Hearing loss in seniors is a common health issue. Medicaid coverage for hearing aids for adults in the United States varies by state. The good news is that more than half of states provide some level of coverage for hearing aids or cover other services such as hearing tests and exams, hearing aid repairs and replacements, and other items such as batteries and accessories. Reviewing the article will help you understand which benefits apply to you.
How Medicaid works
Medicaid is a joint federal and state program that helps cover health care costs for individuals with limited income and other financial resources. This program offers health coverage for eligible adults and children, including pregnant women and people with disabilities. It also offers some long-term care benefits, such as coverage for skilled nursing home facility services.
While the federal government has general rules that all states must follow, each state runs its own Medicaid program. Therefore, the benefits offered and the eligibility requirements can differ from one state to another.
The cost of hearing aids
The average cost for a pair of hearing aids in 2024 is $4,672 in the U.S. Depending on the type and brand, the price can range from below $1,000 to over $8,000.
The need for hearing aids could present a significant financial challenge for retirees living on a fixed income. This is particularly the case for those with limited assets and resources. However, qualified seniors could find some financial relief with Medicaid coverage.
When does Medicaid cover hearing aids?
According to the Hearing Loss Association of America (HLAA), Medicaid coverage of hearing aids varies significantly from state to state. For instance, in some states, such as Alabama, Arizona, Georgia, Louisiana, and Arkansas, Medicaid does not cover hearing aids at all.
In other states, like Alaska, Medicaid covers hearing aids — including approved accessories and supplies — and hearing item repairs. However, to qualify for this coverage, “these services must be determined medically necessary, prescribed, and ordered by a physician or other licensed healthcare practitioner trained to administer hearing assessments and evaluations within the scope of the practitioner’s license.”
The state of Minnesota also offers extensive coverage for hearing aids through Medicaid, such as:
1. Ear impressions.
2. Earmolds.
3. Hearing aid checks.
4. Parts and accessories.
5. Repairs.
6. Re-casing, remakes, and shell modifications.
Similarly, hearing aids are covered by Medicaid in California, along with hearing aid repair and replacement of hearing aid parts (with the exception of batteries). The hearing aids must be supplied by a hearing aid dispenser via a prescription from an otolaryngologist or the individual’s attending physician.
Hearing aid-related items that Medicaid does not generally cover in many states include:
1. Routine maintenance.
2. Hearing aid batteries.
3. Cord and wire replacement.
4. Cleanings.
5. Repairs while the manufacturer’s warranty is still active.
6. Repairs that the hearing aid manufacturer’s warranty would not otherwise cover.
With that in mind, it is important to understand what your particular state’s Medicaid program will and will not cover with regard to hearing aids so that you’ll know better what to anticipate and can plan accordingly for any out-of-pocket costs.
How to get coverage for hearing aids through Medicaid
Before getting coverage for hearing aids through Medicaid, you must first qualify for the Medicaid program itself in your state. This typically requires that you meet certain low income and asset thresholds. These, too, can differ from state to state.
Next, you must determine if you can get coverage for hearing aids through Medicaid in your state. If you reside in a state where Medicaid covers hearing aids for seniors, you will likely have to take several steps to qualify for these benefits. Depending on your state, these steps will often include the following:
1. Obtaining a hearing assessment and evaluation.
2. Receiving a prescription and order from a qualified physician or other licensed health care professional.
3. Obtaining hearing aids from a specific dispenser or vendor.
4. Requesting prior approval for hearing aid repairs and/or replacement.
Certain covered services may have time limits. For instance, in some states, Medicaid will not provide reimbursement for hearing aid repairs more often than once every 12 months.
The best place to start is with your state’s Medicaid agency, where you can see if you are eligible for Medicaid, apply for coverage, find a health care provider, and check on your application status and claims. You can also verify whether Medicaid covers hearing aids and any limitations on this coverage.
Learn more about whether Medicaid covers hearing aids in your state
To learn more about Medicaid’s coverage of hearing aids in each state — along with limitations and qualification parameters — visit the HLAA’s page detailing Medicaid coverage of hearing aids.
Before proceeding with any type of Medicaid application, it is recommended that you first talk with a professional who is well-versed in this program and can guide you in the right direction for your specific situation.
