In the last year, I’ve tried more than 50 hearing aids—from brands I’d never heard of on Amazon to well-known names like Sony and Bose. I used their smartphone apps, took notes on comfort and ease of use, and worked with Soundly’s audiology team to test them with professional audiological equipment.
What did I find? Some OTC hearing aids can go toe-to-toe with prescription brands you’d find in clinics for 2–3x the price. Others? They’re not much help at all.
In this guide, we’ll break it all down: the products, the pros and cons, and what you need to know to decide between OTC and prescription options.
Let’s dig in.
Prefer to watch? Here's my video guide to the market in 2025. 👇
- 50+ hearing aid brands reviewed and rated by our team of hearing aid wearers and audiologists
- 200+ hours each month spent researching brands and care options
- 100% independently owned and operated
We launched Soundly.com in 2022 to create a better starting point for the hearing health experience.
Instead of selling hearing aids directly, we spend our time reviewing products, publishing clearly organized information, and building modern tools to make the process of accessing hearing health easier. Learn more.
Our work is funded through reader support. When you buy through our links, we may earn a commission. Read more about our research process here.
- 50+ hearing aid brands reviewed and rated by our team of hearing aid wearers and audiologists
- 200+ hours each month spent researching brands and care options
- 100% independently owned and operated
We launched Soundly.com in 2022 to create a better starting point for the hearing health experience.
Instead of selling hearing aids directly, we spend our time reviewing products, publishing clearly organized information, and building modern tools to make the process of accessing hearing health easier. Learn more.
Our work is funded through reader support. When you buy through our links, we may earn a commission. Read more about our research process here.
Featured in this article
Other OTC Hearing Aids Brands We Love
Eargo, Lexie B2+, Sony CRE-E10 and Elehear Beyond complete our shortlist, earning a spot for their modern design, earbud-style streaming, and affordability.
Over-The-Counter Hearing Aid History
The concept of buying hearing aids directly, without a doctor’s visit, is relatively new. The over-the-counter (OTC) hearing aid category was officially created in late 2022 by the FDA after years of bipartisan advocacy and collaboration across multiple presidential administrations.
The goal was simple: increase hearing aid adoption. Wearing hearing aids is one of the most effective ways to improve overall health, reducing risks associated with falls, social isolation, earnings loss, and even dementia. Hearing aids are safe and highly effective for most users.
The push began in 2015, when the President’s Council of Advisors on Science and Technology (PCAST) sent a letter to President Obama urging action. In 2017, Congress passed the Over-the-Counter Hearing Aid Act of 2017, laying the foundation for the category.
From there, the FDA spent years designing a framework that would make sense to consumers while fostering competition in the hearing aid industry. Finally, in 2022, the FDA published its guidelines.
OTC Hearing Aid Categories: Self-Fitting, Standard
The 200-page document capped the maximum volume output for OTC hearing aids to ensure consumer safety and divided products into two main classes: standard OTC hearing aids and OTC self-fitting hearing aids.
Self-fitting hearing aids go through more rigorous assessment and provide audiology-grade customization, delivering outcomes comparable to those from in-clinic fittings. Most of the devices listed in this guide fall into that category, making them suitable for individuals with mild to moderate hearing loss.
Standard OTC hearing aids are registered with the FDA but do not offer a robust fitting system and typically rely on pre-set sound settings.
For those with severe or profound hearing loss, visiting a clinic for higher-powered options is still necessary. Below, you’ll find additional resources to explore this important topic further.
New Brand Entrants to the Category: Bose, Sony, Sennheiser
The finalized guidelines sparked a wave of new brands entering the OTC category, which continues to evolve. Interestingly, by 2025, the largest prescription hearing aid manufacturers also dominate the OTC market—such as Sonova with Sennheiser and Signia with Sony.
For those curious, we’ve included a full history in the FAQ section of this guide.
How does the process work?
The cochlear implant process has several stages.
First, a patient undergoes a preoperative evaluation, including a comprehensive hearing test, medical evaluation, and counseling on the procedure, post-operative rehabilitation period, and potential benefits and risks. If the patient is a suitable candidate and decides to proceed, the doctor recommends a cochlear implant and requests predetermination or recertification of benefits from your health plan (ie. insurance, Medicare or Medicaid).
Next, your health plan will contact you and your doctor to determine whether the surgery and device are covered. After this written notification, the procedure can move forward, and the surgery is scheduled. At that point, any applicable coinsurance or co-pays apply.
Will insurance cover the cost?
Unlike hearing aids, cochlear implants are generally substantially covered by insurance. However, specific coverage will vary depending on your health insurance.
While your insurance is the best source to determine your specific coverage, let's look at what is typical for common types of insurance.
Medicare
For patients who meet candidacy criteria for a cochlear implant, Original Medicare covers 80% of the cochlear implant costs. A supplemental Medicare program sometimes covers the remaining 20%.
Patients may also have coverage through Medicare Advantage if they selected this over Original Medicare. Sometimes, Medicare with supplemental coverage or Medicare Advantage may fully cover the costs. Remember, you'll want to look specifically at which type of Medicare and supplemental coverage you have to understand better how much out-of-pocket cost you can expect.
Medicaid
Medicaid covers cochlear implants for eligible children in all fifty states from birth to age 21. However, Medicaid does not cover cochlear implants for adults in every state. About 60% of states currently offer adult Medicaid coverage for cochlear implants. You should check what is covered in your state.
Veterans Affairs
The VA is another option that can help cover cochlear implantation. If you have hearing loss as a result of military service, you may be eligible for services through the VA system. Read more about hearing healthcare benefits for veterans here.
Private Insurance
Coverage from private insurance plans varies, but many offer cochlear implant coverage. Check with your health insurance about your covered benefits.
To learn more about health insurance coverage, look at this helpful document from Cochlear Americas.
How much would it cost without insurance coverage?
The sticker price of cochlear implants can be daunting, with an estimated cost of $60,000 to $100,000 per ear, including implantation surgery and post-operative rehabilitation.
It's a jaw-dropping number, but this procedure involves:
- Pre-op Assessment
- Meningococcal vaccination
- MR of the brain pre and post contrast
- Hospital visit
- General anesthesia
- Cath Surflo IV SROX225
- Facial nerve monitoring
- Cochlear device implantation, with or without mastoidectomy
- Electrode array insertion
- Premium processor Cochlear Implant & Sound Processor
- Cochlear Implant surgery
- Cranioplasty
- Local skin flaps (large, complicated)
- Diagnostic Radiology
- Post-operative recovery
Keep in mind, this does not include ongoing maintenance costs, such as replacement batteries, external processors, and other parts that may need replacement over time.
Fortunately, most insurance companies offer coverage for cochlear implants, significantly reducing the cost burden for patients. But, there are several options available for individuals without insurance coverage.
Some manufacturers offer payment plans or financial assistance programs based on the patient's income level.
Additionally, some non-profit organizations help fund cochlear implant procedures for those who cannot afford them. For example, the Colorado Neurological Institute has an assistance fund for cochlear implants.
OTC Hearing Aid Prices: What to Expect
OTC hearing aid prices range from about $100 to $2,000, making them significantly more affordable than prescription hearing aids, which average $4,500 per pair. But what drives the price differences within the OTC category? Broadly, we see three pricing tiers:
- Budget-Friendly Options ($100–$500)
Most hearing aids in this range do not meet our quality standards. We’ve tested dozens, and many are uncomfortable to wear or simply ineffective. Reviews on platforms like Amazon and Best Buy echo these concerns. However, there are exceptions. After extensive testing, we’ve found the Elehear Beyond at $399 to be a reliable and affordable option. - Mid-Tier Options ($800–$1,000)
This price range offers the best value for most people. Products like Sony, Sennheiser, and Bose hearing aids deliver high-quality performance at a fraction of the cost of prescription models. These devices are backed by trusted manufacturers and feature technology comparable to what you will find in a clinic. For many, this is the sweet spot for balancing quality and affordability. - Premium Options ($1,500–$2,000)
At the higher end, brands like Jabra Enhance Select and Eargo justify their price with added features. Jabra, for instance, includes professional programming before your devices are shipped, while Eargo invests heavily in R&D to create nearly invisible hearing aids. These products cater to those seeking extra convenience or cutting-edge design.
While prices vary widely, the $1,000 range is where most people find the right balance of cost and quality. If you’re considering an OTC hearing aid, this guide will help you identify the best option for your needs and budget.
Conclusion
While the costs associated with cochlear implants can sound intimidating, it is essential to consider the potential benefits to your quality of life and your out-of-pocket costs. By understanding the costs and options available, you can decide whether cochlear implants are the right choice for you.
As always, it is advisable to consult with your audiologist or physician to determine if you are a suitable candidate and to discuss the procedure's risks and rewards. By taking on an informed and proactive approach, you can make your journey towards better hearing more empowered and fulfilling.
