Medicaid covers hearing aids in most states, but the rules vary widely by state and by which Medicaid program you're in
Medicaid does cover hearing aids in 48 states and Washington, D.C., but the coverage is not uniform. Some states cover the full cost of two hearing aids per year. Others cover only one aid, or only for children, or only through managed care plans. A handful of states — Missouri and New Hampshire — do not cover hearing aids for adults at all. Your state's Medicaid program decides what it will pay for, so the first step is to find out what your state actually covers.
Coverage also depends on which Medicaid program you're enrolled in. If you're on traditional fee-for-service Medicaid, your state's rules explore directly. If you're in a Medicaid managed care plan (an HMO or PPO run by a private insurer), that plan may cover more or less than the state minimum, and you'll need to check your plan's formulary or call the plan directly. The same hearing aid might be covered under one plan and not another, even in the same state.
Key Takeaways
- Most states cover hearing aids through Medicaid, but coverage limits — such as one or two aids per year, or only for children — vary by state.
- You must get a hearing test and a written order from a doctor or audiologist before Medicaid will pay; the test itself is usually covered.
- Medicaid typically pays the provider directly, and you may owe a copay (usually $0 to $50 per aid, depending on your state).
- If your state doesn't cover hearing aids or limits coverage, you can ask your doctor to request a coverage exception, though approval is not may provide.
- Managed care plans sometimes cover more than fee-for-service Medicaid, so check your specific plan's rules before you buy.
How to find out what your state covers
Call your state Medicaid office directly and ask: "Does Medicaid cover hearing aids for adults?" and "How many per year?" Write down the answer. The state office can also tell you whether you need a referral, which providers are in-network, and what your copay will be. You can find your state Medicaid office phone number on the Medicaid.gov website under "Contact Your State".
If you're in a managed care plan, call the plan's customer service number (it's on your insurance card) and ask the same questions. Ask specifically whether hearing aids are covered under your plan's formulary, and whether you need prior authorization before you see an audiologist. Some plans require you to use an in-network provider; others let you go anywhere and will reimburse you.
Write down the name of the person you spoke to, the date, and what they told you. If coverage is denied later, you'll have a record of what you were told.
What you need before Medicaid will pay
Medicaid requires a written order from a licensed physician or audiologist before it will cover a hearing aid. This means you must have a hearing test first. The test itself is covered by Medicaid in all states. During the test, the audiologist or doctor will measure your hearing loss and decide whether a hearing aid is medically necessary.
If the test shows you need a hearing aid, the provider will write an order that includes the type of aid recommended, which ear or ears need it, and the medical reason. Bring this order to the hearing aid provider. The provider will then submit it to Medicaid for authorization. This step usually takes a few days to a week.
You'll also need to show proof of Medicaid coverage — your Medicaid card or a printout from your state's online portal. If you're in a managed care plan, bring your plan card instead.
How much Medicaid pays and what you might owe
Medicaid sets a maximum payment amount for each hearing aid, and this amount varies by state. Some states pay up to $1,000 per aid; others pay $500 or less. The provider is supposed to accept Medicaid's payment as full payment, but you may owe a copay. Most states set copays between $0 and $50 per hearing aid, though a few states charge more.
If the hearing aid you want costs more than Medicaid's maximum, you can pay the difference out of pocket. The provider should tell you the Medicaid payment amount and your copay before you buy, so you know what you'll owe.
Medicaid typically pays the provider directly, not you. The provider bills Medicaid, receives payment, and you pay your copay at the time of purchase or fitting.
Coverage limits: how many aids and how often
Most states that cover hearing aids allow you to get one or two aids per year. Some states cover only one aid per ear every two years. A few states cover hearing aids only for children under 18, or only for children and working-age adults, not seniors. Check your state's specific rules when you call.
If you've already used your annual benefit and need another aid, you can ask your doctor to request a coverage exception or prior authorization override. This is a formal request to Medicaid asking it to pay for an extra aid outside the normal limit. The request must include medical documentation — usually a letter from your doctor explaining why you need the aid sooner than the policy allows. Medicaid may approve or deny the request; there's no may provide.
What to do if your state doesn't cover hearing aids
If you live in Missouri or New Hampshire, or if your state limits coverage to children only, you have a few options. First, ask your doctor to request a coverage exception in writing. Explain the medical need and ask Medicaid to make an exception to its policy. Some states will grant exceptions for severe hearing loss or medical hardship, though approval is not may provide.
Second, look into whether you may have access to for other programs. Some nonprofits, such as the Hearing Loss Association of America and local Lions Clubs, offer reduced-cost or donated hearing aids. Your state's vocational rehabilitation agency may also cover hearing aids if you're working or looking for work. The Starkey Hearing Foundation and other manufacturers run donation programs for people who cannot afford aids.
Third, ask about payment plans. Some hearing aid providers offer financing or monthly payment options, which can make the cost more manageable even if Medicaid doesn't pay.
How to start the process
Call your primary care doctor or your state Medicaid office and ask for a referral to an audiologist who accepts Medicaid. Some states have a list of in-network providers on their Medicaid website; you can also search there. Schedule a hearing test. Bring your Medicaid card and a photo ID.
At the test, tell the audiologist that you want Medicaid to cover the hearing aid. The audiologist will do the test, discuss the results with you, and write an order if a hearing aid is medically necessary. The audiologist or their office will then submit the order to Medicaid for authorization. Once authorization comes back, you can schedule a fitting appointment and pick up the aid.
The whole process — from test to fitting — usually takes two to four weeks, depending on how fast Medicaid processes the authorization and how soon the provider has an appointment.
Frequently Asked Questions
Does Medicaid cover hearing aid batteries and repairs?
Most states cover batteries as part of the hearing aid benefit, though some limit how many batteries per month you can get. Repairs are usually covered if the aid is still under warranty, which is typically one to three years. After warranty expires, you may have to pay for repairs out of pocket. Call your state Medicaid office to ask about battery and repair coverage.
What if I'm on Medicare instead of Medicaid?
Original Medicare does not cover hearing aids. However, some Medicare Advantage plans (Part C) do cover them. If you're on both Medicare and Medicaid (called "dual may be able to access"), Medicaid is usually the primary payer for hearing aids. Check with your Medicare Advantage plan or your state Medicaid office to confirm which program will pay.
Can I choose any hearing aid, or does Medicaid limit which brands I can get?
Medicaid doesn't usually restrict brands, but it does set a maximum payment amount per aid. If you want a more expensive brand or model, you can pay the difference yourself. Ask the audiologist which aids fall within Medicaid's payment limit, and which ones cost more. Some providers have relationships with specific manufacturers and may steer you toward those brands.
What happens if I lose or damage my hearing aid before the year is up?
Most states will not cover a replacement if you lose or damage an aid outside the normal coverage window. Some states make exceptions for accidental damage if you report it quickly and provide documentation. Call your state Medicaid office and ask about its policy on lost or damaged aids before you buy.
Do I need a referral from my doctor to see an audiologist?
It depends on your state and your specific Medicaid plan. Some states require a referral; others don't. Some managed care plans require a referral; others let you see an audiologist directly. Call your state Medicaid office or your plan before you schedule an appointment to find out whether you need a referral first.