When Medicaid pays for hearing aids
Medicaid hearing aid coverage is different for children and adults. Children under 21 have broader federal protections through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, while adult coverage depends largely on state and plan rules.
Coverage can also come with requirements for medical necessity, prior authorization, providers, devices and replacement schedules.
Hearing aid coverage for children under 21
Medicaid has to cover needed hearing services for any enrollee under 21 through the EPSDT benefit. This benefit also covers additional testing, hearing aids and fresh batteries whenever necessary.
Hearing aid coverage for adults
Coverage for adult hearing aids depends on where you live. States can choose which optional benefits to include, so your Medicaid program might cover hearing aids, limit coverage to certain circumstances or exclude them entirely.
Managed care plans can have different provider networks and authorization requirements than fee-for-service Medicaid, even when they cover the same state Medicaid benefits.
If your state covers hearing aids through Medicaid, your benefits might cover a hearing test, fitting, earmolds, batteries, repairs and follow-up care. Coverage varies by state, and some require a medical evaluation and hearing test before approving a hearing aid.
Coverage limits and restrictions
Coverage may come with restrictions such as:
- Medical necessity: You may need documentation showing that hearing aids are medically necessary.
- Hearing loss requirements: Some programs limit coverage based on the severity or type of hearing loss.
- Prior authorization: Your state or plan may require approval before covering a hearing aid.
- Device limits: Coverage may be limited to certain types or models of hearing aids.
- Payment limits: Some states cap how much Medicaid will pay for hearing aids.
- Provider restrictions: You may need to use an approved hearing care provider or vendor.
- Repair and accessory limits: Repairs, batteries and other accessories may have separate coverage rules.
- Replacement schedules: Coverage may limit how often you can replace a hearing aid.
- Copays: Some adult Medicaid enrollees may have to pay a copay, depending on the state and their eligibility.
If you have both Medicare and Medicaid, check the rules for each program. Original Medicare doesn’t cover hearing aids or exams for fitting them, while some Medicare Advantage plans offer hearing benefits.
» MORE : How much do hearing aids cost?
Medicaid hearing aid coverage by state
Adult Medicaid hearing aid coverage varies widely by state. The table below shows state Medicaid policies as of Dec. 31, 2023. Of the 50 states and Washington, D.C., 32 states covered at least one hearing aid for eligible adults. Coverage limits and other requirements vary by state.
| State | Adult hearing aids |
|---|---|
| Alabama | |
| Alaska | |
| Arizona | |
| Arkansas | |
| California | |
| Colorado | |
| Connecticut | |
| Delaware | |
| District of Columbia | |
| Florida | |
| Georgia | |
| Hawaii | |
| Idaho | |
| Illinois | |
| Indiana | |
| Iowa | |
| Kansas | |
| Kentucky | |
| Louisiana | |
| Maine | |
| Maryland | |
| Massachusetts | |
| Michigan | |
| Minnesota | |
| Mississippi | |
| Missouri | |
| Montana | |
| Nebraska | |
| Nevada | |
| New Hampshire | |
| New Jersey | |
| New Mexico | |
| New York | |
| North Carolina | |
| North Dakota | |
| Ohio | |
| Oklahoma | |
| Oregon | |
| Pennsylvania | |
| Rhode Island | |
| South Carolina | |
| South Dakota | |
| Tennessee | |
| Texas | |
| Utah | |
| Vermont | |
| Virginia | |
| Washington | |
| West Virginia | |
| Wisconsin | |
| Wyoming |
Medicaid requirements for hearing aid approval
Medicaid doesn’t have one national minimum hearing-loss requirement or approval process for adult hearing aids. Medically necessary hearing services for children are covered under EPSDT, while adult coverage depends on the state and, often, the Medicaid plan.
Approval requests commonly include:
- Hearing evaluation: Comprehensive testing to document your hearing loss
- Medical necessity: Documentation supporting the need for a hearing aid
- Medical exam: An ear examination or physician clearance, when required
- Referral or prescription: When required by the state or plan
- Prior authorization: A request with supporting medical records, when required
- Qualified provider: A Medicaid-enrolled or in-network provider to fit and dispense your hearing aids
- State-specific requirements: Additional hearing-loss thresholds or clinical criteria, depending on the state or plan
Proof of medical necessity
Medical-necessity documentation usually explains why you need a hearing aid and includes your test results. Some states also require a medical ear examination. For example, Missouri requires an MD or DO to perform one within six months before the device is dispensed.
Each state and managed-care plan defines medical necessity and may apply their own clinical criteria and service limits.
Provider enrollment requirements
States set provider qualifications. You’ll generally need to see an audiologist or hearing aid specialist who is enrolled with Medicaid or in your plan’s network and meets state licensing and certification requirements.
Prior authorization and referrals
When prior authorization is required, your doctor submits the records to Medicaid or the managed-care plan before fitting or dispensing your hearing aids. Submission steps and decision timing vary by state and plan.
Medicaid vs. Medicare hearing aid coverage
Medicaid's probably where you'd get hearing aid coverage, but each state decides who qualifies and what's covered. Original Medicare pays for hearing tests if providers are checking for or treating a medical issue, but not for hearing aids or fitting exams.
| Program | Hearing exams | Hearing aids | Fittings and follow-ups | Repairs and batteries | Who qualifies |
|---|---|---|---|---|---|
| Medicaid | When medically necessary for children; state-specific for adults | When medically necessary for children; state-specific for adults | State- and plan-specific | State-specific; EPSDT includes necessary batteries for children | Eligible enrollees; EPSDT applies until age 21 |
| Original Medicare | Diagnostic exams when medically necessary | No | No fitting exams; diagnostic follow-up may be covered | No | Part B enrollees who meet exam requirements |
| Medicare Advantage | Original Medicare exams; may add hearing benefits | Only with a supplemental hearing benefit | Plan-specific | Plan-specific | Plan enrollees |
| Dual eligible | Medicare and Medicaid rules both apply | Medicaid may cover the device if the state benefit applies | Medicaid benefit rules apply | Medicaid benefit rules apply | People with Medicare and full-benefit Medicaid |
The hearing benefits of Medicare Advantage vary. A plan might cover hearing services not included in Original Medicare, but its network, approval rules and costs can vary and might change every year.
If you have both Medicare and full-benefit Medicaid, Medicare generally pays first for services it covers, while Medicaid may cover additional services or costs that Medicare doesn’t.
For hearing care, this can mean Medicaid covers a hearing aid if your state’s benefit includes it, even though Original Medicare doesn’t. People enrolled only in a Medicare Savings Program may receive help with Medicare costs but don’t necessarily have full Medicaid benefits.
FAQ
How do you get hearing aids covered by Medicaid?
You get hearing aids covered by Medicaid by checking your state’s benefit rules, using an enrolled provider and completing any required hearing evaluation or prior authorization. Your state Medicaid agency can help you find participating providers.
Does Medicaid cover hearing aids for adults?
Medicaid may cover hearing aids for adults, but coverage, eligibility and replacement limits depend on the state. Eligible children are more likely to have hearing aid coverage through Medicaid.
Does Medicaid cover hearing aids for seniors?
Medicaid may cover hearing aids for seniors if your state includes an adult hearing aid benefit. Original Medicare doesn’t cover hearing aids or fitting exams, but full-benefit Medicaid may cover services Medicare excludes.
How often does Medicaid pay for hearing aids?
Medicaid doesn’t have one nationwide replacement schedule. States set their own benefit limits, so check your state Medicaid agency or plan for its current policy.
Article sources
ConsumerAffairs writers primarily rely on government data, industry experts and original research from other reputable publications to inform their work. Specific sources for this article include:
- Centers for Medicare & Medicaid Services, "Vision and Hearing Screening Services for Children and Adolescents." Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "Hearing aids." Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "Mandatory & Optional Medicaid Benefits." Accessed Sept. 28, 2026.
- National Library of Medicine, "Number Of States Providing Medicaid Hearing Aid Coverage For Adults Increased; Variability Was Substantive, 2017-23." Accessed Sept. 28, 2026.
- Missouri Senate, "SB 79 - Bill Information - Missouri Senate." Accessed Sept. 28, 2026.
- Utah Department of Health and Human Services, "Traditional vs. Non-Traditional Benefits Comparison Chart Effective January 1, 2024." Accessed Sept. 28, 2026.
- Missouri Secretary of State, "13 CSR 70-45." Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "§ 438.210 Coverage and authorization of services." Accessed Sept. 28, 2026.
- Centers for Medicare and Medicaid Services, "Hearing & balance exams." Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "Understanding Medicare Advantage Plans." Accessed Sept. 28, 2026.
- Centers for Medicare and Medicaid Services, "Medicaid." Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "Where Can People Get Help with Medicaid & CHIP?" Accessed Sept. 28, 2026.
- Centers for Medicare & Medicaid Services, "Medicaid State Plan Amendments." Accessed Sept. 28, 2026.
