'Some audiologists expressed worry that giving people direct access to hearing tests and hearing aids would hurt their business model, which has traditionally relied on bundled pricing that lumped the device cost with services, Lin said.
Surveyed in August 2022 just after the FDA ruling, less than 27 percent of audiologists said they would start selling OTC hearing aids, about 42 percent indicated they would “unbundle” their fees to compete with OTC hearing aid prices, and about 56 percent would support patients with OTC hearing aids purchased elsewhere. In another recent survey, about one in five audiologists said they will not sell or service OTC devices.
In discussions leading up to the launch of Hearing Number, hearing aid companies were “not very keen,” Lin said. On a call explaining the idea of a standard metric to equip people to measure their hearing and act on it, he recalled a director of marketing piping up in disbelief: “So, Dr. Lin, you’re telling me you want to emancipate the consumers?”'
I need hearing aids. I even want hearing aids. After finally getting to see an audiologist I looked at the $5000US price offered by the in-house shop and could not stomach it (in part because they were not covered by my insurance). This was back in February of this year, so OTC hearing aids were officially a thing, and I'd hoped against hope that the prices would reflect that. After surveying the OTC hearing aid landscape for the past 10/11 months I may just go ahead and get them, because I've not found any good sources of information on them. Just lots and lots of marketing copy.
First let me say I purchased OTC hearing aids for $799 (Jabra Enhance) out of frustration and the particular ones I use are adequate at best. They tune to your hearing loss via a crude test which only has three frequency ranges categorized as high, medium and low frequency bands. They additionally have three modes that change the mix of in room sound to help to adapt to different listening situations.
The biggest frustration with them is they aren't particularly discrete around amplification or rejection of sound: want to hear someone speaking? You're going to get lots of room noise too because of the wide bands which just amplify everything rather than say just speech and/or where your specific hearing loss is deepest.
In fact even though my insurance does cover hearing aids, it's through a certain discount supplier, and their offerings strike me as lower-end. As you've discovered the most expensive options are eye-poppingly expensive, but they are also have the most features. For example I was quoted between $5k and 7.5k for the best performing hearing aid. And here's the frustrating bit: for that difference in price it's the same fucking hearing aid, just with features unlocked! The audiologist told me the real difference in price is mostly more discrete bands. lol. From memory it tops out at twenty four bands.
I'm currently debating between going to Costco and using my insurance with Amplifon. I suggest you investigate both as Costco's hearing aids get decent reviews. Also apparently the prices vary by state, but here in Texas the cheapest ones are $1,499; less than half the price you quoted.
I went to an audiologist and they found nothing wrong with my hearing, but yet, I have trouble hearing normal conversational tones. Hearing completely fucking annoying sounds like fluorescent lights? That I can do with abandon, but hearing someone in the same room as me comes out muffled, particularly if there is a noisy background. The audiologist actually had the audacity to tell me that my wife may just be making things up.
So, OTC hearing aides may be a solution for me, but while they are far more inexpensive than prescription aides, they are still expensive ($1000+) and what if they do not work or do not work to solve my problems and only exacerbate the issues I have?
Does anyone have recommendations on which ones to try when I eventually bite the bullet?
You may have some form of APD [1], and if so there is basically nothing on the market for you. It affects me, and it's frustrating as hell when people get angry at you for it, and especially when they think you're just making it up.
I'd love to have the opposite. A way to turn down the volume on my ears. Lots of noise really causes me mental fatigue.
I've seen some adjustable earplugs like the Loop Switch but they start at 15dB which is too high. There was the Knops which started at 0 which was great but they don't seem to be available anymore and their website is gone. They were also pretty prohibitively expensive for passive earplugs.
I'd also love active noise cancelling plugs that could eliminate background noise and make voices more intelligible. Like when you're trying to speak on a noisy street or in a nightclub. But I don't think the tech is there yet.
If anyone knows a comparable product to the Knops that are still available I'd be interested. I've been looking all over.
I love loops for their comfort, but they still distort the sound and make it a bit muffly. Vibes are great if you want to lower everything without changing the audio. They are magical for when you just want the world to be LESS. They're also mostly transparent and harder to see/notice.
Edit: ah they look similar in construction and filtering to the etymotic ones I have from years ago. They work well indeed. But etymotic seem to be unavailable now.
They don't seem to have a version with volume control though just like etymotic.
I just use regular old foam earplugs. I keep a couple in my back pocket so that I can pull them out whenever needed, which is very often in urban environments and surprisingly often in suburbia. Also I can lose them constantly and it doesn't matter because I have a big container with more.
Occasionally some random person asks me a question and I have to pull one out and say "what?", which is a bit awkward, but thanks to my hearing loss I would have had to say "what?" anyway - when someone talks to me and I'm not "ready" for it it sounds like an adult talking in a Peanuts cartoon.
Yeah, I have an issue with noise which it makes it extremely tiring for me to decode voices. That tech would be a blessing. The only workaround for now is to avoid crowded places, parties with too many people, etc
I have long standing hearing loss, but just don't need one right now. I don't have enough of a social/work life for it to matter. If I bought one it would just sit unused. It wouldn't empower me to be more social because there are many other reasons inhibiting me from that.
For now I do ok in my normal environment, and I wear an earplug in my "good ear" to protect it in loud environments. There are situations where I struggle to hear but I avoid those. So I'm making do.
Interestingly, I had completely forgotten that these were legal to sell OTC these days. I don't think I've ever seen them in shops where I would have expected them to be.
I bought a pair based on bose technology for $1,000 they felt a bit hyped up. “Lexie B1 by Bose”
The iphone app controls feel like +/- treble or bass and that’s it. Felt like a real letdown, it does amplify audio just feels like loudness is all you control.
No remapping of frequencies, no fancy dsp.
There’s an open source hearing aid project that’s pretty good, more flexibility with filters definitely cooler:
First, hearing aids are, unfortunately, not covered by most Americans' health insurance. I'm completely deaf in one ear, and in the other ear I'm profoundly deaf (basically as deaf as you can get without being totally deaf). An OTC hearing aid is simply not powerful enough to help me. I have to go to an audiologist, and as another poster said, these kinds of hearing aids routinely run into $3000-5000 range PER AID. If I needed it for both ears, I could be out 6-10 grand alone. And no insurance I've ever had will cover it.
Second, and probably the more relevant reason, is that most people who need hearing aids are people who have had "normal" hearing their entire lives, and have simply noticed some degradation of hearing over time. They've gone their entire lives without having something in their ear all day long. Now they go get a hearing aid, they put it in their ear, and you know what? It's uncomfortable.
It's not fun. It's annoying. Your ear sweats. You don't realize it if you don't wear hearing aids, but your ear sweats. Your hearing aid squishes around. It feels like something's stuck in your ear -- because it is!
When your jaw moves, you can sometimes hear it. You can hear yourself eat. Crunchy food is louder than anything else.
For someone who hasn't had to deal with it their entire lives like I have, it's awful. It's not a pleasant experience. And why should you wear something uncomfortable like that when you can just turn the TV up as loud as it goes?
It's a real problem, and I'm not sure there's a true way out of it.
That said... the advances in hearing aid technology in the last 25 years are astounding. They used to just be microphones that amplified noise. Then in the late 90s, they introduced digital hearing aids. In the mid-teens, they introduced Bluetooth integration. I now don't need to wear clunky headphones -- I can stream directly from my iPhone or computer straight to my hearing aid with no loss in fidelity of sound! It's quite frankly incredible.
My audiologist sent me an email last week because the newer models are now water-proof. Up until now, I've had to take my hearing aid out to shower, to go outside in the rain, to swim. Now? I can do all of those things and actually hear. Showering with my partner might actually be sexy instead of silent. Swimming with friends might become a social activity instead of me having to choose between sitting outside the pool with my hearing aid on and participating in conversation, or getting into the pool with my hearing aid out and being unable hear anything.
I'm sure soon enough they'll introduce some other really clever technology. Maybe direct integrations with an AI assistant. Maybe AI-powered translation software a la the babel fish of Hitchhiker's Guide fame. Who knows? The sky's the limit.
But for now? For OTC stuff? For Grandma and Grandpa who can't hear the TV? They aren't going to buy it, because it's uncomfortable, it's expensive, and they'd have to admit to everyone around them that they're less than they were before. It's sad.
Question for you - who's offering a waterproof UP hearing aid? I know Siemens had one for a while, but they discontinued it several years ago. My partner is profoundly deaf in one ear and completely deaf in the other as you are, and loves swimming.
As someone who has pretty good hearing loss, I can comfortably say that the reason I finally got some was the ability to stream audiobooks and podcasts.
Interestingly, the social stigma is probably at an all-time low. I used to get a lot of stares for wearing my hearing aids, but ever since the advent of Bluetooth devices, it's become relatively normal to have things in your ears!
Airpods are not hearing aid replacements (yet). Hearing aids are specifically designed to compensate for loss, not simply to filter out background noise and boost voices. Hearing aids frequently need an audiologist to tune them to get maximum value out of them. In fact, AirPods might actually make hearing worse for those with hearing loss!
I mean, real hearing aids are being sold COTS now, aren't they? Do those still require a medical consultation?
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Actually, this has a much better overview of the kind of calibration they do for real hearing aids: https://www.youtube.com/watch?v=TMSQemYlC80 (not sure if the COTS stuff do anything similar)
The Airpod calibration is nowhere near as thorough.
Yeah, that last part is the right part. AirPod calibration is nowhere close to the level of calibration that an audiologist would put you through. It's more than simply boosting voices and filtering out background noises, it's calibrating to a much higher level of precision for this.
On top of that, the difference between "just right" and "too loud" is pretty small, and you really want a professional to set it to the point where it aids your hearing without damaging your hearing further. If you just pump the volume up, you can hear better, but you're also potentially causing even more damage. A professional can help you do that better.
OTC hearing aids are still calibrated by professionals, although probably not to the degree that a more serious hearing aid would be.
How well do those work I wonder? I'm not on Apple so I can't buy those. Do they really make it possible to speak on a crowded street or a nightclub? Or is it a few dB of improvement only?
Thanks for that! Excellent article. Too bad that they're not quite "there yet" but it's about what I expected
Edit: ah they look similar in construction and filtering to the etymotic ones I have from years ago. They work well indeed. But etymotic seem to be unavailable now.
They don't seem to have a version with volume control though just like etymotic.
> They don't seem to have a version with volume control though just like etymotic.
Are you talking about Airpods? The second generation Pros actually do have volume controls. The stem is touch sensitive and you can drag a finger up or down it to change the volume. You can also use different gestures to play/pause, skip, rewind, change transparency modes, etc. These all work on Android and Windows too, FWIW.
Surveyed in August 2022 just after the FDA ruling, less than 27 percent of audiologists said they would start selling OTC hearing aids, about 42 percent indicated they would “unbundle” their fees to compete with OTC hearing aid prices, and about 56 percent would support patients with OTC hearing aids purchased elsewhere. In another recent survey, about one in five audiologists said they will not sell or service OTC devices.
In discussions leading up to the launch of Hearing Number, hearing aid companies were “not very keen,” Lin said. On a call explaining the idea of a standard metric to equip people to measure their hearing and act on it, he recalled a director of marketing piping up in disbelief: “So, Dr. Lin, you’re telling me you want to emancipate the consumers?”'