Over-the-Counter Hearing Aids: How Much Retirees Can Save

The most common mistake people make about hearing aids is assuming that Medicare will cover them, finding out it does not, and then putting off the whole idea for years. That is understandable. For a long time, a pair of prescription hearing aids could cost thousands of dollars, and the sticker shock alone kept many retirees from even asking.

Since October 2022, there has been another route. Over-the-counter (OTC) hearing aids can be bought without a prescription, and they often cost a lot less. Here are six questions to answer before you spend a dollar, with the facts behind each, so you can decide whether they are worth a look.

Question 1: Will Medicare pay for hearing aids?

Original Medicare does not cover hearing aids, or the exams used to fit them, according to Medicare.gov. You pay all of those costs yourself.

There are two things worth knowing. First, Original Medicare Part B does cover a diagnostic hearing exam when a doctor or other provider orders it to find out whether you need medical treatment. You pay 20 percent of the Medicare-approved amount after the Part B deductible. Second, some Medicare Advantage plans include extra hearing benefits. If you have one, call the plan and ask exactly what it pays toward hearing aids and which providers it uses.

Question 2: What do they actually cost?

Prescription hearing aids from an audiologist often run roughly $2,000 to $7,000 a pair, and that price usually includes visits and adjustments. OTC models commonly start far lower. Prices are often quoted from about $100 up to around $2,000, depending on the brand and features.

When the FDA finalized its OTC rule, it estimated consumers could save about $1,400 per hearing aid, or more than $2,800 per pair. Your own savings will depend on what you buy. As a simple illustration, if a prescription pair would cost $4,500 and an OTC pair costs $1,200, you would keep about $3,300 in your pocket.

That money matters in retirement, when a surprise bill hits harder. Many retirees have fixed income, and a single large purchase can eat up what they planned to spend on other things for months.

Question 3: Is an OTC model right for my kind of hearing loss?

OTC hearing aids are designed for adults 18 and older with perceived mild to moderate hearing loss. The FDA says they are not meant for severe or profound loss. Signs of mild to moderate loss include trouble following speech in noisy places or groups, difficulty on the phone, turning the TV up so loud that others complain, and feeling tired after listening.

If you cannot hear speech even in a quiet room, or you do not hear loud sounds well, an OTC device may not be your best choice. A professional can tell you more.

The FDA also lists red flags that call for a doctor first, preferably an ear, nose and throat doctor. They include ear pain or discomfort, fluid or blood draining from the ear in the past six months, a lot of earwax, sudden changes in hearing in the past six months, dizziness or spinning, hearing that is much worse in one ear, and ringing in only one ear. Hearing loss can have simple causes like earwax or more serious ones, so a checkup is worth it.

Question 4: Is a cheap sound amplifier the same thing?

Personal sound amplification products, or PSAPs, are not hearing aids. The FDA says they are meant for people with normal hearing who want to boost certain sounds, such as birdwatching or hunting. They are sold as consumer electronics and can vary a lot in quality.

Look for the words "OTC" and "hearing aid" on the package. Genuine OTC hearing aids must carry labeling that includes when to see a doctor and the manufacturer's return policy. That brings us to one of the most useful tips of all.

Question 5: Will I hear normally right away?

The FDA says hearing aids make sounds louder, but they usually will not bring your hearing back to normal the way eyeglasses can bring vision to 20/20. Expect an adjustment period. Voices may sound different at first, and background noise may be more noticeable.

Plan to wear them daily for a few weeks and note what works and what does not. A short list, such as "restaurant too loud" or "TV is clearer", gives you something concrete to bring to the store or a hearing professional if you want help adjusting them.

Question 6: What if they do not work for me?

Hearing aids work differently for everyone, and the first pair you try may not be the right one. Before you buy, find out how many days you have to return them, who pays shipping and whether there is a restocking fee. Keep the box, the receipt and the paperwork.

Give them a fair trial in the places you actually need them, like a busy restaurant, a family dinner or a phone call. Notice whether they are comfortable and whether you can manage the app or controls on your own. If they are not working, return them and try something else, or get help from a hearing professional.

Ways to pay less, no matter which route you choose

Start with the hearing test. Ask your doctor whether a hearing exam makes sense. Medicare may help with the diagnostic exam when it is ordered for medical reasons. Medicare also says you can see an audiologist once every 12 months without an order for non-acute hearing conditions, such as hearing loss that develops over many years. Costs and rules apply, so confirm with the provider.

Use tax-advantaged accounts. The IRS counts hearing aids, batteries, repairs and maintenance as medical expenses, which means they are generally eligible for HSA or FSA spending. Some FSAs set their own limits, so check your plan and keep your receipts. If you itemize deductions, medical expenses may count toward a deduction, but only above a threshold, so ask a tax professional.

Check veteran benefits. Veterans who are enrolled and eligible for VA care can receive hearing aids, repairs and batteries at no cost. If you served, call your local VA before buying anything.

Compare plans during open enrollment. If you have Medicare Advantage, you can review its hearing benefit when you look at next year's plan, and open enrollment begins soon. A plan with a hearing benefit may beat paying out of pocket.

Is an OTC hearing aid right for you? A simple check

If you have mild trouble with speech in noisy places, no warning signs from the FDA's red flag list and you can handle a smartphone app or simple controls, an OTC device may be a reasonable first step. If you have any red flags, severe loss, or want help with fitting, start with a professional.

Neither route is wrong. Some people buy OTC and are happy. Others try OTC, then move to a professional for a better fit. What matters is not waiting years. Hearing well makes conversations easier and daily life safer.

The best next step is a short list of questions: What does my plan cover? What is the return policy? Do I have any red flags? Once you have those answers, you can compare options with confidence, and you may find hearing help costs far less than you expected.