Most people who would benefit from hearing aids never get them. But many who do start using them are astounded by how they improve their lives.

Cost is a big reason people opt out: Hearing aids usually run from $2,000 to more than $7,000 per pair, and Medicare and most private insurance plans don’t cover those costs or reimburse audiologists for their services. To help make hearing aids more affordable, a federal law passed in 2017 instructed the FDA to develop guidelines to approve over-the-counter (OTC) hearing aids that people can buy and program themselves for a fraction of the cost charged by licensed pros.

In 2020, the FDA signaled it finally was nearly ready to issue regulatory guidance that OTC hearing aid manufacturers can follow to seek federal approval to sell OTC aids. These devices are being designed to benefit those with mild or moderate hearing loss. Those with more severe disabilities will still probably benefit the most with hearing aids selected, programmed, maintained, and periodically adjusted by an audiologist or licensed hearing instrument specialist.

Our Ratings Tables report on local hearing centers for quality and price. Consider only businesses with staff offering thorough advice, providing a wide variety of styles and brands, and with flexible policies that allow you to test out aids and return them at little or no cost.

Before buying anything, decide what you want in a hearing aid. The advanced features of some aids mean they can better adapt to varying hearing environments, compared to basic models, but some extras may significantly up the price.

Get in writing how long you have to test out any aid you purchase; what charges, if any, you have to pay if you return it; and whether the test period will be extended if, instead of returning the aid, you agree to let the dispenser first try to adjust it to suit you better.

And be sure to shop for price. For one specific model of hearing aid we found prices among local hearing centers ranging from $3,400 to $5,200 per pair, including testing, fitting, and programming. For another, prices ranged from $3,895 to $5,900.

Don’t buy any hearing aid before first having a physician or audiologist determine that it will actually improve your hearing.