearing aids, they're considered safe. The primary risk is not damage, but the primary risk is delay. So what does that mean? Well, delaying evaluation when hearing loss is more significant can really prolong frustration, it can reduce long-term success, and it can lead people to believe that nothing works. In hearing healthcare, timing matters. When I was practicing full-time with my patients, and we had patients visit our practice. Now, again, remember the statistic I shared earlier in this episode talking about how most patients will wait seven to 10 years before they do something about their hearing loss. Well, that was always in the front of my mind when new patients, especially, visited the practice. And here's why. This patient has waited seven to ten years. Chances are they've done their research about hearing aids. Chances are they're anxious or going through that grieving process, kind of bargaining with do I have a hearing loss? Maybe I don't have a hearing loss, maybe it's just wax. It's so important to meet your patients where they're at. And that was something that as a professional, I wanted to ensure that I did every single day because this patient waited seven to 10 years. I want to make sure that I am incredibly compassionate, understanding. I don't want to show the patient how, quote, smart I am. Like it's not my job as a hearing care professional to talk about all the bells and whistles at that first appointment. It's to meet you, the patient, where you're at. It's to understand what your communication goals are. What are your primary communication settings? Who's your primary communication partner? And we'll work through there. We'll do a full comprehensive hearing test, speech and noise testing, autoacoustic emissions, tympanometry, autoscopy, you know, best practice, standard of care, soup to nuts. And then when I review your type and degree of hearing loss with you, we're going to meet you where you're at. And I'm grateful in that most patients who did visit the clinic, eight out of 10 would always walk out making the decision to hear better, or as we said, hear life's story. And it was because we educated them and they felt confident. And oftentimes, again, those patients would ask us about OTC hearing aids, and I was never on the defense. Timing matters. I never wanted a patient to leave without becoming more educated on hearing health care. And I never wanted them to then wait another seven to ten years to address their hearing loss. Living with untreated hearing loss, we know, can be incredibly frustrating, but it not only affects the patient, it affects the family members as well. Now, when do you need to see a hearing care professional? You should strongly consider seeking professional evaluation if, first and foremost, OTC hearing devices don't help after a reasonable trial. Speech remains unclear. And if you're talking one-on-one and you can't quite grasp what your spouse or caregiver is saying, others are noticeing ongoing difficulty. I would always tell my patients you often listen with your eyes when you present with untreated hearing loss, or you'll lean in because that's what we call listening effort. And you're placing immense amount of stress on your brain to hear with increased clarity. And then you put noise on top of that, it's going to be incredibly difficult for you to understand. So, again, if speech remains unclear, that's when you should strongly consider a professional evaluation. Also, others may notice ongoing difficulty. As I previously stated, you know, hearing loss and untreated hearing loss doesn't just affect the patient, it also affects the family. And it can create these rifts amongst family members. And family members may withdraw or stop communicating with you out of their own frustration. You might stop communicating with said family members out of your frustration. Now all of a sudden no one's talking to each other in the house. And that's incredibly stressful and it's real. I mean, it's real. I've seen and heard this talked about amongst my own patients. And that's where that counseling with a hearing care professional really does come into play. And then again, Again, you should consider professional evaluation if you feel unsure about your hearing status. And that's where, as a hearing care professional, I see OTC devices being a positive in that you're allowing at first, you're going to have patience. And tuned in right now, you might be a consumer where you kind of want to try before you buy, which a lot of hearing care professionals will implement trial periods. And even in some states, it's actually mandated. I know in Pennsylvania it was a 30-day adjustment period. But getting used to the technology and with OTC, you try self-fit, it doesn't work. That's when absolutely when you feel unsure about your hearing status and OTC devices aren't helping after a reasonable trial period, please visit a hearing care professional. Now, this is so important to note as well because a hearing test doesn't commit you to hearing aids. I want you to really feel that. A hearing test doesn't commit you to hearing aids. It gives you information. And if you're going to the right hearing care professional, you are not going to feel pressured to buy hearing aids right on the spot and get$500 off today only if you buy. That's not the model that personally, as a former private practice owner, we implemented. It was an opportunity to educate our community members because, as hearing care professionals, chances are you're a community member, you want to educate your community on the importance of hearing healthcare. A hearing test gives you information. And research consistently shows that informed patients make better decisions regardless of what they choose next. That's why here at the Hearing Matters Podcast, you know, we're releasing weekly content to help not only consumers, but also professionals make better informed hearing healthcare decisions. Now, can OTC hearing aids be a first step? Yes, they can, but for the right person. Today, research suggests that early exposure to amplification can reduce stigma, increase comfort, and support earlier engagement. And the stigma piece is something that we as hearing care professionals have been kind of fighting against for quite some time. And a lot of the media outlets today will even use photos of hearing aids that are, you know, 40 years old. And that's not what hearing tech is today. OTC hearing aids work best when expectations are realistic. So because OTC hearing aids don't require professional intervention, you, as the consumer of that product, you need to set realistic expectations for yourself. Again, OTC hearing aids work best when symptoms are mild. And it's that perceived, self-perceived, mild to moderate hearing loss. And again, OTC hearing aids are going to work best when you remain open to reassessment. OTC hearing aids fail most often when they're expected to do what they weren't designed to do. I want to close out today's episode and say that OTC hearing aids are not a shortcut. They are an option. For some people, they're helpful. For others, they're a learning step that really does lead to better care. Hearing health care, in my professional opinion, is not about choosing sides. It's really about choosing understanding. Again, if you are interested in visiting your local hearing care professional, please visit our website, hearing matterspodcast.com. On there, you'll be able to locate our provider locator. If you plug in your zip code, you'll be able to find hearing care professional near you. And then also, I'd encourage you to try out our hearing screener. You can get a baseline, it is online. And if you decide to visit a hearing care professional near you, you can at least bring the hearing screening results with you to that appointment. I appreciate you listening. And in the next episode, we're going to be talking about 10 signs that it may be time to get your hearing tested. So stay tuned. And until next time, hear life story.

Head Shot

Blaise M. Delfino, M.S. - HIS

Host