Introduced in November 2023, Neo XS is MDHearing’s latest addition to its over-the-counter (OTC) hearing aid product line. At $397 per pair, Neo XS represents an upgraded version of its predecessor Neo in-ear device, offering improvements in rechargeable battery life, audio processing, and an overall smaller size.

MDHearing Neo XS in-ear OTC hearing aids with charger and packaging.
MDHearing Neo XS in-ear OTC hearing aids with charger and packaging.

While the Neo XS has several benefits, including its discreet Completely-in-Canal (CIC) design, comfortable fit, and inexpensive pricing, I found its performance underwhelming in terms of audio quality and customization options after a hands-on assessment and audio lab testing.

MDHearing Neo XS is a "wear-and-go" type OTC hearing aid that relies on preset programs for customization and is roughly half the size of the Neo—making it the smallest hearing aid MDHearing offers. As such, it likely competes with other small in-ear OTC hearing aids, ranging from Lucid Enrich Pro at $199 to Eargo Link and Sony CRE-C10 at $799.

ReSound image

In this article, we'll tell you everything you need to know about MDHearing and its new Neo XS OTC hearing aid, including its features, pricing, and how it performed in independent lab tests at HearAdvisor.

NEO XS is a Completely-in-Canal (CIC) OTC hearing aid and roughly half the size of its predecessor, NEO. Photo: MDHearing.
NEO XS is a Completely-in-Canal (CIC) OTC hearing aid and roughly half the size of its predecessor, NEO. Photo: MDHearing.

What we love about MDHearing Neo XS

  • Small & Nearly Invisible
    They fit almost completely in your ears, making them discrete and natural-feeling without extra technology behind your ear.
  • Instant-Fit for Most People
    Uses soft silicone sleeves, making them “instant-fit” without the need for custom Earmolds.
  • Near All-Day Battery Life
    Features internal rechargeable lithium-ion batteries, and you can expect around 18 hours of use per charge, although this varies with factors such as streaming, hearing loss, listening environment, age of hearing aid, and more.
  • Resilient Case with Power Bank
    These hearing aids come with a fairly resilient case that doubles as a charger, offering a reported 100+ hours of additional on-the-go use.
  • Avoid the Doctor
    Some may like that Neo XS does not require you to visit a clinic; you can go through the fitting process in the comfort of your home without needing a hearing professional.

Limitations

  • Amount of Benefit is a Gamble
    It is not possible to verify the gain, or amplification, you receive from hearing aids without real-ear measurements. As Neo XS is fit at your home without a hearing care provider, it is uncertain how accurate the gain will be for your hearing loss and whether some hearing benefit is left on the table.
  • Frequent Feedback Limited Amplification
    I experienced regular feedback while using Neo XS which limited speech clarity as the higher-volume settings were unusable. 
  • No Bluetooth Streaming
    Neo XS does not offer wireless audio streaming or remote control.
  • May be Difficult to Handle
    These hearing aids are small which may make them difficult to handle and see, especially if you have low vision and or dexterity issues.
  • Not Appropriate for Everyone
    Neo XS are a direct-to-consumer product and therefore should not be used by those with more significant hearing loss and or other complex needs.
  • No IP Rating
    Neo XS do not have an Ingress Protection (IP) rating, suggesting they do not offer great protection against moisture and debris. Extra routine care should be taken with Neo XS, especially as they are exposed to regular wax, moisture in the ear, rainfall, etc.
  • No T-coil
    You will not be able to pick up audio broadcasted by hearing loops in public auditoriums or other places where hearing loops are in use.
  • No Accessories
    Currently, MDHearing does not offer any wireless accessories for Neo XS, such as a remote microphone, TV streamer, or remote control. This may limit the benefits you experience, especially in noisier situations.

Frequently Asked Questions

MD Hearing claims that Neo XS is supposed to last up to 18 hours per charge. However, depending on your settings and uses, you can likely expect to see shorter run times. The Neo XS comes with a rechargeable case that reportedly provides up to 100 hours of extra run time.

Neo XS is substantially smaller, offers more selectable programs, and has a longer battery life compared to the older generation Neo. Neo XS is also supposed to have improved audio processing with more advanced noise reduction and feedback control.

Neo XS does not offer tinnitus maskers though it is possible that amplification alone can reduce your annoying tinnitus.

No, Neo is a preset-based over-the-counter hearing aid that can be purchased online and shipped directly to you.

Neo XS is controlled with a multi-use push-button on the faceplate of the hearing aid (short press for volume increase and long press for program change). Adjustments need to be made independently to the left and right hearing aids, as they do not offer synchronous wireless control. This hearing aid does not use an app or app-based controls.

Neo XS are preset-based hearing aids. This means you can personalize them by adjusting volume and selecting among the four preset programs (e.g., Quite, Social, Noisy, and Restaurant).

No, these hearing aids do not offer Bluetooth wireless controls or audio streaming. They also do not communicate with one another, so you need to manually adjust each hearing aid individually.

Who is MDHearing?

MDHearing is one of the most prominently advertised OTC hearing aid companies. It was founded near Chicago in 2009 by two brothers, ENT physician Sreek Cherukuri, MD, and engineer/entrepreneur Sreeny Cherukuri, MBA, who sold the company in 2016 to a private investment group. With the MDHearing Pro as one of the earliest direct-to-consumer (DTC) online hearing aids, MDHearing's product line has now further evolved for today's new age of OTC devices—offering FDA-registered hearing aids at less than $400 per pair. This means their products are significantly more affordable than traditional hearing aids sold at private practice clinics or mass merchandisers like Costco or Sam's Club ($1,500-$6,000+) and are generally in the "less expensive range" of competing OTC hearing devices ($200-$1,400).

Starkey image

MDHearing offers several hearing aid styles, from BTEs to CICs, and its newer products include more modern features, such as rechargeability. As noted above, it has offered many products over the years, but along with the Neo and Neo XS, its current featured devices include the Behind-the-Ear (BTE) AIR and VOLT OTC hearing aids for $297 and $397 per pair, respectively. (Note: MDHearing often advertises special sales and discounted pricing, so costs may change.)

NFL Hall of Fame quarterback Joe Namath is often featured prominently in MDHearing commercials and advertising.
NFL Hall of Fame quarterback Joe Namath is often featured prominently in MDHearing commercials and advertising.

These hearing aids can be purchased directly at the MDHearing website or through retailers and online at Best Buy, Amazon, and more. All of their products come with free shipping, lifetime technical support, a 1-year warranty, and a 45-day money-back trial period.

One notable quality of MDHearing products is their lack of features and customization. This is understandable given their low cost; however, compared to other OTC hearing aids, their hearing aids may feel minimalistic, lacking wireless capabilities like app controls or other forms of personalization like on-ear and in-app hearing tests. While some users may miss these additional features, others may prefer their ease of use and general user-friendly setup.

Controls for the Neo XS are relatively minimalist. A button on the faceplate changes the volume (short press) or the program setting (longer press). However, you need to do this for each hearing aid individually, and there is no available app or remote control.
Controls for the Neo XS are relatively minimalist. A button on the faceplate changes the volume (short press) or the program setting (longer press). However, you need to do this for each hearing aid individually, and there is no available app or remote control.

What's it like using MDHearing Neo XS hearing aids?

Neo XS is the latest addition to MDHearing’s product line, and their completely-in-the-canal (CIC) design is meant to make them nearly invisible in the ear. You can expect several improvements over its predecessor, the MDHearing Neo, such as longer battery life, a smaller size, more advanced audio processing, and various selectable programs. The table below provides a quick comparison of the two devices.

NEO XSNEO
Rechargeable battery life18 hours (100+ w/ charging case)17 hours
Noise reductionAdvancedStandard
Feedback reductionAdvancedStandard
Selectable programs41
Price$397$297

Comparison of MDHearing Neo XS versus its predecessor, Neo.

After unboxing Neo XS, I was pleasantly surprised by its small size and sturdy build quality. It definitely feels more modern than other MDHearing products I have tested and looks similar to Signia Silk Charge&Go IX and Sony CRE-C10. The fit and comfort are similar to both of these products, and they even appear to share the same silicone sleeve ear tip.

However, the similarities unfortunately stop there. I found the sound quality of Neo XS muffled and lacking in clarity. I did not notice much improvement when cycling through the four available programs, and I also encountered feedback when boosting the volume. Lastly, I noticed a constant “hissing” in the background regardless of the program or volume setting selected.

MDHearing Neo XS hearing aid on Dr. Taddei's ear
I'm wearing the Neo XS in this photo and assessing their comfort and sound quality.

Overall, I was disappointed with Neo XS's sound quality performance, especially since it is supposed to offer advanced noise and feedback processing. Neo XS may offer some limited benefits in quiet settings, but I still found it to fall short compared to other products I've tested (please see results below).

Controls for the Neo XS

As noted earlier, MDHearing Neo XS hearing aids can be controlled with a multi-function push-button located on the device's faceplate. A single press cycles through the 9 available volume steps, while a longer 3-second press changes programs. The hearing aids do not communicate wirelessly, so you need to make adjustments separately to both devices.

Phonak image

The table below describes the 4 available programs in Neo XS and their intended uses.

ProgramDescription
QuietWatching TV and time with family at home. Both low- and high-pitched hearing loss.
SocialTime with friends, places of worship, small group meetings, or hearing loss in the higher pitches.
NoisyLarge crowds, cafes, traffic, nature sounds, high-octave music, or hearing loss in the higher pitches.
RestaurantAny loud environment where you need to reduce background noise.

Table of MDHearing Neo XS four selectable programs (adapted from Neo XS manual).

One issue I encountered with Neo XS is difficulty pressing (or not pressing!) the button. I occasionally struggled to click the button with my finger as Neo XS is located completely in the ear. Alternatively, when inserting the hearing aids into my ears, I would inevitably depress the button and change the settings. In this way, the small size of Neo XS is a double-edged sword that may cause frustration for some.

Power and rechargeability of Neo XS

Neo XS has internal lithium-ion rechargeable batteries, which reportedly offer you up to 18 hours of use per charge. This is a marginal improvement over MDHearing’s older Neo model which lasted up to 17 hours.

ReSound image

Charging Neo XS is as easy as placing them in the included charger case. MDHearing includes a nice magnetic lock, making it easy to tell when they are placed properly. There is also an LED display on the front of the case indicating battery or charging status.

Set of two MDHearing Neo XS hearing aids in light blue charging case
Neo XS comes with a portable charger case offering up to an additional 6 charges.

It takes about 2-3 hours to charge Neo XS and its charging case, depending on your battery status. Once fully charged, the portable case offers 6 additional charges, which is enough for even the most adventurous weekend trip. Neo XS turns off while charging, so there is no need to worry about annoying feedback once they are placed in their case.

A "C" Grade in Performance: HearAdvisor lab testing of the MDHearing Neo XS

HearAdvisor testing shows that Neo XS performs on the lower end of budget OTC hearing aids, and it received an overall SoundScore of 2.5 (out of 5) for a SoundGrade of C. Neo XS will likely offer limited improvements to speech clarity in quiet settings and no speech benefits in louder noisy environments.

Starkey image

Customization is also limited with Neo XS meaning there are not many options for improving audio performance beyond the default settings. No squealing or whistling was recorded during testing, although feedback was present at higher volume settings.

MDHearing Neo XS situated on the KEMAR test manikin in the HearAdvisor lab.
MDHearing Neo XS situated on the KEMAR test manikin in the HearAdvisor lab.

Below are the lab scores for Neo XS for the five test parameters and two test conditions evaluated at HearAdvisor. The Initial Fit can be considered the results you're likely to get after unboxing and closely following the manufacturer's instructions and advice during setup; the Tuned Fit is the best fit I could achieve with all the tools at my disposal as an audiologist. For overall scores and to hear sound samples, please see the sidebar at the top-right of this page.

SoundScoreSpeech in Quiet/ModSpeech in NoiseFeedbackOwn VoiceStreamed Audio
Initial Fit2.5 (C)1.005.03.2n/a
Tuned Fit2.5 (C)105.03.2n/a

HearAdvisor lab scores (0 to 5, with 5 being the highest performance level) for the MDHearing Neo XS OTC hearing aid in the five HearAdvisor parameters. The SoundGrade is determined by weighting the factors considered most important by consumers.

Minimal speech improvement in quiet and noise

MDHearing Neo XS was found to offer minimal speech benefits in quiet environments and no benefit in louder noisy settings. This can largely be attributed to minimal gain, or amplification, in the higher tones responsible for speech clarity. Testing did not change between Initial and Tuned settings due to a lack of available adjustments on Neo XS.

No feedback

No feedback, or squealing, was present during the lab testing of MDHearing Neo XS.

Will your voice be boomy or sound unnatural?

This metric is largely determined by how Neo XS plugs your ears. Neo XS performed relatively well and did not significantly plug, or occlude, the ear. This means you should not experience an extreme “boomy” or closed-off feeling when wearing Neo XS.

No streamed music

Neo XS does not offer audio streaming.

How hearing aids are tested and graded at the HearAdvisor lab

HearAdvisor is an independent lab located in Rockford, Ill, that provides objective comparisons of prescription, OTC, and hearable devices. All products are tested in two settings which approximate what consumers experience when fit with hearing aids:

  • Initial Fit: The Initial Fit programming reflects how a device performs “out of the box” when the recommended settings are used. Volume adjustments may be made depending on the device but real-ear measurements are not performed. HearAdvisor’s Initial Fit aims to reflect the performance most people experience with their hearing aids.
  • Tuned Fit: The second test setting involves professional adjustments, such as real-ear measurements, and optimizing the device’s amplification. This reflects how hearing aids perform when best practices are followed and you are professionally fit with the devices by a hearing care provider.

Phonak image

For a more detailed explanation of HearAdvisor testing, please see our YouTube video and download our white paper about the test protocol.

Final Verdict

Neo XS offers several improvements over other OTC hearing aids sold by MDHearing. You may like the improved battery life, sound processing, and discreet, nearly invisible fit in your ears. However, based on my experiences and lab testing with Neo XS, its audio performance falls short of that of other similarly priced OTC hearing aids. You may experience some audibility benefits if you are in quiet environments and need of only mild improvements. Overall, Neo XS felt limiting, and at a price point of nearly $400, there are other OTC hearing aids offering better audio performance and features.

Where to buy Neo XS and potential OTC hearing aid alternatives

Neo XS is available for purchase online directly from MDHearing at the MDHearingAid.com website and at retailers or online at Amazon.

If you're considering a discreet OTC hearing aid, RxEars RXi could be a viable alternative. Priced at around $275, it uses size 10 (yellow) disposable batteries, unlike Neo XS's rechargeable ones. HearAdvisor's testing found its audio performance to be significantly better. Another option in this price range is the JLab Hear earbud, a recently launched product that scored higher and has a budget-friendly price of $99.

If you are interested in a prescription solution of a similar style, look no further than the Signia Silk Charge&Go IX. Silk IX was released in 2023, and while it is in another price league (around $3,800), you will experience vastly improved audio performance, customization, and guidance from a hearing care provider.

There are also several other quality OTC hearing aids and hearables with high SoundScores that have been named HearAdvisor Expert Choice Award winners, including Sony CRE-E10 and CRE-C10, Lucid Engage, and Sennheiser Conversation Clear Plus earbuds. You can read more about these on HearingTracker's OTC hearing aid page.