Choosing your hearing kit
The right tool for hearing loss depends on the situation. Room conversation, phone calls, TV, and group settings each have a different best answer. This guide walks through every mainstream option in 2026, with honest cost, privacy and everyday-use trade-offs, so you can pick the combination that actually works for your life.
Start with the situation, not the device
A hearing aid is a general-purpose device. A captioning app solves one specific situation, the phone call, extremely well. Before you spend anything, list the moments where you struggle most. If it's the phone, a free captioning app closes that gap without touching your hearing aids budget.
Prescription hearing aids
The primary medical device. Fitted to your audiogram by an audiologist, they amplify and shape sound across a wide range of situations. Expensive ($2,000–$6,000 a pair), often not covered by insurance, and, critically, most people still find phone calls difficult even with excellent aids, because the phone strips out the frequencies aids rely on to disambiguate speech.
OTC hearing aids & PSAPs
The FDA opened up over-the-counter hearing aids in 2022. Prices range from $200 to $1,000 for the aids themselves; PSAPs (personal sound amplifiers) sit in a similar bracket but are legally not hearing aids. Sensible starting point for mild loss, less effective for moderate-to-severe. Same phone-call limitation as prescription aids.
Captioned calling apps (IP CTS)
Free for eligible US users under the FCC's TRS program. Runs on the iPhone or Android you already own, shows real-time text of the other person's speech, and, with Rogervoice, uses AI only, so no human is on the line. This is the highest-leverage add-on to any hearing setup because it solves the one situation most aids don't.
Legacy captioned phones (CapTel-style)
The beige desktop unit tethered to a wall outlet. Works, and free with self-attested hearing loss, but ties captioning to one room and often uses human captioners. Sensible for someone with a landline-only lifestyle; unnecessary for anyone comfortable using a smartphone.
Video Relay Service (VRS)
A video call with an ASL interpreter who voices for you. Free and federally funded. The right lane if ASL is your primary language, but not comparable to captioned calling, which keeps you on a normal voice call and shows text of the other person's words.
How to choose (and combine)
Most people end up with two tools: hearing aids (or OTC amplifiers) for the world, plus a captioning app for the phone. That combination costs at most the price of the aids, the app is free, and covers the widest range of situations. Add VRS if ASL is your primary language, or a captioned phone if you genuinely only use a landline.
The full side-by-side comparison
For a row-by-row breakdown of cost, prescription requirements, human-listener presence, phone compatibility and FCC funding across all five tool categories, see the full comparison page linked from the Resources hub.
Frequently asked
Do I need hearing aids or a captioning app?
For most people it is not either/or. Hearing aids handle in-person conversation; a captioning app handles phone calls, which even excellent aids struggle with. Because captioned calling is free for eligible US users, adding it to a hearing-aids setup costs nothing.
Are OTC hearing aids worth it?
For mild-to-moderate hearing loss, OTC aids are a reasonable low-cost entry point. They are not a substitute for a professional fitting if you have moderate-to-severe loss, and they will not fix phone-call clarity, that is a job for a captioning app.
What's the difference between a PSAP and a hearing aid?
A hearing aid is an FDA-regulated medical device tuned to correct a diagnosed hearing loss. A PSAP is a consumer amplifier meant for situational listening (birdwatching, lectures) and is not regulated for hearing loss. OTC hearing aids sit in between: consumer-purchasable but FDA-cleared.
Is captioned calling a replacement for hearing aids?
No. Captioned calling only helps on the phone. Hearing aids help you understand people in the room. They solve different problems and work best together.
Captions that keep up with you.
Free, FCC-certified captioned calling on the phone you already own.