Start with the right kind of care
OTC vs. prescription hearing aids: how to choose
OTC hearing aids are bought directly and set up at home. Prescription hearing aids are selected and fitted with a hearing care professional. Compare the two routes.
01 / The difference
OTC vs. prescription: the main differences.
OTC means over the counter. In the US, adults with perceived mild to moderate hearing loss can buy OTC hearing aids without a prescription or a medical exam. Prescription hearing aids are obtained through a licensed hearing care professional and can address a wider range of hearing needs.1
OTC hearing aids
You choose and set up the devices, following the manufacturer's instructions. The amount of help available varies by brand. Check the setup process and support before buying.
- Choose
- Set up
- Ask for help
Prescription hearing aids
A hearing care professional evaluates your hearing and helps select, fit and adjust the devices. Ask what appointments, follow-up care and service are included in the price.
- Assessment
- Fitting
- Follow-up
Choose the care you need, then the device.
Price, fit and ongoing help all belong in the comparison.02 / Your hearing needs
Who is each option for?
OTC hearing aids are intended for people 18 and older with perceived mild to moderate hearing loss. You might notice difficulty following a group conversation, understanding speech in background noise or hearing the television at a comfortable volume for others. These experiences can be a reason to explore your hearing; they do not establish a diagnosis.2
Prescription hearing aids are not reserved for severe hearing loss. A professional can also help people with mild or moderate loss who want individual assessment, fitting and follow-up. Children and people whose hearing needs fall outside the OTC category need professional care.1
When to seek medical advice first
Contact a medical professional if you have sudden or rapidly worsening hearing, hearing that is much worse in one ear, ear pain, drainage or dizziness. Do not use a purchase decision as a substitute for investigating these symptoms.1
03 / Making your choice
Compare the whole experience.
Setup
Would you feel comfortable following instructions and making adjustments yourself? Or would you prefer someone to guide the fitting in person? Look at the actual setup steps, not just the product photos.
Support
Ask how you get help, what the team can assist with and whether follow-up appointments are included. A clear support route matters when the first settings or fit are not quite right.
Cost & trial
Compare the price for a pair, what is included, the trial period, warranty and return costs. For a smaller budget, our guide to hearing aids under $500 gives you a practical checklist.
Wearing style
Once you know which route suits your needs, compare comfort and handling. Our in-ear vs. behind-the-ear guide explains the main differences in how the devices are worn.
A few useful clarifications.
Can I have my hearing checked before buying OTC?
Yes. An exam is not required to buy OTC hearing aids, but a professional assessment can help you understand your hearing and decide which type of help is appropriate.2
Will hearing aids make everything sound normal immediately?
No. Hearing aids can help with listening, but they do not restore normal hearing. Expect a period of adjustment, and ask for help with persistent discomfort or difficulty.3
Your next step
Find your NILO.
If OTC hearing aids suit your hearing needs, explore two rechargeable NILO styles for everyday conversations.
In the ear
NILO Air
A discreet in-ear design that leaves the space behind your ear clear.
$299
Pair with charging case
Behind the ear
NILO Pro
A slim receiver-in-canal design that sits neatly behind your ear.
$399
Pair with charging case
Return shipping is paid by the customer. See return terms.
