Verified July 2026 · Official Sources

Hearing Aid Insurance in Wisconsin

Wisconsin is one of the friendlier states for hearing help: Medicaid (ForwardHealth/BadgerCare Plus) covers hearing aids for both kids and adults, and state law makes most private insurers cover hearing aids and cochlear implants for children under 18. If cost is still a barrier, the Division of Vocational Rehabilitation can help pay for hearing aids you need to work, and the TEPP program gives vouchers for amplified phones and other telecom equipment.

By Lilly Seay · Updated July 2026

Medicaid — Adults 21+
Covered
Medicaid — Kids Under 21
Covered (EPSDT)
Private Plans Must Cover
Children only

Medicaid in Wisconsin: Adults 21 and Older Covered

ForwardHealth (Wisconsin Medicaid/BadgerCare Plus) covers medically necessary hearing aids for adults. All hearing instruments require prior authorization, with extra documentation for binaural (two-ear) fittings. Replacement is generally on a roughly 3-year cycle: KFF's Medicaid benefits survey lists Wisconsin's adult limit as 1 hearing aid per 3 years and 1 repair per 6 months, and ForwardHealth policy uses a 3-year hearing aid life expectancy when reviewing replacement requests. Hearing exams, fittings, ear molds, and hearing aid batteries are covered; batteries are exempt from copays, and small copays on other hearing services do not apply to children under 18, HMO enrollees, or nursing home residents. Repairs are covered once the manufacturer's warranty (usually the first year) has lapsed. Most members receive the benefit through BadgerCare Plus HMOs, which must cover at least what fee-for-service covers. No 2024-2026 cuts or expansions to the adult benefit were identified; confirm current prior-authorization specifics with ForwardHealth Member Services at 1-800-362-3002.

Medicaid for Kids: Always Covered Covered

Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — Wisconsin included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Children under 21 are covered under EPSDT, which Wisconsin calls HealthCheck. Wisconsin runs its Medicaid and CHIP together as BadgerCare Plus — there is no separately branded CHIP program — so families apply once through access.wisconsin.gov or their county agency. Hearing screenings, exams, hearing aids, ear molds, batteries, and repairs are covered when medically necessary; hearing aids require prior authorization, replacement is generally supported on a 3-year life-expectancy cycle (sooner with documented medical need), and children under 18 are exempt from Medicaid copays.

Does Wisconsin Require Private Insurance to Cover Hearing Aids? Children only

State-regulated health plans and self-insured governmental/school plans must cover hearing aids AND cochlear implants — plus related fitting, procedures, surgery, and therapy — for children under 18 who are certified as deaf or hard of hearing by a physician or by a licensed audiologist (including one practicing under an interstate compact privilege). Coverage of hearing aids must include at least one hearing aid per ear per child every 3 years. Normal deductibles/cost-sharing may apply. In effect since 2010. The broader statute (§ 632.895) was amended in 2025 (Acts 20 and 103), but those changes concern dietitian licensure and breast cancer screening — the children's hearing aid/cochlear implant subsection is unchanged. ERISA self-funded private employer plans are exempt. There is no mandate for adults.

Statute: Wis. Stat. § 632.895(16) (2009 Wisconsin Act 14)

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.

Wisconsin Programs That Help Pay for Hearing Aids

  • Telecommunications Equipment Purchase Program (TEPP) — Run by the Public Service Commission of Wisconsin. Issues vouchers to help people who are deaf or hard of hearing buy specialized telephone equipment (amplified phones, captioned phones, TTYs, etc.). Hard-of-hearing voucher users are exempt from the usual $100 copay, and low-income applicants can get copay help through the Telecommunication Assistance Program (TAP). Applications are processed first-come, first-served (typically 3-4 weeks), and you can apply for another voucher 35 months after your last voucher's completion date.
  • Wisconsin Division of Vocational Rehabilitation (DVR) — DVR can help pay for hearing aids and other assistive technology when hearing loss is a barrier to getting or keeping a job. DVR maintains a dedicated Hearing Aid Policy and Procedures (current version effective May 2026, at dwd.wisconsin.gov/dvr/policy-guidance/services/hearing-aids.htm) covering evaluation, payment rates, maintenance, repairs, and batteries, and counselors walk you through the process. Assistance is not automatic — it must be determined necessary for your employment plan.
  • WisTech (Wisconsin Assistive Technology Program) — Wisconsin's federal Assistive Technology Act program, housed at the Department of Health Services. Provides information on selecting and funding assistive technology, plus device demonstrations and loans — including hearing-related devices — so you can try before you buy.

Major Insurers in Wisconsin

Wisconsin has one of the most competitive insurance markets in the country: 12 insurers sell 2026 marketplace plans, 13 HMOs serve BadgerCare Plus Medicaid members, and national carriers like UnitedHealthcare, Humana, Aetna, and Anthem compete for the 57% of Medicare beneficiaries in Medicare Advantage. State-regulated plans here must cover hearing aids and cochlear implants for children under 18.

Marketplace + Medicare Advantage + BadgerCare Plus HMO

Sells 2026 individual marketplace plans, Medicare Advantage plans, and runs UnitedHealthcare of Wisconsin, a BadgerCare Plus HMO. Its state-regulated Wisconsin plans must cover hearing aids and cochlear implants for children under 18 under Wis. Stat. § 632.895(16); adult hearing benefits vary by plan.

Quartz
Marketplace + BadgerCare Plus HMO

A Wisconsin-based insurer offering 2026 marketplace plans and serving BadgerCare Plus members as an HMO. Its BadgerCare plans must cover at least what fee-for-service Medicaid covers, which includes adult hearing aids with prior authorization.

Dean Health Plan
Marketplace + BadgerCare Plus HMO

A longtime south-central Wisconsin insurer selling 2026 marketplace plans and serving BadgerCare Plus members. As a state-regulated carrier, its individual and group plans must cover children's hearing aids and cochlear implants under the state mandate.

Security Health Plan
Marketplace + BadgerCare Plus HMO

Marshfield-based Security Health Plan offers 2026 marketplace coverage and is one of the thirteen BadgerCare Plus HMOs. Its BadgerCare members get at least the same hearing benefits as fee-for-service Medicaid, including covered hearing aids and batteries.

BadgerCare Plus HMO + Medicare Advantage

Serves Wisconsin Medicaid members as a BadgerCare Plus HMO and offers Medicare Advantage plans in the state. Its BadgerCare plans must cover at least the fee-for-service hearing aid benefit; MA hearing allowances vary by plan, so check the Evidence of Coverage.

BadgerCare Plus HMO

Continues to serve BadgerCare Plus Medicaid members as an HMO, though it exited Wisconsin's individual marketplace at the end of 2025. As a BadgerCare HMO it must cover at least what fee-for-service Medicaid covers, including adult hearing aids with prior authorization.

Medicare Advantage

One of the major Medicare Advantage carriers in Wisconsin, where 57% of Medicare beneficiaries choose MA plans. Hearing aid benefits differ by plan and county — compare on Medicare.gov or read the plan's Evidence of Coverage.

Medicare Advantage

Offers Medicare Advantage plans across Wisconsin alongside UnitedHealthcare, Humana, Anthem, and Wellcare (Centene). Hearing aid allowances vary from plan to plan, so verify a specific plan's hearing benefit before enrolling.

How to Confirm Your Coverage in Wisconsin

  1. Call the member services number on your insurance card and ask: "Does my plan include a hearing aid benefit or allowance — how much, and how often? Please check hearing services billing codes V5008–V5299."
  2. If you have job-based insurance, ask HR whether the plan is fully insured or self-funded — that decides whether Wisconsin's insurance rules apply to you.
  3. On Medicaid or a Medicaid managed-care plan? Call the number on that card and ask about hearing aids, exams, and prior authorization.
  4. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) at 1-877-839-2675 or shiphelp.org.
  5. If you're denied, appeal — you have 180 days for private-plan internal appeals, and a medical-necessity letter from your audiologist materially helps.

Wisconsin Hearing Aid Insurance Questions

Yes. ForwardHealth — Wisconsin Medicaid and BadgerCare Plus — covers medically necessary hearing aids for adults, along with exams, fittings, ear molds, and batteries (batteries are even exempt from copays). Every hearing instrument needs prior authorization, with extra documentation if you're being fitted for both ears, and replacement generally runs on a roughly three-year cycle. Repairs are covered once the manufacturer's warranty lapses. Most members get this benefit through a BadgerCare Plus HMO like Quartz, Anthem, Molina, or UnitedHealthcare, which must cover at least what fee-for-service covers. Questions? Call ForwardHealth Member Services at 1-800-362-3002.

For children, yes. Wisconsin law (Wis. Stat. § 632.895(16)) requires state-regulated health plans — and self-insured government and school plans — to cover hearing aids and cochlear implants, plus fitting, surgery, and therapy, for kids under 18 certified as deaf or hard of hearing by a physician or licensed audiologist. Plans must cover at least one hearing aid per ear every three years, though normal deductibles and cost-sharing can apply. There's no mandate for adults, and self-funded private employer (ERISA) plans are exempt — so adults should check their specific policy.

Wisconsin gives you more paths than most states. If you qualify for Medicaid or BadgerCare Plus, hearing aids are covered at every age with prior authorization. If hearing loss affects your ability to work, the Division of Vocational Rehabilitation (DVR) can help pay for hearing aids you need on the job. The TEPP program provides vouchers toward amplified phones and other telecommunications equipment, and WisTech, the state's assistive technology program, offers device demonstrations and loans so you can try before you buy. For kids under 18 with private insurance, state law requires coverage.

All of them — every BadgerCare Plus HMO must cover at least what fee-for-service Medicaid covers, and that includes hearing aids, exams, fittings, and batteries. Wisconsin's thirteen BadgerCare Plus HMOs are Anthem Blue Cross and Blue Shield, Chorus Community Health Plans, Dean Health Plan, Group Health Cooperative of Eau Claire, Group Health Cooperative of South Central Wisconsin, iCare, MercyCare, MHS Health Wisconsin, Molina Healthcare, Network Health Plan, Quartz, Security Health Plan, and UnitedHealthcare of Wisconsin. Prior authorization is still required for hearing instruments, so work with a Medicaid-enrolled audiologist who can submit the paperwork.

Many do — and about 57% of Wisconsin's Medicare beneficiaries are enrolled in Medicare Advantage, with an average of 21 plans available in 2026. Carriers offering MA plans in the state include UnitedHealthcare, Humana, Aetna, Anthem Blue Cross and Blue Shield, and Wellcare (Centene). Since Original Medicare doesn't cover hearing aids, an MA plan's hearing benefit can make a real difference. Allowances and provider networks vary by plan and county, though, so compare specific plans on Medicare.gov or read the Evidence of Coverage before choosing.

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