Age-related hearing loss is highly prevalent and only 20% of adults with hearing loss report using hearing aids. A major barrier to increased hearing aid use is the high out-of-pocket costs associated with hearing aids. The objective of this brief report is to estimate the numbers of millions of Americans 60 years or older with untreated hearing loss stratified by income level. Using multiple cycles from the National Health and Nutrition Examination Survey (NHANES; 1999–2006 and 2009–2010), the prevalence of untreated hearing loss is reported based on audiometric hearing tests and self-reported hearing aid use from a cross-sectional, nationally representative sample. Overall, approximately 20 million Americans 60 years or older have an untreated clinically significant hearing loss. Importantly for the nearly six million low-income older adults with untreated hearing loss, the high cost of hearing aids makes hearing treatment particularly inaccessible for this vulnerable population.