Illinois is one of the best states in the country for hearing aid coverage: since January 1, 2025, state-regulated private insurance plans must cover medically necessary hearing aids for people of all ages — one aid per ear every 3 years, including exams and fittings. Illinois Medicaid also covers hearing aids for both adults and children, and every Illinois resident with hearing loss can get a free amplified phone through ITAC regardless of age or income. If your plan is a self-funded employer plan (ERISA), the state mandate doesn't apply, so check with HR first.
By Lilly Seay · Updated July 2026
Illinois Medicaid (HFS) covers hearing aids for adults, including exams, fittings, repairs and accessories. A monaural (single) hearing aid does not require prior approval; a binaural or second hearing aid requires prior approval (decision within 30 days). Repairs of $100 or more require prior approval; repairs under $100 do not. Most members receive services through HealthChoice Illinois managed care plans. Separately, Public Act 103-0530 (effective 1/1/2025) expanded Illinois' insurance-code hearing instrument coverage requirement from under-18 to all ages, reinforcing the all-ages coverage environment.
Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — Illinois included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Children under 21 are covered under EPSDT through Illinois Medicaid and the All Kids program (Illinois' children's health coverage/CHIP). Hearing aids, exams, fittings and repairs are covered; families apply through ABE (abe.illinois.gov) or DHS Family Community Resource Centers. Early Intervention (DHS Bureau of Early Intervention) serves children 0-3, and the UIC Division of Specialized Care for Children helps coordinate care for children with hearing loss.
Effective January 1, 2025, state-regulated individual and group policies and managed care plans must cover medically necessary hearing instruments and related services for individuals of ALL ages when prescribed by a qualified hearing care professional — one hearing instrument per ear every 36 months, including audiological exams, selection/fitting and adjustment of ear molds, and medically necessary repairs. No statutory dollar cap; normal cost-sharing (deductibles, copays, coinsurance) applies. Before 2025 the mandate covered only individuals under 18 (in effect since 2019). ERISA self-funded employer plans are exempt. Questions/complaints: Illinois Department of Insurance, 1-866-445-5364.
Statute: 215 ILCS 5/356z.30 (Public Act 103-0530)
Remember: state mandates only reach state-regulated ("fully insured") plans. Self-funded employer plans — covering about two-thirds of insured workers — are exempt under federal ERISA law. One question to HR settles which kind you have.
Illinois is one of the strongest states in the country for hearing coverage: since January 1, 2025, every state-regulated plan — including the marketplace plans from BCBSIL, Ambetter, Molina, Oscar, and UnitedHealthcare — must cover medically necessary hearing aids for all ages, and the HealthChoice Illinois Medicaid plans cover hearing aids for adults and kids alike. About 43% of Illinois Medicare beneficiaries are in Medicare Advantage plans, where hearing extras vary by plan.
The state's dominant Blue plan sells 2026 individual marketplace plans and runs the statewide Blue Cross Community Health Plan for Medicaid. As a state-regulated carrier, its individual and group plans must cover hearing instruments for all ages — one per ear every 36 months — under 215 ILCS 5/356z.30.
Centene's Ambetter/Celtic plans are among the seven carriers on the Illinois marketplace for 2026. As state-regulated policies, they fall under the Illinois all-ages hearing instrument mandate effective January 1, 2025.
Molina sells 2026 marketplace plans and is a statewide HealthChoice Illinois Medicaid plan, so its Medicaid members get the HFS hearing aid benefit — exams, fittings, aids, and repairs, with prior approval needed for a second (binaural) aid.
One of the seven insurers on the 2026 Illinois marketplace; its state-regulated individual plans are subject to the Illinois hearing aid mandate. UnitedHealthcare runs hearing benefits and member hearing aid pricing through its UnitedHealthcare Hearing program — sign in there to see your plan's coverage.
A statewide HealthChoice Illinois plan. Members get Illinois Medicaid's hearing benefit, which covers hearing aids for adults and children — a single aid needs no prior approval, while a second aid or repairs of $100 or more do.
Centene's statewide HealthChoice Illinois plan (also serving current and former DCFS youth through YouthCare). Covers the standard Illinois Medicaid hearing aid benefit for adults and children.
Cook County's Medicaid plan for Chicago-area members. Like all HealthChoice Illinois plans, it covers hearing aids, exams, fittings, and repairs under the state Medicaid benefit.
Yes. Illinois Medicaid (HFS) covers hearing aids for adults, including exams, fittings, repairs, and accessories. A single (monaural) hearing aid doesn't need prior approval; a second aid for the other ear does, with a decision required within 30 days. Repairs of $100 or more need prior approval; smaller repairs don't. Most members get these services through a HealthChoice Illinois managed care plan — Aetna Better Health, Blue Cross Community Health Plan, CountyCare (Cook County), Meridian, or Molina — so start by calling the member number on your card to find a hearing provider in your plan's network.
Yes — for state-regulated plans, Illinois law now requires it at every age. Since January 1, 2025, individual and group policies and managed care plans must cover medically necessary hearing instruments and related services when prescribed by a qualified hearing care professional: one hearing instrument per ear every 36 months, plus audiological exams, ear mold fitting and adjustment, and medically necessary repairs, with no statutory dollar cap (normal deductibles and copays apply). The law is 215 ILCS 5/356z.30. Self-funded employer (ERISA) plans are exempt, so check with HR. Questions or complaints: Illinois Department of Insurance, 1-866-445-5364.
Illinois gives you more paths than most states. If you have Medicaid, hearing aids are covered for adults and children. If you have a state-regulated private plan, the all-ages mandate means your insurance must cover medically necessary aids every 36 months. Beyond insurance, every Illinois resident with hearing loss can get a free amplified phone through ITAC, regardless of age or income. The DHS Division of Rehabilitation Services can help if hearing loss affects your work, DSCC helps children with specialized care, and the Chicago Hearing Society and Illinois Assistive Technology Program offer additional device help.
Public Act 103-0530 — it took effect January 1, 2025, and it's a big deal. Before, Illinois only required state-regulated insurers to cover hearing instruments for people under 18 (in place since 2019). The new law expanded that to all ages: plans must cover one medically necessary hearing instrument per ear every 36 months, plus exams, ear mold selection and fitting, and repairs, when prescribed by a qualified hearing care professional. There's no statutory dollar cap, though your plan's normal cost-sharing applies. The main exception is self-funded employer plans, which are governed by federal ERISA law instead.
While you sort out coverage, the Hearing Buddy app gives you live captions on your phone — free, instantly.