Hearing loss is one of the most common disabilities worldwide. According to Forbes Health, over 25 percent of adults over the age of 60 are affected by disabling hearing loss. In the United States, between two and four of every 1,000 people experience hearing loss, with the majority over the age of 65. Despite the prevalence of hearing loss, the majority of people experiencing difficulty go undiagnosed and untreated. 

In this article, we will discuss hearing aids vs hearing amplifiers and which one is best for your hearing loss situation.

Hearing Aid vs Hearing Amplifiers Introduction

Hearing Aids vs Hearing Amplifiers

There is an increasing amount of research to suggest a link between untreated hearing loss and the advancement of cognitive decline, including dementia. Many researchers theorize that this is related to the isolating nature of hearing loss. Individuals who find it difficult to communicate in social situations may choose to stop attending events, going to restaurants for dinner, participating in family gatherings, or joining church services.

This lack of social interaction can have detrimental effects on one’s emotional and mental well-being, in addition to the evidence suggesting it contributes to the earlier onset of cognitive decline.

So, why does hearing loss go untreated? Certainly, there is some percentage of people who either choose not to have their hearing tested or, depending on their circumstances, do not have the resources to seek professional testing. There are many patients, though, who undergo full diagnostic audiological testing and are told they are a good candidate for binaural amplification but choose not to pursue it.

There are several reasons for this. One is the perception from many individuals that hearing aids will make them “look old” or that needing hearing aids is an undeniable sign of aging. Others, though, cite cost as the major barrier to pursuing hearing aids, which can be quite expensive. 

Medicare, the largest insurer of individuals over the age of 65, does not cover hearing aids. Some commercial insurers are beginning to offer a hearing aid benefit, though it is rarely enough to cover the entire cost of a pair of hearing aids. Much of the elderly population experiencing hearing loss are on a fixed income and find it difficult to budget for such devices.

This is a major reason many patients opt for non-prescription devices such as over-the-counter (OTC) hearing aids, or hearing amplifiers, also known as personal sound amplification products (PSAPs).

What’s The Difference Between Hearing Aid vs Hearing Amplifiers?

Hearing aids are prescription devices that are specifically programmed by an audiologist or hearing aid dispenser according to a patient’s individual hearing loss using proprietary manufacturer software. They provide different levels of volume (more accurately known as “gain”) at different pitches or frequencies based on the patient’s specific hearing loss. Hearing loss due to aging, or presbycusis, typically presents as milder hearing loss in the lower frequencies, sloping to more severe hearing loss in the higher frequencies. 

Thus, the hearing aids would prescribe more amplification in the higher frequencies than the low frequencies. Prescription hearing aids also have sophisticated technology that seeks to amplify speech in the environment and minimize background noise. This is done through algorithms that can identify patterns of speech versus noise, as well as through directional microphones, which are able to focus in front of the hearing aid user and minimize the noise coming from behind and to the sides. 

Hearing amplifiers, or PSAPs, are much simpler devices. They make all sounds equally louder, rather than factoring in the different levels of amplification needed across frequencies and based on the individual’s degree and type of hearing loss. Importantly, making things louder does not necessarily make them clearer. If you have ever been at an event where the microphone or sound system is turned up too loud, you’ll recall that it was actually more difficult to understand what was being said, and it is often accompanied by feedback (whistling), which further contributes to the distortion.

Hearing amplifiers can be purchased in stores or online and are substantially less expensive than hearing aids, partly because of the technology limitations but also because they don’t involve any professional services. Patients can purchase and use the devices without an official hearing test. The table below summarizes some of the major differences between hearing aids vs hearing amplifiers. 

Hearing Aids vs Hearing Amplifiers Comparison

Hearing AidsHearing Amplifiers
Hearing testRequired for recommendation and programmingNot required or used 
Professional servicesRequired for recommendation and programming, often bundled into the cost of hearing aidsNot fit by a professional
Directional microphonesYes, with varying technology levels based on price pointNo
Purchase optionsPurchased through an audiologist or hearing aid dispenser, no option to buy directlyPurchased online or in-store directly by the consumer
FDA RegulatedYesNo
Designed for people with:Mild to profound hearing loss, type and degree determined through diagnostic testingNormal hearing who wish to hear certain soft sounds more easily, such as birdwatchers or hunters (note: hunters should use hearing protection with any use of firearms)

In summary, here are some pros and cons of prescription hearing aids versus hearing amplifiers:

Hearing Aids vs Hearing Amplifiers Pros

  • Hearing aids are fit using a prescription based on your specific type and degree of hearing loss in the right and left ears.
  • Hearing aids offer sophisticated technology to make listening easier in difficult situations such as noise or overdistance
  • Hearing aids offer streaming capabilities, including direct Bluetooth connection to stream phone calls, music, or podcasts directly through your hearing aids.
  • Hearing amplifiers can increase the volume in situations where the user wants to hear soft sounds, such as birdwatching or hunting.
  • Hearing amplifiers can be purchased quickly and easily without the need for an appointment.
  • Some hearing aids and hearing amplifiers offer rechargeable batteries

Hearing Aids vs Hearing Amplifiers Cons

  • Hearing aids can be very expensive, and most of the time, they are not covered by insurance.
  • Hearing aids can require multiple follow-up visits with an audiologist or hearing aid dispenser in order to maximize the user’s perceived benefit
  • Hearing amplifiers, if used incorrectly, can actually damage your hearing by overamplifying sounds
  • Hearing amplifiers will not make sounds clearer for people with diagnosed hearing loss
  • With hearing aids or hearing amplifiers, there will always be situations where communication can remain challenging

How To Get Started With Hearing Aids Vs Hearing Amplifiers

The paths to purchasing these two distinct products should be very different. A person noticing difficulty hearing, particularly in noisy environments, over distance, or when they cannot clearly see the person they are trying to hear, should make an appointment with an audiologist for a diagnostic hearing test. Hearing thresholds would be evaluated in a soundproof booth for the right and left ears at that appointment. Additionally, speech understanding would be assessed with a test of word discrimination presented at a comfortable listening level. 

The audiologist would counsel the patient on the meaning of their test results and potentially make a recommendation for hearing aids, if appropriate. It is entirely possible that the hearing test will show thresholds that do not warrant a recommendation for hearing aids. This is okay! It means you have established a baseline, which can be helpful down the road if you experience greater difficulty. 

If the audiologist does determine that the hearing loss warrants amplification, the manufacturer and technology level of the hearing aids would be selected, and the audiologist orders the devices and fit on a separate day. Continued follow-up appointments would occur to fine-tune the hearing aids and counsel the patient on proper care and maintenance. Hearing aids come with a trial period, during which the patient could choose to

Conversely, hearing amplifiers should be pursued by individuals with normal or near-normal hearing and seeking amplification for soft sounds in specific situations, such as hunting or bird watching. These devices can be purchased in stores or online, and the user may decide to try a few different options because they are at a lower price point.

Depending on where they are purchased, there may or may not be a return policy, particularly if they have been opened and used. Hearing amplifiers may look similar to behind-the-ear (BTE) hearing aids, or they may look more like a set of headphones with a separate microphone component.

Cost of Hearing Aids vs Hearing Amplifiers

There is quite a range in cost for both hearing aids and hearing amplifiers. Hearing amplifiers can be purchased for as low as $40 or upwards of $400. It is important to note that there is some overlap between hearing amplifiers and over-the-counter hearing aids if you try to conduct a simple Amazon.com search.

You will likely find a range of products in the categories of OTC hearing aids and hearing amplifiers, with the price point reflecting (to an extent) their technology capabilities. OTC hearing aids fall somewhere in between hearing amplifiers and hearing aids in that they are designed for people with a mild to moderate degree of hearing loss but do not involve a professional to fit or service the devices. 

Most are also self-fit, meaning the individual would perform their own hearing test using an app or website, and then that data would be used to “program” the OTC hearing aids. Some of the more expensive models more closely approximate prescription hearing aids in that they offer rechargeability, multiple programs, and streaming capabilities. Conversely, a simple hearing amplifier for hobby purposes should be much less expensive because it does not require more advanced technology or factor in an individual’s hearing thresholds. 

Prescription hearing aids can range in cost from about $2,500 to $7,000 for a pair. This is a wide range because there are different tiers of technology. With more expensive hearing aids, the technology is more advanced in terms of automaticity, microphone directionality, and the ability for the hearing aids to detect that the listener is in a variety of different situations. Additionally, advanced-level hearing aids often offer the audiologist greater programming flexibility in the software. The technology level is really dependent upon the demands of your lifestyle and listening environments. 

A person who is retired and lives with their spouse and hopes to hear better during family dinners and at church requires a different device from someone who is still working and maintaining a very active social life. The price of hearing aids can also vary by the type of setting where they are dispensed. Sometimes a private practice will charge more for hearing aids, not only because they need to cover their overhead expenses but because they bundle in additional services and personal attention.

There may be less of a markup on the devices at a university clinic, hospital, or other nonprofit settings. It is very common for audiologists’ services to be bundled in, though, so that is something to consider if you are experiencing sticker shock. Your follow-up visits for programming over a certain period of time are included in that initial purchase price.

Hearing Aids vs Hearing Amplifier Buying Choices

There are several manufacturers of prescription hearing aids. The six largest manufacturers are Oticon, Phonak, Siemens/Signia, GN Resound, Starkey, and Widex. Some audiologists offer devices from all of these (and perhaps additional) manufacturers, while others choose to focus on one or two brands. All of these devices are excellent and have great performance in noise, rechargeable options, Bluetooth connectivity, etc.

Often the audiologist will make a brand recommendation based on their personal preference and programming experience. The prices of these are going to be dictated by the specific center where they are purchased but are generally in that $2,500-$7,000 range for a pair. You can always feel free to shop around for a second opinion at a different setting type and ask about warranties and what services are bundled in.

Here are some examples of OTC hearing aids available for purchase without consulting an audiologist:

EarGo 7Jabra EnhancePhilips HearLinkNano Sigma Plus
Price$2,690/pair$1,195-$1,995/pair$1,599/pair$597/pair
StyleInvisible in canalBehind the earMini receiver in canalBehind the ear
Hearing LossThe 100-day trial, up to 3-year warrantyMild-moderate hearing lossMild-moderate hearing lossMild-moderate hearing loss
Purchase terms45-day trial, 1-year warranty100-day trial, up to 3-year warranty180-day trial, up to 3-year warranty45-day trial, 1-year warranty

Here are some examples of hearing amplifiers, or PSAPs, which do not involve self-fitting and simply amplify everything equally:

iHear Trio ($39.90 per device)

  • Behind the ear, discrete style
  • Maximum of 30 dB of gain
  • Durable and water-resistant for outdoor use

IROGER Rechargeable PSAP ($99)

  • Over-the-ear cushioned headphones with a handheld microphone.
  • 120 hours of use from a single charge
  • Two-year warranty and lifetime repair

iBstone Rechargeable ($134)

  • Completely-in-canal style
  • Lasts for 24 hours on a 3-6-hour charge
  • Devices can be worn in either ear interchangeably

Alternatives to Hearing Amplifiers or Hearing Aids

If you are looking for something specific for a hobby, there are some innovative products on the market. For example, there is a product from Tetra Hearing that is specific for hunters and is designed to amplify the specific sounds needed to localize animals but protect the ears from gunshot noise which can be quite damaging. They have custom products, which would require an earmold impression and universal behind-the-ear styles, and the devices are eligible to be paid for from your health savings account (HSA) if you participate in such a program.

For birdwatching, regular hearing aids will work relatively well, particularly if you have some degree of hearing loss. There is also an app called “Hear Birds Again,” which is used with a headset and lowers the pitch of birdsong into a range that is easier to hear. The app itself is free, and while the company states that it works best with their specific binaural headset, it could be worth a try with headphones you already own.

Other hobbyists may be interested in products that protect their hearing, such as musicians’ earplugs. These can be custom fit by visiting an audiologist for an earmold impression. Musicians’ earplugs attenuate sound equally across frequencies to preserve the quality of music. You have likely noticed if you cover your ears or wear standard earplugs that, while things are quieter, the sound quality is distorted. For musicians or frequent concert attendees, these special earplugs are ideal for preserving both the fidelity of the music, but also your hearing.

A diagnostic hearing test will let you know whether you have hearing loss and, if so, whether it would be appropriate to try OTC hearing aids (for mild-moderate losses only) or if you need to move to something prescription. Most insurances will cover, at least in part, the diagnostic hearing test, so it is a good idea to get a baseline.

Keep in mind that some insurances, including Medicare, require a physician referral to pay for the hearing test. If you aren’t sure which product is most appropriate for you, it might be a good idea to consult an audiologist to discuss your hearing needs. Audiologists are also quite familiar with the hobbyist products and can make a recommendation and take the earmold impressions, if necessary.

erin edwards aud
Clinical Audiologist at Towson University | + posts

Erin Edwards received her Doctor of Audiology degree from Towson University in 2015 and her Ph.D. in Education and Leadership from Pacific University in 2022. She has worked with patients of all ages in a variety of settings and has a specific interest in cochlear implants, the relationship of hearing loss and dementia, and interdisciplinary healthcare.

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