Most people probably associate three things with hearing aids: an elderly demographic, beige plastic construction and high-pitched feedback in public places. As it turns out, all those notions are now obsolete—or will be soon.

The most popular hearing-aid style is still the one that rests over your ear—a design that debuted in the 1950s. You know what else is decades old? Our country’s system for getting and paying for hearing aids.

Basic Medicare and most other insurance providers have never paid for adult hearing aids. At an average cost of $4,700 a pair, that makes hearing aids the third-largest purchase in most people’s lives after a house and a car.

The channel for buying hearing aids hasn’t changed in 60 years, either: You must buy them from an audiologist or doctor. They’re not available over the counter or by mail order.

Only six companies make most of the world’s hearing aids, and they sell them directly through hearing specialists. (You can buy “personal sound amplification products” in stores, but they can’t be marketed as hearing aids. In any case, most are fairly crude and ineffective for severe hearing loss.)

That’s one reason the price of hearing aids hasn’t dropped over time, the way most electronics do: the medical professionals you have to go through account for a significant fraction of the cost. Bottom line: many people who need them don’t get them.

“This is the sad part,” says Frank Lin, director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. “About 20 percent of adults who have a hearing loss actually use a hearing aid. I mean, 20 percent. And this figure hasn’t changed in decades.”

The other 80 percent may wind up missing out on a lot more than conversation in a noisy restaurant. Lin’s studies, which followed older adults for many years, revealed that hearing loss is “incredibly strongly” linked to serious outcomes, including impaired thinking, greater risk of hospitalization, even dementia.

Appalled at these findings, Lin teamed up with the President’s Council of Advisors on Science and Technology, under Barack Obama, and other groups to pursue a radical agenda: deregulating hearing aids. The result passed last year with bipartisan support. It requires that the FDA develop a new category of over-the-counter hearing aids, including safety and reliability standards.

The new law, Lin says, will lower the price and remove obstacles to innovation—and so help more patients. “People widely expect that companies like Bose, Samsung and Apple could all enter the market now,” he observes. Obviously the concept of over-the-counter aids isn’t popular with today’s manufacturers, who will lose their exclusivity.

“The concern is people trying to self-diagnose, people trying to self-program,” says Chris McCormick, chief marketing officer at Starkey Hearing Technologies, the only U.S.-based company among the big six hearing-aid makers. “The products will have to be standardized, and the problem is that everybody’s hearing is different.” Even so, Starkey and others are preparing for the new marketplace. Part of that is taking the hearing aid well beyond the realm of sound processing.

Later this year Starkey will release a new model that incorporates Fitbit-like health and heart rate monitoring and another that will automatically notify a loved one if you fall and can’t get up. Bose already sells something called Hearphones—with noise cancellation, directional microphones and various sound-processing options—that are moderate-strength hearing aids in all but name.

As for those popular misconceptions: Many hearing aids today aren’t beige (turns out that matching them to your hair color is better camouflage). Most have antifeedback circuitry.

And now, thanks partly to the new law, older people may not be the primary customer demographic. Your ear turns out to be a great, inconspicuous place for a computer to hide, as the movie Her brilliantly depicted. Hearing aids may mostly aid your hearing—but soon they’ll help with directions, read our messages, play our music and track our health, all without the distraction of a smartphone screen. This could be the dawn of a new ear era.