NC Medicaid pays for hearing aids only for kids and young adults under 21, so adults on Medicaid generally have to look elsewhere — though some NC Medicaid managed care plans (like WellCare) add a limited adult hearing aid benefit as an extra. A state law does require most NC-regulated private plans, including the State Health Plan, to cover hearing aids up to $2,500 per ear every 3 years for anyone under 22. Adults with hearing loss can also get free phone and alerting equipment from the state's DSDHH Equipment Distribution Service, and Vocational Rehabilitation may help pay for hearing aids you need for work.
By Lilly Seay · Updated July 2026
NC Medicaid's hearing aid benefit (Clinical Coverage Policy 7) is limited to beneficiaries under age 21; there is no state-plan hearing aid benefit for adults 21+. However, NC Medicaid is delivered through managed care, and some plans offer a value-added adult benefit — e.g., WellCare of NC's Enhanced Hearing Aid Benefit (clinical policy WNC.CP.276, last reviewed Feb. 2026) covers one medically necessary hearing aid every 2 years for members 21+, though it excludes battery chargers, phone/TV adapters, loss insurance and cosmetic in-the-ear aids — so adults should check their specific plan. No 2024-2026 change adding a statewide adult benefit was found.
Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — North Carolina included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Children under 21 are covered under EPSDT: hearing aids, FM systems, earmolds, accessories, supplies and dispensing fees, with prior approval required (Clinical Coverage Policy 7). NC's separate CHIP program, NC Health Choice, was merged into NC Medicaid effective April 1, 2023 — former CHIP kids now get full Medicaid benefits with no enrollment fees or copays. Families apply through ePASS (epass.nc.gov) or their county DSS, and services are delivered through NC Medicaid Managed Care health plans.
State-regulated health plans (including the State Health Plan for Teachers and State Employees) must cover one hearing aid per hearing-impaired ear, up to $2,500 per hearing aid every 36 months, for covered individuals under age 22, plus initial and replacement aids, evaluation, fitting, adjustments and ear molds ordered by a physician or licensed audiologist. Normal deductibles/coinsurance apply and plans may use utilization review for medical necessity. Self-funded ERISA employer plans are exempt. In effect since 2011 (no recent changes found).
Statute: N.C. Gen. Stat. § 58-3-285
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.
Six insurers sell 2026 marketplace plans in North Carolina, Medicaid runs through managed care with four standard plans (some adding extra hearing benefits), and about 58% of the state's Medicare beneficiaries are in Medicare Advantage — while a state law makes state-regulated plans cover hearing aids for people under 22.
The state's Blue plan and one of six insurers offering 2026 marketplace coverage. As a state-regulated insurer, its fully insured plans must follow N.C. Gen. Stat. § 58-3-285 — up to $2,500 per hearing aid per ear every 36 months for members under 22; adult hearing coverage varies by plan.
Centene's exchange brand, among the six insurers selling 2026 individual plans in North Carolina. Its state-regulated plans are subject to the under-22 hearing aid mandate; adult hearing benefits vary by plan.
Offers 2026 marketplace plans, is a major Medicare Advantage carrier, and runs UnitedHealthcare of North Carolina, one of the four NC Medicaid standard plans. Its hearing care program runs through the UnitedHealthcare Hearing platform; benefit amounts vary by plan.
One of the four NC Medicaid standard plans, and also among the six insurers offering 2026 marketplace coverage. Its base Medicaid benefit covers hearing aids only for members under 21, per state policy — ask about any value-added adult benefits.
A standard plan in NC Medicaid managed care (alongside Carolina Complete Health, AmeriHealth Caritas, and UnitedHealthcare). NC Medicaid's hearing aid benefit is limited to members under 21, so adult members should ask about extra benefits.
Centene's NC Medicaid standard plan, which absorbed WellCare of North Carolina in an April 1, 2026 merger and now serves all six Medicaid regions as the state's largest Medicaid plan. Its value-added hearing benefit gives members 21 and older one hearing aid every two years with a doctor's referral — a rare adult hearing extra in NC Medicaid.
One of the six insurers offering 2026 individual/family plans in North Carolina. Its state-regulated plans must follow the under-22 hearing aid mandate; adult coverage varies by plan.
For most adults, no — NC Medicaid's hearing aid benefit only covers people under 21. But there's a real bright spot: NC Medicaid runs through managed care plans, and some add extra benefits. Carolina Complete Health — which absorbed WellCare of North Carolina in an April 2026 merger and now serves all six Medicaid regions — offers a value-added benefit for members 21 and older: one hearing aid every two years, with a doctor's referral required. If you're with AmeriHealth Caritas, Healthy Blue, or UnitedHealthcare, call member services and ask whether your plan offers any value-added hearing benefit.
Only for young people. N.C. Gen. Stat. § 58-3-285 requires state-regulated health plans — including the State Health Plan for teachers and state employees — to cover one hearing aid per impaired ear, up to $2,500 per aid every 36 months, for covered members under age 22. That includes evaluations, fittings, adjustments, and ear molds ordered by a physician or licensed audiologist. Normal deductibles and coinsurance apply. Adults have no mandate, and self-funded employer (ERISA) plans are exempt at any age — so if you're 22 or older, check your specific policy.
A few good doors to knock on. The state's DSDHH Equipment Distribution Service gives qualifying residents free amplified phones and alerting equipment. NC Vocational Rehabilitation can help pay for hearing aids you need to get or keep a job. The North Carolina Assistive Technology Program lets you borrow and try devices before you buy. Kids and young adults under 21 can get hearing aids through NC Medicaid, and under-22s on state-regulated insurance are covered up to $2,500 per ear every 3 years. Adults on Medicaid should ask their plan about extra hearing benefits.
For members under 22 on state-regulated Blue Cross NC plans, yes — the state mandate requires coverage up to $2,500 per hearing aid per ear every 36 months, including fitting and ear molds. For adults, it depends on your specific plan, because North Carolina's law stops at age 22. Blue Cross NC is one of six insurers selling 2026 marketplace plans here (alongside Ambetter, AmeriHealth Caritas, Cigna, Oscar, and UnitedHealthcare), and hearing aid coverage on adult plans varies — check your benefits booklet or call the number on your card.
Original Medicare doesn't, but about 58% of North Carolina's Medicare beneficiaries — over 1.3 million people — choose Medicare Advantage, and many MA plans include hearing aid benefits. The average NC beneficiary can pick from 33 MA plans for 2026, and everyone in the state has at least one $0-premium option. Benefit amounts vary a lot between plans, so before buying hearing aids, check your plan's Evidence of Coverage or call member services to ask exactly what's covered and through which hearing network.
While you sort out coverage, the Hearing Buddy app gives you live captions on your phone — free, instantly.