Medicaid covers hearing aids in most states, but the details vary widely by where you live

Medicaid does pay for hearing aids in 48 states plus Washington, D.C., but coverage is not the same everywhere. Some states cover the full cost of hearing aids and related services. Others cover only a hearing test, or only one hearing aid per ear, or only one aid every few years. A handful of states—currently Missouri and New Hampshire—do not cover hearing aids through Medicaid at all. Your state's rules depend on its Medicaid program, which operates separately from the federal program.

The fastest way to find out what your state covers is to call your state Medicaid office directly and ask what hearing aid benefits are available to you. You can also ask your primary care doctor or an audiologist whether they work with your state's Medicaid program for hearing aids. Many do, and they know the coverage rules for your area.

Key Takeaways

  • Medicaid hearing aid coverage exists in 48 states and Washington, D.C., but the amount covered—whether one or two aids, how often you can get them, and what the copay is—differs by state.
  • You must have a hearing test from an audiologist or physician before Medicaid will cover a hearing aid, and some states require prior approval from Medicaid before you buy one.
  • Your state Medicaid office can tell you in one phone call whether hearing aids are covered under your plan and what the out-of-pocket cost will be.
  • If your state does not cover hearing aids through Medicaid, you may still find lower-cost options through nonprofit organizations, hearing aid manufacturers' programs, or community health centers.

How much Medicaid pays and what you pay out of pocket

The amount Medicaid covers for a hearing aid ranges from nothing to the full cost, depending on your state. Some states cover up to $1,000 per hearing aid, others up to $3,000, and some cover the actual cost without a limit. A few states cover only the hearing test, leaving you to pay for the device itself. You may also have a copay—typically $0 to $50 per visit or per device—that you pay at the time of service.

Many states limit how often you can get a new hearing aid through Medicaid. Common limits are one aid every three years, or one aid per ear every five years. If you need a replacement sooner because your aid broke or stopped working, some states will cover it; others will not. Ask your state Medicaid office whether replacement coverage exists and what you need to prove (such as a repair estimate) to get it approved.

The audiologist or hearing aid provider you see should be able to tell you upfront what Medicaid will pay and what you will owe. If they cannot, that is a sign to call your state Medicaid office yourself before your appointment, so you know the cost before you go.

What you need to do before Medicaid will pay

Medicaid requires a hearing test from a licensed audiologist or physician before it will cover a hearing aid. This test must show that you have hearing loss that a hearing aid can help. The test itself is usually covered by Medicaid, though some states charge a small copay. If you have not had a hearing test in the past year, you will need one before you can move forward.

After the test, some states require you to get prior approval from Medicaid before you buy the hearing aid. This means the audiologist or provider sends your test results and the hearing aid prescription to your state Medicaid program, and Medicaid says yes or no before you pay. Other states do not require prior approval; you can buy the aid and then submit the receipt to Medicaid for reimbursement. Ask your provider which process your state uses, because it affects how long approval takes and whether you have to pay upfront.

You will also need to be enrolled in Medicaid at the time you get the hearing aid. If your Medicaid coverage has ended or you are unsure whether you are currently enrolled, contact your state Medicaid office to check your status before you schedule a hearing test.

States that do not cover hearing aids through Medicaid

Missouri and New Hampshire currently do not cover hearing aids as a Medicaid benefit. If you live in one of these states and have Medicaid, you will need to pay for a hearing aid out of pocket, though the hearing test may still be covered. Some people in these states turn to other programs for help paying for hearing aids.

The Hearing Loss Association of America maintains a list of programs that help pay for hearing aids based on income, age, or medical need. Some hearing aid manufacturers offer reduced-price programs for people who cannot afford full cost. Community health centers and nonprofit organizations in your area may also know of local funds or discounts. Your audiologist can point you toward these options if your state does not cover hearing aids through Medicaid.

How to find out what your state covers

Call your state Medicaid office and ask: "Does Medicaid cover hearing aids? If yes, how much does it cover, how often can I get one, and what is my copay?" Write down the answers. You can find your state Medicaid office phone number by searching "[your state] Medicaid" online, or by calling 1-800-MEDICARE and asking for your state's Medicaid number.

You can also ask your primary care doctor's office to look up your coverage for you. Many medical offices have staff who work with Medicaid regularly and can answer these questions quickly. If you already see an audiologist, call them and ask the same question—they often know the coverage rules for your state because they deal with Medicaid claims every day.

Write down the name of the person you spoke with and the date, in case you need to follow up later or if there is a disagreement about what is covered. If you are told something different by two different people, ask to speak with a supervisor or call back and ask again to confirm.

What happens if Medicaid denies your hearing aid

If your state Medicaid program says no to a hearing aid, ask why. Common reasons include: your hearing test did not show enough hearing loss to benefit from an aid, you already received a hearing aid within the time limit your state allows, or you do not meet your state's other coverage rules. Ask what you would need to do to be approved—for example, whether a second opinion from a different audiologist would help, or whether you can reapply after a certain date.

You have the right to appeal a Medicaid denial. Your state Medicaid office can tell you how to file an appeal and what important date you have. The appeal process usually involves submitting additional information (such as a letter from your doctor explaining why you need the hearing aid) and waiting for a decision. Ask your state Medicaid office how long an appeal typically takes in your state.

Frequently Asked Questions

Does Medicare cover hearing aids if I am on both Medicare and Medicaid?

No. Original Medicare does not cover hearing aids or hearing tests. If you are on both Medicare and Medicaid (called "dual may be able to access"), your Medicaid program is the one that may cover hearing aids. Call your state Medicaid office to find out what your state covers. Some states that are dual may be able to access have different rules than other Medicaid beneficiaries, so mention that you have both programs when you call.

Can I get two hearing aids if I have hearing loss in both ears?

It depends on your state. Some states cover two hearing aids (one per ear) as a standard benefit. Others cover only one aid per ear every few years, or one aid total. Ask your state Medicaid office whether two-ear coverage is available and, if so, whether there is an extra cost or time limit between them.

What if my hearing aid breaks and I need a replacement?

Some states cover replacement hearing aids if the original one breaks within a certain time period (such as one year). Others do not. Call your state Medicaid office and ask whether replacement coverage exists. If it does, ask what proof you need—usually a repair estimate from the audiologist showing the aid cannot be fixed.

Do I have to use a specific audiologist or hearing aid brand?

Most states allow you to choose any licensed audiologist or hearing aid provider. However, some states have a list of approved providers, and you may get better coverage if you use someone on that list. Ask your state Medicaid office whether there is a preferred provider list, and ask your audiologist whether they accept your state's Medicaid program before you schedule an appointment.

What if I cannot afford the copay or the part Medicaid does not cover?

Talk to your audiologist about payment plans or discounts. Some providers offer to spread the cost over several months with no interest. Hearing aid manufacturers sometimes have programs for people with low income. The Hearing Loss Association of America and local nonprofit organizations may also know of funds that help cover out-of-pocket costs.