Montana Medicaid covers prescription hearing aids for both adults and kids — adults need at least a 40-decibel hearing loss and prior authorization, with a replacement allowed once every five years; children qualify with a milder 25-decibel loss under EPSDT. State law also requires private insurers to cover hearing aids for kids 18 and younger (one per ear every 3 years); a 2025 bill to extend that to adults was vetoed. MonTECH lends assistive devices and offers low-interest loans, and Montana Accessible Communications (formerly MTAP) provides specialized phone equipment at no cost.
By Lilly Seay · Updated July 2026
Fee-for-service Montana Medicaid covers prescription hearing aids, repairs, and batteries for adults 21+. Criteria: average pure-tone loss of at least 40 dB (at 500/1000/2000/3000 Hz, better ear) for a monaural aid; binaural aids have stricter criteria (two-frequency averages of 40-90 dB at 1-2 kHz in both ears, interaural difference under 15 dB) including six months of successful monaural use. Prior authorization is required for hearing aids, submitted to Mountain Pacific Quality Health via the Qualitrac portal with physician referral, audiogram, and audiologist report. Replacement: once within a 5-year period if the aid is lost, irreparably damaged after warranty, or no longer meets clinical needs. Batteries: up to 4 cells per month per aid (prior authorization needed beyond that). Over-the-counter hearing aids are NOT covered (provider notice dated 01/26/2024). Montana Medicaid is not delivered through managed-care plans.
Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — Montana included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Children under 21 are covered under the EPSDT Well-Child benefit — all medically necessary audiology services and hearing aids, with a lower qualifying threshold (25 dB average pure-tone loss, better ear) than adults. Montana's CHIP is Healthy Montana Kids (HMK), which together with HMK Plus (children's Medicaid) covers audiology and hearing services; families apply at dphhs.mt.gov/hmk or apply.mt.gov.
Group and individual plans (plus state, university, and local-government employee plans and some non-ERISA MEWAs) must cover diagnosis and treatment of hearing loss for covered children 18 or younger, including up to one hearing device with required accessories per ear every 3 years — or more often if a licensed audiologist determines it necessary. Effective for plans issued/renewed on or after January 1, 2022; the statute's 2025 amendment (Ch. 237, L. 2025) did not change the child-only scope. HB 607 (2025), which would have extended the mandate to all ages, was vetoed by Gov. Gianforte on May 2, 2025 as an unfunded insurance mandate. ERISA self-funded employer plans are exempt.
Statute: MCA § 33-22-128 (enacted Ch. 209, Laws of 2021; amended Ch. 237, Laws of 2025)
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.
Montana's market is small and consolidated: three insurers sell 2026 marketplace plans (all bound by the state's children's hearing aid mandate), Medicaid is fee-for-service with no managed-care plans, and Medicare Advantage — where most private hearing aid benefits live — is served mainly by national carriers plus Blue Cross and Blue Shield of Montana.
Montana's Blue plan, part of Health Care Service Corporation, sells 2026 marketplace plans and Blue Cross Medicare Advantage plans. Its state-regulated plans must cover one hearing device per ear every three years for kids 18 and younger under MCA 33-22-128.
One of only two ACA-created CO-OPs still operating nationally. Its Montana individual plans are state-regulated, so the children's hearing aid mandate applies.
Offers 2026 individual plans but has announced it will leave Montana's marketplace after 2026, so current enrollees will choose new plans during the fall 2026 open enrollment.
One of the two largest Medicare Advantage insurers nationally. The average Montana beneficiary can choose from about 14 MA plans in 2026, many including hearing aid benefits that vary by plan — check each plan's Evidence of Coverage.
The largest Medicare Advantage carrier nationally, with hearing benefits delivered through the UnitedHealthcare Hearing network. Montana-specific allowances vary by plan, so confirm details before enrolling.
Yes. Montana Medicaid covers prescription hearing aids, repairs, and batteries for adults 21 and older with at least a 40-decibel average hearing loss in the better ear. You'll need prior authorization — your provider submits a physician referral, audiogram, and audiologist report to Mountain Pacific Quality Health through the Qualitrac portal. A replacement is allowed once in five years if your aid is lost, damaged beyond repair, or no longer meets your needs, and batteries are covered up to four per month per aid. Over-the-counter hearing aids are not covered, and Montana Medicaid is fee-for-service, not managed care.
For children, yes. Montana law (MCA 33-22-128) requires state-regulated group and individual plans — plus state, university, and local-government employee plans — to cover hearing loss treatment for kids 18 and younger, including one hearing device with accessories per ear every three years, or more often if an audiologist determines it's necessary. That applies to marketplace insurers like Blue Cross and Blue Shield of Montana, Montana Health CO-OP, and PacificSource. There's no adult mandate: HB 607, which would have extended coverage to all ages, was vetoed in May 2025. Self-funded employer plans are exempt.
If you're on Medicaid, prescription hearing aids are covered for both adults and kids — start there. Otherwise, MonTECH, Montana's assistive technology program, lets you borrow hearing devices to try before you buy and offers low-interest financial loans for purchasing equipment. Montana Accessible Communications (formerly MTAP) provides specialized phone and communication equipment at no cost to qualifying residents with hearing loss. And if hearing loss is affecting your ability to work, Montana Vocational Rehabilitation and Blind Services may pay for hearing aids as part of an employment plan.
No. Montana Medicaid issued a provider notice dated January 26, 2024 stating that over-the-counter hearing aids are not covered. The program covers prescription hearing aids instead — dispensed through a provider, with prior authorization, a physician referral, and an audiogram documenting at least a 40-decibel average loss for adults. There's an upside: covered prescription aids come with professional fitting and follow-up care. If cost is pushing you toward OTC aids, check whether you qualify for Medicaid first, or try MonTECH's device loan program before spending your own money.
Yes. Kids on Montana Medicaid qualify for hearing aids with a milder hearing loss threshold than adults — a 25-decibel loss rather than the 40-decibel adult standard — under EPSDT, the federal benefit covering medically necessary care for children. Private insurance helps too: Montana's children's mandate requires state-regulated plans to cover one hearing device per ear every three years for kids 18 and younger, or more often if an audiologist says it's needed. Families can also borrow devices through MonTECH while waiting on approvals, and Healthy Montana Kids (CHIP) enrollment is open year-round.
While you sort out coverage, the Hearing Buddy app gives you live captions on your phone — free, instantly.