Texas Medicaid covers hearing aids at every age — kids get one aid per ear every 5 years, while adults 21+ with significant loss in both ears get one aid (for one ear) every 5 years. If your child is on private insurance, Texas law also requires most state-regulated plans to cover hearing aids and cochlear implants for anyone 18 or younger, one per ear every 3 years. Working adults can also ask Texas Workforce Commission Vocational Rehabilitation to help buy hearing aids needed for a job.
By Lilly Seay · Updated July 2026
Per the TMHP Vision and Hearing Services Handbook (July 2026): adults 21+ with at least a 35 dB hearing loss in BOTH ears may receive 1 hearing aid device (either the left or right ear, not both) every 5 years from the month dispensed. Replacements within the 5-year window require prior authorization; repairs/modifications are payable once per rolling year after the 1-year warranty without prior authorization. There is a 30-day trial period before the device date of service. Fitting/dispensing visits, post-fitting follow-up, and replacement batteries (for devices billed within the past 5 rolling years) are covered. Hearing devices are a benefit at any age, though some types are age-restricted: cochlear implants require prior authorization, and implanted bone-anchored hearing devices are limited to ages 5+ (a non-implanted soft-headband processor is available for younger children). Most members receive services through STAR/STAR+PLUS managed care plans. Clients whose jobs depend on a hearing aid may be referred to Texas Workforce Commission for aids.
Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — Texas included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Children birth through 20 receive 1 hearing aid device PER EAR every 5 rolling years (more generous than the adult one-ear limit), plus exams, fittings, follow-up visits, batteries, and repairs, with medically necessary exceptions available beyond limits under EPSDT (Texas Health Steps). Newborn and school-age screenings are covered. Texas CHIP (for families over Medicaid income limits) also covers hearing tests and hearing aids with low copays. Families apply for both through YourTexasBenefits.com or 2-1-1.
HB 490 (2017), applying to state-regulated plans delivered, issued, or renewed on or after January 1, 2018: health benefit plans must cover medically necessary hearing aids and cochlear implants for covered individuals 18 or younger — one hearing aid per ear every 3 years, one cochlear implant per ear with a new external speech processor every 3 years — plus fitting and dispensing services, ear molds, and related habilitation/rehabilitation. Cost-sharing must be no less favorable than for physical illness generally. ERISA self-funded employer plans are exempt. No adult mandate.
Statute: Tex. Ins. Code § 1367.253
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.
Texas has one of the busiest insurance markets in the country — 16 insurers sell 2026 marketplace plans, led by Blue Cross and Blue Shield of Texas, Ambetter (Celtic and Superior), UnitedHealthcare, Molina, and Cigna, while most Medicaid members are in STAR or STAR+PLUS managed-care plans from carriers like Superior HealthPlan and BCBSTX. State-regulated plans must cover kids' hearing aids under the 2018 mandate; adults rely on Medicaid's limited benefit or their plan's own terms.
The state's flagship insurer, a division of Health Care Service Corporation, selling 2026 individual marketplace plans and serving Medicaid STAR members in the Travis service area (Austin region). Its state-regulated plans must cover hearing aids and cochlear implants for members 18 or younger under Texas's mandate.
Centene's Texas plan runs STAR, STAR+PLUS, STAR Kids, STAR Health (foster care), and CHIP, making it one of the biggest Medicaid carriers in the state; Ambetter marketplace plans are sold through both Superior and Celtic. Medicaid members get the state's hearing benefit: kids one aid per ear every 5 years, adults one aid every 5 years.
Offers 2026 individual marketplace plans in Texas and is one of the leading Medicare Advantage carriers in a state where about 55% of Medicare beneficiaries choose MA. Hearing aid allowances on its MA plans vary by plan and county — check the Evidence of Coverage.
One of the 16 carriers selling 2026 individual marketplace plans in Texas. As state-regulated coverage, its plans must include the child hearing aid and cochlear implant benefit under Tex. Ins. Code § 1367.253; adult coverage varies by plan.
Sells 2026 individual marketplace plans in Texas. Its state-regulated plans fall under the children's hearing aid mandate; for adults, hearing aid coverage depends on the specific policy.
Offers 2026 individual marketplace plans in Texas (note: Aetna/CVS exited the Texas marketplace at the end of 2025). State-regulated Cigna plans must follow the child hearing aid mandate; adult benefits vary by plan.
Yes — with limits worth understanding. Adults 21 and older with at least a 35 dB hearing loss in both ears can get one hearing aid (for one ear, not both) every 5 years. Fitting and dispensing visits, follow-up care, and replacement batteries are covered, and there's a 30-day trial period before the device date of service. Replacements inside the 5-year window need prior authorization; repairs are payable once per rolling year after the 1-year warranty. Most members get this through STAR or STAR+PLUS plans like Superior HealthPlan — and if your job depends on hearing, ask about a Texas Workforce Commission referral.
For children and teens, yes. Under HB 490 (Tex. Ins. Code § 1367.253), state-regulated health plans issued or renewed since January 1, 2018 must cover medically necessary hearing aids and cochlear implants for covered individuals 18 or younger — one hearing aid per ear every 3 years, one cochlear implant per ear with a new external speech processor every 3 years, plus fittings, ear molds, and related habilitation. Cost-sharing can't be worse than for physical illness generally. Self-funded employer (ERISA) plans are exempt, and there's no adult mandate, so adults should check their specific policy.
Several doors are open. If hearing loss affects your job or job search, Texas Workforce Commission Vocational Rehabilitation can help pay for hearing aids as part of an employment plan. The Specialized Telecommunications Assistance Program (STAP) gives vouchers for phones and communication devices. The Texas Technology Access Program (TTAP) lets you borrow and try assistive devices. Families may qualify for the Children with Special Health Care Needs (CSHCN) Services Program, and Texas Medicaid covers hearing aids at every age — kids get one per ear every 5 years, and adults with qualifying loss in both ears get one aid every 5 years.
The standard schedule is one hearing aid every 5 years, counted from the month it was dispensed — one aid per ear for children, and one aid (for one ear) for adults 21 and up. If your aid is lost or fails sooner, replacements within that 5-year window are possible but require prior authorization. Repairs and modifications are payable once per rolling year after the 1-year warranty ends, without prior authorization. Replacement batteries are covered for devices billed within the past 5 rolling years. Your STAR or STAR+PLUS plan handles the approvals, so start with a call to member services.
Yes — if the plan is state-regulated, which marketplace plans are. All 16 insurers selling 2026 Texas marketplace plans, from Blue Cross and Blue Shield of Texas to Ambetter, Molina, UnitedHealthcare, and Cigna, must cover medically necessary hearing aids and cochlear implants for covered kids 18 or younger: one hearing aid per ear every 3 years, plus fitting, dispensing, ear molds, and related habilitation services. Cost-sharing must be no less favorable than for physical illness generally. The catch is employer plans — if your coverage is self-funded through work, the mandate doesn't apply, so ask HR which type you have.
While you sort out coverage, the Hearing Buddy app gives you live captions on your phone — free, instantly.