How to Tell If Over-the-Counter Hearing Aids Are Right for You

The Food and Drug Administration requires that over-the-counter hearing aids be labeled with some of the common signs of mild to moderate hearing loss. These include having trouble hearing speech in noisy places or in groups, having a hard time hearing when talking on the phone, or finding that you have to turn up the TV volume to hear it, and other people tell you it’s too loud. Another sign: Listening makes you tired. If any of these apply to you, you might want to try an over-the-counter hearing aid. 

Most hearing loss is irreversible. Still, sometimes changes in hearing can be caused by medical conditions such as infections, earwax buildup, or certain types of injuries. In those cases, you should see a doctor to resolve the problem rather than jumping right to a hearing aid.

The FDA also requires hearing aids to be labeled with a list of red flags that indicate you need to see a doctor to get your ears checked out. These include symptoms such as blood, pus, or fluid coming out of your ears, ear pain or discomfort, feelings of dizziness or vertigo, and sudden changes in your hearing. 

You can also use an online tool called the Consumer Ear Disease Risk Assessment , or CEDRA, developed at Northwestern University, to help rule out any ear problems that would warrant a trip to a doctor. 

If you think you’re a candidate for an over-the-counter hearing aid, you can still decide to get an in-person hearing exam.

“For consumers, the gold standard would be to go get your hearing tested from a licensed provider, get a copy of that test, and then come home and do your own research on what the best options for you are,” says Kim Cavitt, AuD, a hearing healthcare consultant.

Increasingly, providers are unbundling hearing assessments or consultations from the cost of hearing aids themselves, so you should be able to find one who’ll test you even if you don’t want to buy hearing aids from their office. Call ahead to find out how much a test will cost, whether it will be covered by your insurance, and whether you need a referral. Medicare, for example, will cover a hearing test only if your doctor refers you for one.

If you’d rather skip an in-person test—which is what OTC hearing aids are designed to allow—a number of valid remote or self-test screening options are available that can help you gauge your level of hearing loss without even leaving your house. 

Tone-based testing apps. In-person hearing examinations usually include what’s called pure-tone audiometry. This is done with audio tones played in decreasing volumes to determine your specific level of hearing loss. An app-based version can’t totally replicate the in-office experience. Still, certain well-designed ones can produce a measurement called a “pure-tone average” (PTA), or, as some public health experts call it, your “hearing number.” 

The hearing number reflects how loud speech must be for you to be able to hear it, and it provides a simple shorthand for your level of hearing loss. A hearing number of about 25 to 40 means you have a mild hearing loss, while 41 to 60 means a moderate hearing loss. 

One benefit of the hearing number is that it provides a simple measurement of hearing loss that’s also more concrete than the imprecise labels of “mild” and “moderate,” says Nicholas Reed, AuD, an adjunct associate professor in the department of otolaryngology-head and neck surgery at New York University’s Grossman School of Medicine. “For OTCs to succeed, we actually need common language around hearing loss,” he says. “We can’t use this vague language.”

The limitation of remote or app-based pure-tone audiometry is that it requires specifically calibrated equipment to work to ensure that the tones are played at the proper volume. This tends to be more achievable within the Apple ecosystem because the specs for both the devices and the Apple-made headphones are controlled by the same company.

Still, Johns Hopkins Bloomberg School of Public Health has developed an app, available for both iOS and Android, that can provide a hearing number, aptly called Hearing Number. 

Apple users have a couple of additional options for finding their hearing number, according to a group of scientists advocating for more widespread use of it. You can use the app Mimi, or, using AirPods Pro 2 or 3, the native Apple Hearing Test app. If you do get an in-person hearing test, you can also ask the provider who administers the test to get this number.

Digits-in-noise or speech-in-noise tests. In this type of test, your task is to identify spoken numbers or other words while background noise plays. These tests have their own advantages, including that they don’t require any special equipment, which makes them more accessible. And they provide a more real-world test of hearing, says Dewet Swanepoel, DPhil, a professor of audiology at the University of Pretoria in South Africa. “That’s actually what people have difficulty with when they have hearing loss—speech in background noise,” he says. “So this test really gets to the heart of what people have difficulty with.”

The downside: Speech-in-noise tests don’t provide as precise a measure of hearing loss as pure-tone audiometry. Still, they can be a useful screening tool to help you figure out whether you might have at least some degree of hearing loss. 

The World Health Organization’s hearing test app, hearWHO, employs such a testing method. Many other websites also offer to screen your hearing with a digits or speech-in-noise test. Keep in mind, Cavitt advises, that online tests may also be accompanied by marketing pitches from various companies selling hearing aids or hearing care services. 

An evidence-based self-assessment. Another approach for figuring out if an over-the-counter hearing aid is right for you involves assessing how much hearing difficulty you experience in daily life.

“The FDA is sending this signal that you can self-determine if you have mild to moderate hearing difficulty,” Dhar says. “Inherent in that claim is that your perception of mild to moderate hearing difficulty will be well correlated” with a professional measurement of hearing loss.

The Hearing Handicap Inventory (HHI) is a tool that can help you with that self-assessment.

There are a few versions of the HHI. They involve a series of questions designed to evaluate how much a hearing problem affects your life. The simple questionnaires, developed and validated by audiologists in the 1980s and 1990s, have been used for decades to assess the extent to which hearing loss affects people emotionally and socially. Questions include: “Does a hearing problem cause you to feel frustrated when talking to members of your family?” and “Does a hearing problem cause you difficulty when visiting friends, relatives, or neighbors?” This approach can be a good way to figure out if you might get use out of an over-the-counter hearing aid.

“The factor that most likely determines whether somebody will seek hearing aids and use them and benefit from them is their perceived hearing disability, not what the audiogram says,” says Larry Humes, PhD, a distinguished professor emeritus of speech, language, and hearing sciences at Indiana University. (An audiogram is a graph that shows the results of a hearing test.)

To test yourself, you can download a printable copy of a 10-question version of the HHI for adults or one specifically for older adults. If you score in the mild to moderate range, or if you receive a fair score in our online quiz (which is based on the HHI), an over-the-counter hearing aid could be a good fit.

CR members who are ready to start shopping can check out our full OTC hearing aid ratings, our best over-the-counter hearing aids, and our hearing aid buying guide. Here are a few of our top-rated models.