An over-the-counter hearing aid can help tinnitus that comes with mild to moderate hearing loss, and costs far less, but it lacks the tinnitus-specific programmes and individual fitting that prescription aids can offer.
Why amplification helps tinnitus at all is covered in hearing aids for tinnitus. Since 2022 the choice has become more complicated in a useful way: a cheaper category of over-the-counter hearing aids now exists, and since 2024 it has included earbuds many people already own. Each comes with specific tradeoffs worth understanding before buying one for tinnitus.
What changed in 2022
Congress passed the Over-the-Counter Hearing Aid Act in 2017, directing the FDA to create a new device category; the FDA's final rule was published in August 2022 and took effect that October. It established a category of OTC hearing aids available without a prescription, exam, or audiologist fitting, specifically for adults 18 and older who perceive themselves as having mild to moderate hearing loss. The FDA also set a maximum output limit (111 dB SPL generally, up to 117 dB SPL under specific compression conditions) as a safety guardrail for self-fit devices.
What hearing aids cost
The cost figures below are as the sources report them — survey medians, averages and ranges rather than quotes. Prices vary by device, seller and what services are bundled in.
In the US. The MarkeTrak 25 survey, in which nearly 5,000 adults with perceived hearing difficulty answered questions about their devices, found a median reported cost of $1,560 per prescription hearing aid and $150 per OTC hearing aid. Most prescription owners (83%) had a pair. Satisfaction was similar — 83% of prescription owners and 76% of OTC owners said they were satisfied.
An earlier affordability analysis, using 2016 national survey data, found that an average bundled cost of $2,500 would be a catastrophic expense, as the study defined it, for 77% of Americans with functional hearing loss. Its authors note that most hearing aid and rehabilitation costs are excluded from insurance coverage, including Medicare. Medicare's own page is direct: Original Medicare does not cover hearing aids or exams for fitting them, and you pay all costs for those. Some Medicare Advantage plans offer extra hearing benefits, so it is worth asking your plan.
In the UK. The NHS provides hearing aids free, as a long-term loan, after a GP referral to an NHS hearing aid provider. Batteries, repairs, follow-up appointments and aftercare are free too, though there may be a charge if an aid is lost or broken. The range is narrower — usually behind-the-ear models. Privately, the NHS says a single hearing aid can cost anything from £500 to £3,500 or more.
What "over the counter" means in practice. In the same US survey, only one in five OTC owners reported receiving no professional services at all. Most had some help from a hearing care professional anyway, and satisfaction was lower among those who had none.
Earbuds with a hearing-aid feature
On 12 September 2024 the FDA authorised the first over-the-counter hearing aid software: a Hearing Aid Feature that lets compatible versions of Apple's AirPods Pro work as an OTC hearing aid. It is intended for adults 18 and over with perceived mild to moderate hearing impairment. It is set up on an iPhone or iPad, using hearing levels stored in the device's health app, and the user can adjust it without a hearing professional.
The FDA's evidence was a study of 118 people with perceived mild to moderate hearing loss at several US sites: those who used the self-fitting setup reported similar benefit to those whose same device was fitted by a professional, and no device-related adverse events were observed.
Earbuds with hearing features are now more common than OTC hearing aids. In MarkeTrak 25, about 21% of adults with hearing difficulty used earbuds with a feature for hearing improvement, against about 6% who owned an OTC hearing aid — though that earbud category covers features such as conversation boost as well as authorised hearing-aid software. A 2025 viewpoint in JAMA Otolaryngology–Head & Neck Surgery discusses how hearing aid–enabled earbuds could make hearing care easier to reach and help make treating hearing loss more ordinary.
For tinnitus specifically, what this feature offers is amplification for mild to moderate hearing loss, which is the mechanism by which any hearing aid helps tinnitus. The FDA's announcement does not mention tinnitus, and no study among those reviewed for this article tested the feature on it. The FDA describes the feature as amplification; it does not describe a tinnitus sound programme of the kind the American Tinnitus Association says prescription aids typically include.
The specific gap for tinnitus
The American Tinnitus Association's guidance on this is direct: OTC devices are not currently equipped with the tinnitus-specific masking or habituation features that prescription hearing aids typically include as built-in programs. The other difference is the fit. A prescription aid is fitted to your audiogram, and the ATA counts verification with real-ear or probe-microphone measurements as part of what makes a hearing aid well fitted; a self-fit device relies on your own adjustments. The evidence on how much that matters is mixed — in the FDA's study of the AirPods feature, self-fitting gave similar perceived benefit to professional fitting of the same device, and in the MarkeTrak survey OTC and prescription owners were similarly satisfied — but none of that was measured on tinnitus.
Why customisation is the dividing line
The ATA specifically calls out the ability to customise the fit to an individual's needs as a major advantage of the prescription path — a process, not just a product. Its broader framing is worth repeating: tinnitus is not simply a hearing loss issue for many people, and OTC hearing aids may not be the best option for someone bothered by it. It notes that not all audiologists provide tinnitus assessment and management, and that some hold a voluntary tinnitus credential such as the Certificate in Tinnitus Management — so it is worth checking a provider's experience rather than assuming any hearing aid, OTC or prescription, will address tinnitus on its own.
Where OTC devices make sense
None of this means OTC hearing aids are pointless for someone with tinnitus. If cost or access has been the real barrier keeping you from any hearing aid at all, and your hearing loss is mild to moderate, a reasonable OTC device is still very likely better than no amplification — restoring some auditory input is the core mechanism thought to help tinnitus regardless of which device delivers it. The clearer, more targeted benefit of the prescription path shows up for people with more complex tinnitus, more significant hearing loss, or hearing loss concentrated at unusual frequencies that a generic self-fit profile won't match well.
When to see a doctor instead
The FDA lists signs that mean you should see a doctor before using an OTC hearing aid. Several are common with tinnitus:
- ringing or buzzing in only one ear
- hearing that changed suddenly in the past six months, hearing that gets worse and then better again, or worse hearing in one ear
- dizziness or a spinning feeling (vertigo)
- ear pain or discomfort, or blood, pus or fluid from the ear in the past six months
- a lot of earwax, or something that might be in the ear
- an ear that is unusually shaped from birth or was injured
A sudden drop in hearing is the urgent one: sudden sensorineural hearing loss is treated against the clock.
Before you buy one
- Get a professional hearing evaluation first if at all possible, even if you choose an OTC device in the end — knowing your hearing loss pattern (see your first audiology appointment and how to read your audiogram) makes any device choice better informed.
- OTC devices are intended for mild-to-moderate hearing loss — if a hearing test shows more significant loss, the OTC category isn't designed for your situation.
- If tinnitus-specific sound features matter to you, confirm a device has them before buying; per the ATA, OTC devices generally do not.
- In the UK, ask your GP about NHS provision before paying privately.