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The modern world has its comforts, but it can also be rough on your precious ears. Loud music, house-rumbling construction noises, and more can all contribute to gradual hearing loss.

Some conditions and medications can cause hearing loss, too. It can also be age-related or run in families.

However, there are ways to cope with hearing loss, including wearing a hearing aid or personal sound amplification product (PSAP).

Below, we take a closer look at Nano Hearing Aids and outline the difference between PSAPs and hearing aids.

Nano Hearing Aids has a line of over-the-counter (OTC) hearing devices. These aren’t technically the same as hearing aids, so the company’s name and their language on the Nano website under the FAQ section is a bit deceiving.

Many individuals have difficulty hearing sometimes and could benefit from a little extra assistance. PSAPs are designed to amplify environmental sounds for those without hearing loss.

Since 2017, the Over-the-Counter Hearing Aid Act has allowed the sale of OTC PSAPs to improve access to these kinds of devices. The Food and Drug Administration (FDA) doesn’t currently regulate PSAPs the same way they do hearing aids, though.

Prescription hearing aids are FDA-regulated class 1 medical devices that treat hearing loss. Ear, nose, and throat (ENT) doctors and audiologists typically prescribe them after they’ve figured out what’s causing hearing loss.

On the other hand, PSAPs don’t require a prescription or doctor’s visit, but they also don’t actually treat hearing loss. Rather, they just make the sounds around you louder.

A key difference between the two categories is that licensed professionals program medical hearing aids based on a doctor’s prescription or audiogram, while PSAPs are mass-produced.

In October 2021, the FDA proposed a third new category: OTC hearing aids. Once approved, this category would allow hearing aids to be sold directly online or in stores without requiring a medical exam or fitting appointment with an audiologist.

This would allow the FDA more quality control over companies like Nano Hearing Aids, ideally giving consumers more ability to trust in the advertising and products offered.

Nano offers a variety of different models. They sell both behind-the-ear and in-the-ear devices. Current options include the following:

Nano SX2000

Nano SX2000 hearing aids

These are the priciest option that Nano sells. They fit behind the ear but have earbuds that go inside the ear. They’re very small, making them almost invisible, and come in two colors: silver and beige.

When the battery is low, users get an audible alert.

Users can also access frequency and feedback controls to eliminate unwanted noise.

Along with the hearing aids, the package comes with a 6-month supply of batteries, cleaning supplies, four earbud sizes, and a portable case.

Nano Sigma +

Nano Sigma+ hearing aids

These devices are Bluetooth-enabled and work with the Nano mobile app. They use two directional microphones to enhance the important noises and minimize sounds you don’t want to focus on. They’re battery-powered and fit behind the ear.

The Nano mobile app allows you to complete a hearing test on your smartphone, which will then help the hearing aid adjust based on the results of your test.

A protective carrying case, charging dock, cleaning supplies, a manual with directions, and four-plus earbud sizes are included with purchase.

Nano X2 Recharge

Nano X2 Recharge hearing aids

These feature noise-filtering and -canceling technology and large, easy-to-press buttons. They also fit behind the ear.

They offer four different settings, depending on the type of environment you’re in. You can use the Nano X2 Recharge for up to 16 hours on a single charge. They come with a charging case.

Along with a protective carrying case, the X2 Recharge hearing aids come with four different earbud sizes, cleaning supplies, and a user manual.

Nano RX2000 Rechargeable

Nano RX2000 Rechargeable

The units go behind the ear and feature noise-reduction technology. Like Nano X2 Recharge, these can be used for up to 16 hours after charging.

The RX2000 only offers two environmental sound settings and doesn’t have a directional microphone. Because of this, they cost a little less than the Nano X2 Rechargeable.

This model also comes with cleaning supplies, extra ear tubes, and four different earbud sizes.

Nano CIC Recharge

Nano CIC Recharge hearing aids

These are Nano’s in-the-canal devices. They come with multiple earbud sizes. They feature noise-canceling technology, but don’t have any environmental sound settings.

These hearing aids are fully rechargeable with over 16 hours of battery. These aids come with cleaning accessories, extra ear tubes, and a manual for directions on how to operate them.

Nano Hearing Aids cost between $1,289 and $3,500, and that’s for one unit to outfit one ear. However, there are frequent sales and options to buy one get one free.

The cost for a set of prescription hearing aids ranges from $1,600 to $8,000.

Based on the following criteria, Nano Hearing Aids has a fair to poor reputation:

  • The name Nano Hearing Aids is misleading since they’re not true medical hearing aids nor are they FDA-approved.
  • There are currently no FDA warning letters addressed specifically to Nano. However, in 2018, the FDA issued a letter to all hearing device companies, cautioning them against advertising their products as OTC hearing aids.
  • There are no recent or pending lawsuits involving Nano Hearing Aids, but there have been many complaints lodged with the BBB.

Most of the complaints we found have to do with product quality issues or issues with refunds. Some customers note they were not satisfied with the responses or outcomes. (There have even been examples of local news stations stepping in to try to help clients get a full refund.)

Unsurprisingly, most of the reviews on the company website are positive. Many of the negative comments have to do with background noise issues. People also say that the devices don’t clarify sound very well.

Nano has a 45-day satisfaction guarantee. People who are unsatisfied with their new device can return it for a full refund within the 45-day time frame. It’s important to note, though, that shipping fees are nonrefundable.

To start a return, you’ll need to call or email the company. Some complaints outline problems with the return process. In some cases, people say they never received their refunds.

The company also offers protection plans for its devices. These plans will cover you for 1 year if you accidentally damage the device or if you discover a manufacturing defect or malfunction. You can read more about Nano’s return policies here.

Here’s an overview of the pros and cons of Nano Hearing Aids:


  • More affordable than prescription hearing aids. Some of Nano’s options are cheaper than medical hearing aids, making them more accessible to those on a budget.
  • Easier to access than prescription hearing aids. You don’t need a prescription to buy one of these devices.


  • Not FDA-approved. Nano Hearing Aids are registered with the FDA, which is something that every company selling medical devices has to do. They’re not regulated like prescription hearing aids.
  • No evidence behind the newer tech. Nano claims that their app, which works with some of their more recent devices, can perform hearing tests. There’s no evidence that these tests can replace audiograms and other doctor-performed hearing tests.
  • A significant number of customer complaints. Most of these complaints are about product quality, customer service, and success with returns.

Although you don’t need to get seen by a doctor unless you’re under 18, the FDA recommends getting an examination before buying any type of hearing aid.

A healthcare professional — preferably an ENT or audiologist — can evaluate the cause and amount of your hearing loss. They can also fit you with a hearing aid for your needs.

The FDA suggests double-checking whether an audiologist or hearing aid dispenser is licensed.

Want the convenience of ordering hearing devices online but not sold on Nano Hearing Aids? Similar online competitors include:

  • Audicus. Audicus focuses on customer support, with a free online hearing test and a 45-day risk-free trial.
  • Lively. Lively offers a 100-day risk-free trial and on-demand audiologist care and hearing device adjustments.
  • Eargo. Eargo includes unlimited lifetime support via phone, chat, and video. Extended warranties are also available on these hearing devices.

Comparison table

NamePriceType of hearing aidType of hearing lossTrial periodWarranty
Audicusranges from $998–$2,798BTE (behind-the-ear), RIC (receiver-in-canal), and CIC (completely-in-canal) availablemild to severe45 days1 year
Livelyranges from $1,195–$1,995 per earBTE onlymild to moderate100 days3 years
Eargoranges from $1,450–$2,950IIC (invisible-in-canal)mild to moderate high frequency45 days1–2 years

If you’re experiencing hearing loss, your best bet is to speak with an ENT doctor. If there’s no known medical cause for your hearing loss, an audiologist can perform a hearing test and recommend a suitable device to treat it.

If you’re having trouble hearing, it’s important to get your hearing tested. During these exams, your healthcare professional can identify any underlying health issues, including life-threatening conditions, that may affect your hearing.

Companies should be transparent about the differences between prescription devices and OTC devices. Unfortunately, many brands are more interested in selling their products than giving sound advice to customers.

On Nano’s FAQ page, they say that it’s unnecessary to see an audiologist, which makes us hesitant to recommend their products.

They also say that the hearing aids are FDA-registered and “are Medical Prosthetic Devices classified as Class I.” This is a misleading description. An FDA-registered device is different from an FDA-approved one.

All medical devices need to be registered with the FDA before being sold, so saying a product is registered doesn’t tell you much. Class I just means that it’s a type of device that’s considered low risk by the FDA.

Talk with a doctor if:

  • hearing loss interferes with your daily activities
  • hearing loss becomes worse or doesn’t go away
  • sudden hearing loss occurs
  • you hear ringing sounds in your ears
  • ear pain occurs in addition to hearing loss
  • hearing loss results in headaches
  • an accident or injury occurs that affects your hearing

If you have concerns about your hearing, it’s important to mention them to your healthcare professional. They may refer you to an ENT for further diagnosis or treatment. In some cases, hearing aids aren’t necessary, but other forms of treatment are required.

Are Nano Hearing Aids covered by Medicare?

Original Medicare doesn’t cover any hearing aids or hearing exams. Some Medicare Advantage plans (part C) include extra coverage benefits, but you’ll want to contact them to further discuss what your plan does and doesn’t cover.

It’s important to note that the Nano webpage specifically states they don’t accept insurance as a form of payment.

Where are Nano Hearing Aids made?

It’s not advertised where Nano Hearing Aids are made.

Does Nano Hearing Aids provide good hearing aids?

Nano Hearing Aids aren’t actually hearing aids. They are PSAPs. While they can amplify and diminish certain sounds, they don’t actually treat hearing loss. How well Nano Hearing Aids work is personal and depends on the surrounding noises and your hearing.

If you have concerns about your hearing, you’ll want to discuss it with a healthcare professional and get appropriate treatment. Nano Hearing Aids shouldn’t be used as a substitute for medical care.

Without a firm FDA ruling, we can’t recommend Nano Hearing Aids. We’re also wary of the way Nano markets their products as “hearing aids.”

That said, nothing is stopping you from trying out this type of device for yourself. However, it’s best to talk with a healthcare professional or an audiologist before buying any kind of hearing aid.

If you’re experiencing hearing loss, a healthcare professional can determine what’s causing your hearing loss and help treat it.

Steph Coelho is a freelance writer with chronic migraine who has a particular interest in health and wellness. When she’s not click-clacking away on her keyboard, she’s probably nose-deep in a good book.

Catherine Crider, CD/PCD(DONA), CLEC, CBE, JD, MEd, has worked with children for the past decade as a trained elementary and special education teacher, and finds special joy in supporting blossoming families and their infants. She enjoys educating new parents and parents-to-be about their different options as well as the current best practices in baby care. Catherine writes for various websites and teaches full-spectrum childbirth and postpartum education in several locations in California’s North Bay Area and Peninsula.