Last August, lawmakers passed federal legislation that will allow certain types of prescription hearing aids to be sold over the counter. The hope is that increasing market competition will drive down costs—currently, prescription hearing aids start at around $1,650 each. But the Food and Drug Administration has until 2020 to come up with rules for over-the-counter hearing aids, so you might not see these devices on store shelves for years.

More on Hearing

In the meantime, you might be considering a personal sound amplification product, or PSAP. These over-the-ear devices, sold over the counter, are not legally considered hearing aids, but they can make sounds louder.

Our experts say that some PSAPs could benefit certain people with hearing problems. These four questions will help you determine whether a PSAP is a good choice for you.

1. Is a PSAP Right for Your Hearing Problems?

In a small study published last July in the Journal of the American Medical Association, researchers pitted five different PSAPs against a traditional hearing aid. They found that among 42 older adults with mild to moderate hearing loss, three of the five PSAPs performed nearly as well as the hearing aid.

Some PSAPS may help with mild to moderate hearing challenges (such as difficulty hearing the TV or a conversation in a noisy bar), experts say, but won’t work for more severe hearing loss. And neither a PSAP nor a hearing aid will help with medical conditions that can affect hearing, such as impacted earwax or a perforated eardrum.

How can you determine whether a PSAP might be useful for you? “My advice is to consider having a professional test your hearing to at least get an idea if one of these might be appropriate for you,” says Todd Ricketts, Ph.D., director of graduate studies in hearing and speech sciences at the Vanderbilt University Medical Center in Nashville.

This assessment typically means visiting a licensed, certified audiologist or other certified hearing specialist. Otolaryngologists and otologists (ear, nose, and throat doctors) and primary care physicians can also test for hearing loss and rule out any medical conditions. In most cases, your hearing exam will be covered by insurance. 

2. Can You Teach Yourself to Use the Device?

In our test of four PSAPs last year, we found all to be relatively simple and straightforward to use. But as with a hearing aid, a PSAP won’t work right out of the box.

You have to learn how to insert and remove the device from the ear, adjust the settings to maximize its performance, change the battery, and clean and maintain it, says Kim Cavitt, Au.D., an audiologist and adjunct lecturer at Northwestern University in Illinois.

Certain parts could also be small and hard to manipulate, and some higher-end PSAPs may require you to download an app for making adjustments.

If you aren’t able to perform these tasks, you may need to pay an audiologist to do it for you, Cavitt says. And in some cases, that could end up costing you close to the price of a prescription aid.

“Consumers generally don’t realize that a big chunk of the price [of a hearing aid] is the professional services fee,” says Ricketts. “It's about half.”

Also keep in mind that not all audiologists are willing or able to work with PSAPs, Ricketts notes. So check with your audiologist before you buy a PSAP; also ask what the charges would be for these services.  

3. Are You Clear on What the PSAP Can Do?

PSAPs come in a wide range of prices, from $10 or $20 each to $400 or $500 per device. The two cheaper models we tested, the Bell & Howell Silver Sonic XL, $20, and the MSA 30X, $30, offer basic functions, such as on/off switches and volume control.

Pricier models, such as the SoundWorld Solutions CS50+, $350, allow you to customize settings to amplify sounds in the frequencies where you need the most help or stream music or take phone calls through your smartphone via Bluetooth.

These pricier PSAPs might also have such features as a directional microphone, which can pick up sounds in front of you and not those behind or to the side of you. This makes it easier to hear conversations in a crowded restaurant or other noisy places.

Consider What’s Most Important and How You’ll Use a PSAP
If you simply want a little amplification while watching TV, for example, you may do well with a moderately priced device. But if you’re looking for help in a range of situations—dining out with friends, taking phone calls, listening to music—you might consider a pricier, full-featured version. 

For now, however, CR advises that you avoid very inexpensive models, such as those under $50.

In our tests, we found that the two very inexpensive models offered little benefit to our volunteer testers and in some cases interfered with their hearing by blocking incoming sounds the way earplugs do.

Additionally, our hearing expert says these low-end devices might overamplify loud noises, such as a fire engine wail, which could potentially damage hearing further.

It’s also important to temper your expectations. Because the FDA doesn’t regulate PSAPs as it does hearing aids, manufacturers aren’t permitted to claim that they improve impaired hearing.

They also aren’t held to the same safety or efficacy standards as hearing-aid manufacturers, which can make determining the quality of a given PSAP challenging before you buy.

4. Do PSAPs Have a Good Return Policy?

Most prescription hearing aids come with a trial period so that you can test them out and return them for a full refund if you’re unsatisfied.

But a PSAP may have a limited return policy, or none at all. The SoundWorld Solutions CS50+ and Etymotic Bean, for example, which both fared well in the CR tests, have 45- and 30-day return policies, respectively. The inexpensive Bell & Howell Silver Sonic XL, on the other hand, is returnable only if the product is defective. 

This is important, because it could take you several days or even weeks to become used to the way the PSAP sounds, or to get the settings just right.