The short version: Since 2022 you can buy real hearing aids over the counter, no prescription needed, for perceived mild to moderate loss, typically $200 to $600 a pair. Do not confuse them with cheap sound amplifiers (PSAPs), which are for normal-hearing people and are not hearing aids. Get a hearing test first anyway, and see an audiologist for severe, sudden, or one-sided loss.
Three very different things
The hearing-help aisle is confusing on purpose, so start by sorting it into three categories. They are not interchangeable.
- Prescription hearing aids. Medical devices fitted and tuned by an audiologist, for any level of hearing loss. The most capable, the most expensive, and the most support.
- OTC hearing aids. Real hearing aids you buy without a prescription, for adults with perceived mild to moderate loss. New since 2022, and much cheaper.
- PSAPs, or personal sound amplifiers. Consumer gadgets that make sound louder for people with normal hearing. By law, not hearing aids.
Getting the category right is most of the decision. This guide walks through each, and when each is the right call.
OTC hearing aids: what changed in 2022
In October 2022, the FDA created a new over-the-counter category of hearing aids.1 For the first time, an adult with perceived mild to moderate hearing loss can walk into a pharmacy or order online and buy genuine hearing aids, with no medical exam, no prescription, and no audiologist fitting. You choose and adjust them yourself, often with a phone app.
The big change is price. OTC aids typically run $200 to $600 a pair, and up to around $3,000 for premium models, against $3,000 to $7,000 for prescription aids.2 The savings come from skipping the professional fitting and support, which you take on yourself.
The limits matter: OTC aids are only for mild to moderate loss. Severe or profound loss, and anyone under 18, still needs prescription hearing aids.1
PSAPs are not hearing aids
This is the trap that costs people money and hearing. A personal sound amplifier (PSAP) is a consumer electronic that makes all sounds louder, meant for people with normal hearing in situations like birdwatching or hunting. By law it is not a hearing aid and is not designed to treat hearing loss.1
Read the label. Some cheap amplifiers are marketed to look and sound like hearing aids, at tempting prices. The test is simple: if the box does not say “hearing aid,” it is a PSAP. For actual hearing loss, a PSAP just makes everything, including background noise, louder without correcting what you cannot hear. Buy an OTC or prescription hearing aid instead, and report misleading “hearing aid” ads to the Federal Trade Commission.
When you still need an audiologist
OTC is a great option for many, but it is not for everyone. See an audiologist for prescription hearing aids, or at least an evaluation, if:
- Your hearing loss is more than mild to moderate.
- Only one ear is affected, or the loss came on suddenly.
- You have ear pain, drainage, ringing, or dizziness, which need a medical check first.
- OTC aids did not help enough, or you want professional fitting and ongoing support.
Prescription aids cost more, but the audiologist measures your exact hearing, tunes the devices to it, and coaches you through the weeks of adjustment that many people need. That support is the reason to pay for it.
Get a hearing test first, even for OTC
You are not required to, but it is the step worth taking. Here is why, from the audiology profession’s own guidance.4
OTC aids are chosen on the loss you perceive, not loss that has been measured, so it is easy to pick the wrong amount of amplification. A quick hearing test tells you whether your loss is really mild to moderate, or worse than you thought.
More important, a professional exam can catch a treatable problem, like impacted wax, an infection, or something that needs a doctor, which a hearing aid would only mask.3 A hearing check is inexpensive or free at many clinics, and it makes whatever you buy work better.
How to choose, and what it costs
Once you know your loss is mild to moderate and you have ruled out a medical cause, match the device to you.
| Category | Best for | Rough cost (pair) |
|---|---|---|
| PSAP / amplifier | Normal hearing, occasional boost | $20 to $100 |
| OTC hearing aid | Perceived mild to moderate loss | $200 to $600, up to ~$3,000 |
| Prescription hearing aid | Moderate to profound loss, or wanting full support | $3,000 to $7,000 |
When buying an OTC aid, look for:
- A “hearing aid” label, not a PSAP.
- A self-fitting model with an app, which tunes to your hearing far better than a one-size device.
- A real trial period and return policy, ideally 30 to 45 days, since you fit them yourself.
- Rechargeable batteries if tiny batteries are hard to handle.
- A style you will actually wear every day.
Pair the device with the home changes that help hearing loss regardless of what you wear, in our hearing loss home modifications guide, and see the smart-home side in hearing aids and the smart home.
Key takeaways
- Three categories, not one. Prescription aids, OTC aids, and PSAPs are different things; match the category to your loss.
- OTC aids are real and cheap. Since 2022, $200 to $600 a pair for perceived mild to moderate loss, no prescription.
- PSAPs are not hearing aids. If it does not say “hearing aid,” it is an amplifier for normal hearing.
- Test first, and know the red flags. Get a hearing check, and see an audiologist for severe, sudden, one-sided, or painful hearing loss.
What’s next
- Make the home easier to hear in with hearing loss home modifications.
- Connect modern aids to devices in hearing aids and the smart home.
- Stay in touch with technology to help seniors stay connected.
- Add a safety net with the best medical alert systems.
Reviewed by John Smith, CAPS, Certified Aging-in-Place Specialist. This guide is general information, not medical advice. See an audiologist for a hearing evaluation, especially for sudden, one-sided, or painful hearing loss.
- OTC Hearing Aids: What You Should Know. U.S. Food and Drug Administration, retrieved September 19, 2026. fda.gov OTC hearing aids.
- Hearing Aids. National Institute on Deafness and Other Communication Disorders, U.S. National Institutes of Health, retrieved September 19, 2026. nidcd.nih.gov hearing aids.
- Hearing Loss: A Common Problem for Older Adults. National Institute on Aging, U.S. National Institutes of Health, retrieved September 19, 2026. nia.nih.gov hearing loss older adults.
- Consumers and OTC Hearing Aids. American Academy of Audiology, retrieved September 19, 2026. audiology.org consumers and OTC hearing aids.