Does Medicaid cover hearing aids?
Last verified:
For children, yes, in every state under EPSDT; for adults, only in the states that include them, roughly half. Federal rule: optional for adults.
What federal law says
Adult hearing aids can be covered under two optional categories: prosthetic devices (42 CFR 440.120(c)) or speech, hearing and language disorder services (440.110(c)). A state can adopt one, both or neither, which is why coverage is roughly a coin flip across the country and why the details, such as one aid or two, a dollar cap, and the replacement interval, vary so much.
States that do cover adult hearing aids usually require an audiologist's evaluation showing a hearing loss above a threshold, prior authorization, and a replacement interval of three to five years, with batteries and repairs sometimes covered and sometimes not.
Since 2022 over-the-counter hearing aids have been legal for adults with mild to moderate loss, and they are far cheaper than prescription devices. Medicaid does not generally pay for them, but they change the math in states with no benefit.
Children under 21
EPSDT requires hearing services for anyone under 21, including diagnosis and treatment for defects in hearing and hearing aids.
What to ask your state plan
- Ask whether your plan covers 'binaural' (two) aids; several states pay for one.
- Keep the audiogram; it is the document every prior authorization turns on.
- Find your state's agency, program name and phone on Medicaid by state.
Related questions
- Does Medicaid cover therapy?
- Does Medicaid cover physical therapy?
- Does Medicaid cover chiropractic care?
Common questions
Does Medicaid cover hearing aids?
For children, yes, in every state under EPSDT; for adults, only in the states that include them, roughly half.
Does Medicaid cover hearing aids for children?
EPSDT requires hearing services for anyone under 21, including diagnosis and treatment for defects in hearing and hearing aids.
How do I find out whether my state's Medicaid covers hearing aids?
Three places. Your plan's member handbook or benefit summary, which lists the covered services and limits; the state Medicaid agency's provider manual for the service, which is public and states the medical-necessity criteria; and the member services line on your card, which can run a coverage check for a specific procedure code. Our state pages list each agency's phone and portal.
Sources
- 42 CFR 440.120 (prescribed drugs, dentures, prosthetic devices, eyeglasses)
- 42 CFR 440.110 (physical therapy, occupational therapy, speech and hearing services)
- medicaid.gov: EPSDT (children under 21)
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