A listening assistant is a device sold without a prescription that amplifies sounds, especially voices, to help a person who hears less well follow a conversation. Unlike a hearing aid, it is not a medical device: it is not fitted by a hearing-care professional, it is not reimbursed, and it is mainly used for specific moments (conversations, TV, appointments).
| Criteria | Hearing aid | Listening assistant |
|---|---|---|
| Status | Medical device | Consumer device |
| Prescription | Yes, from an ENT doctor, for a first fitting (France) | No, freely available |
| Fitting | Custom, by a hearing-care professional | Preset, ready to use |
| Sound delivery | Through the ear canal, with an earpiece | Through the ear, sometimes also through the bones (bone conduction) |
| Use | Worn all day, every day | Occasional: conversations, TV, appointments |
| Hearing loss | Mild to profound | Mild to moderate |
| Price | From €0 (class 1) to ≈ €1,475 per ear (class 2) in France | About €20 to €600, depending on the technology |
| Reimbursement | Yes in France: €0 out of pocket for class 1 | No, it is not a medical device |
| Where to buy | From a hearing-care professional, with a prescription | In pharmacies or online |
The two are not opposed. A hearing aid corrects hearing loss day to day; a listening assistant helps at specific moments, including for people who already wear hearing aids, for example in a restaurant or during a consultation. Prescription and reimbursement rules refer to the French health system.
They all amplify sound. What sets them apart: what their microphone picks up.
The microphone is in the earpiece: it amplifies voices, but also every noise. It is the most common model in pharmacies.
Connected to the TV, it sends the sound straight to the ears.
The person speaking wears the microphone: their voice is picked up and isolated from the noise of the room.
With Spokeo: the headset also connects to the TV and the phone via Bluetooth.
Spokeo is a microphone + headset listening assistant, designed in France and winner of the First Prize at the Concours Lépine International 2025. The person speaking wears the microphone near their mouth: it picks up their voice, not the noise of the room. The person listening wears the headset and hears clearly, even with earwax blockage, thanks to a patented technology that carries sound through the air and through the bones of the skull.
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“My mother, 87, lives in a care home. […] Until the day she could no longer wear her hearing aids. It was terrible for her: she was cut off from communication and isolated. […] At the very first try, her face suddenly lit up. […] Since then she can take part in activities again and sing karaoke.”
“The few residents of our care home who had no hearing aids (or could not even use them) and for whom we intended it were able to talk naturally for the first time in a long while. Take Mr R., 95, who spoke with his 3-year-old great-granddaughter and heard her say “great-grandpa”!”
A listening assistant can be bought without a prescription, in a pharmacy or online. Pharmacies mostly sell in-ear amplifiers that amplify everything. Handy for mild discomfort, they often disappoint in noisy places. Online, the choice is wider, including headsets and systems with a microphone. No prescription is needed in either case.
That is what makes the difference in a restaurant or at a family gathering.
Decisive in case of cognitive impairment or shaky hands.
In the ear or over the ear is not the same thing.
A 30-day return option avoids unpleasant surprises.
Looking for a hearing aid without a prescription? Our answers on prescription-free hearing solutions
At €20, a basic amplifier makes every sound louder, noise included. More advanced models isolate the voice, filter out noise or also carry sound through the bones of the skull: they go up to €600.
The price is capped at €950 per ear. With a standard French top-up health insurance, the national health insurance and the insurer cover it in full: nothing to pay. Renewal possible every 4 years.
Average reported by DREES: €2,951 per pair. French national health insurance reimburses 60% of a €400 rate per ear (over age 20). With a standard top-up insurance, total reimbursement is capped at €1,700 per ear.
Sources: French national health insurance, “Aides auditives : quelle prise en charge ?” (ameli.fr, February 2026); DREES, “La complémentaire santé”, 2024 edition (2021 average price)
Because they are not used in the same situations: when cognitive impairment makes a hearing aid hard to use, when it is refused, lost or broken before the 4 years are up, or when it is not enough in noisy places.
First, a check-up with an ENT doctor: hearing loss can have a treatable cause (earwax, ear infection). Then, five criteria.
A long care pathway, the discomfort of a foreign body in the ear, devices too small to handle, devices lost and not replaced. Uncompensated hearing loss isolates people, and the link with cognitive decline is established: hearing loss and Alzheimer's.
Not only people who hear poorly: also those who talk to them.
Especially in noise: in restaurants, with family.
Discomfort, forgetting it, a device that stays in the drawer.
So that a loved one no longer stays on the sidelines of conversations.
Being understood the first time, obtaining informed consent.
Simple equipment, shared between residents.
No. A hearing aid corrects hearing loss all day long, with custom settings. A listening assistant helps at specific moments. It can, however, be enough for mild hearing loss, or take over when a hearing aid is refused or poorly tolerated.
No for a listening assistant: it is freely available, in pharmacies or online. In France, yes for a first hearing aid: it must be prescribed by an ENT doctor or a doctor trained in otology, and it is supplied by a hearing-care professional. More details: prescription-free hearing solutions.
In France, it is a hearing aid outside the “100% Santé” scheme, with free pricing (about €1,475 per ear on average) and more options than class 1 (settings, comfort, rechargeable battery). French national health insurance reimburses 60% of a €400 rate per ear over age 20; with a standard top-up insurance, total reimbursement is capped at €1,700 per ear (sources: ameli.fr, DREES).
No. It is not a medical device, so it is not covered by French national health insurance.
None: they are three names for the same type of device. PSAP stands for Personal Sound Amplification Product. To learn more: PSAP: definition and how it works.
Sound travels through the bones of the skull to the inner ear, without going through the ear canal. Combined with conventional transmission through the air, it helps when the ear canal is blocked (earwax) or sensitive. It is the principle of the Spokeo headset, protected by a patent. To learn more: bone conduction explained.
Yes, it is common: the listening assistant provides extra help in noisy places, during consultations or at family gatherings. With a headset, check that it sits comfortably over the hearing aids.
Yes, it is one of the most useful settings. Hearing aids there are often lost, poorly maintained or refused. A simple headset requires no fine handling and can be shared between residents after disinfection.
In pharmacies, at some opticians and online. The Spokeo listening assistant is sold on myspokeo.com, with a 30-day money-back guarantee.
