Does Medicaid Cover Hearing Aids?

Alabama Medicaid's Hearing Services policy states directly that 'hearing services or hearing aids are not covered for adults' (21+). Coverage is limited to EPSDT-eligible children under 21 under Alabama Administrative Code ch. 560-X-19 and the Audiology/Hearing Services provider manual chapter. No 2024-2026 adult expansion found. Alabama Medicaid is delivered largely fee-for-service (with primary-care case management), not through comprehensive managed-care plans.

Per the official 2025 Alaska Medicaid Recipient Handbook (revised April 16, 2025), adult hearing services include audiology, diagnostic testing, hearing therapy, rehabilitative therapy, hearing aids (including approved accessories and supplies), and hearing item repairs; services must be prescribed/ordered by a physician or other licensed practitioner. After the manufacturer's warranty expires, adults are allowed up to two new ear molds per ear, two repairs per hearing aid, and one full replacement of a lost or broken device within a three-year period. Service (prior) authorization may be required for specific items, including certain hearing aids. Alaska Medicaid is fee-for-service (no managed care). Note: some local provider websites incorrectly state adults are not covered — the state handbook is the controlling source.

AHCCCS does not pay for hearing aids for members 21 and older — its covered services list specifies hearing aids for children under age 21 only. Recent change: effective October 1, 2025, AHCCCS added coverage of cochlear implants, related rehabilitation, and outpatient speech therapy for adults 21+ when medically necessary — a notable 2025 expansion, but it does not extend to conventional hearing aids. Diagnostic audiology may be covered when medically necessary. Nearly all AHCCCS members receive services through managed-care plans (AHCCCS Complete Care).

The Arkansas Medicaid Hearing Services provider manual limits hearing services coverage to beneficiaries under age 21 in the Child Health Services (EPSDT) program; adults 21+ have no hearing aid benefit. No 2024-2026 adult expansion found. Note that most Medicaid expansion adults are enrolled in private qualified health plans through ARHOME rather than traditional fee-for-service — hearing benefits in those plans follow the plan's terms. Confirm current status with the Arkansas Medicaid office (1-800-482-5431).

Medi-Cal restored the adult hearing aid benefit on Jan 1, 2020. Adults 21+ have a $1,510 per-person cap per state fiscal year (July 1–June 30) covering hearing aids, molds, supplies, an initial set of batteries, rental, and six visits for fitting/adjustment/training with the same vendor; hearing exams and audiology testing are covered separately. The cap can be exceeded with prior approval when medically necessary, and replacements for aids lost, stolen, or irreparably damaged (with documentation) don't count against it. Replacement batteries are only paid for members under 21. Adults get one standard battery packet with a new aid and buy batteries after that. The cap does not apply to pregnancy-related services, members under 21, nursing facility or ICF residents, or members of PACE, SCAN, or AHF plans. A Treatment Authorization Request (prior authorization) is required to buy or rent a hearing aid and for repairs over $25, and adults need a prescription from an otolaryngologist or attending physician plus an audiological evaluation. Most members receive the benefit through their Medi-Cal managed care plan.

Health First Colorado's Audiology Billing Manual states plainly that hearing aids are a covered benefit only for members ages 20 and under: 'Hearing aids for adults are not a covered service.' This did not change in 2024-2026. Diagnostic hearing exams may be covered for adults when medically necessary, but the devices themselves are not. Cochlear implants are covered for members aged 12 months through 20 years, with replacement components covered at all ages.

HUSKY Health (HUSKY A, C, and D) covers hearing aids and related audiology services for adults, delivered fee-for-service through the Connecticut Medical Assistance Program (CT uses an ASO model rather than private managed care plans). Providers must follow DSS policy, prior authorization, and fee-schedule requirements; devices are reimbursed up to fee-schedule maximums. Exact replacement-interval rules for adults are set in DSS policy/fee schedules — check with your provider or the CMAP Provider Assistance Center (1-800-842-8440).

Delaware Medicaid's own policy covers hearing aids only for members under 21. The DMAP Supplies and DME Provider Policy Manual (section 5.17) says 'The DMAP may cover hearing aids for individuals who are under 21 years of age,' so adults 21 and older have no state hearing aid benefit. One of the three Diamond State Health Plan managed care plans, Highmark Health Options, lists adult hearing aids as an extra benefit: one hearing aid per ear every 2 years plus 1 year of batteries for members 21 and older. That is a plan extra, not a state benefit, so it can change from year to year. We could not confirm whether AmeriHealth Caritas Delaware or Delaware First Health offer anything similar, so adults should ask their plan directly.

DC Medicaid covers hearing aids for adults when medically necessary. KFF's Medicaid benefits survey lists DC adult hearing aid coverage as requiring a utilization review before the service rather than a fixed numerical limit. Most beneficiaries receive the benefit through Medicaid managed care plans (AmeriHealth Caritas DC, MedStar Family Choice DC, CareFirst CHPDC), which maintain their own hearing aid medical-necessity policies under DHCF guidelines. Specific replacement intervals, battery, and repair rules are set in plan/DHCF policy rather than published as a fixed statewide schedule — confirm with your managed care plan or DHCF at (202) 442-5988. No 2024-2026 cuts to the adult benefit were identified.

Florida Medicaid covers hearing services for recipients of all ages — verified against the Hearing Services Coverage Policy (June 2016, incorporated in Rule 59G-4.110, F.A.C.): one new (not refurbished) hearing aid per ear every 3 years for recipients with moderate or greater hearing loss, one hearing assessment every 3 years to determine candidacy, one fitting/dispensing service per ear every 3 years, up to 3 pairs of ear molds per year, up to 2 hearing aid repairs every 366 days after the 1-year warranty expires, and bone-anchored hearing aid / cochlear implant external components and batteries after the manufacturer warranty ends. No coinsurance, copayment, or deductible. Exceeding these limits (or not meeting the hearing-loss criteria) requires prior authorization. Most enrollees get the benefit through Statewide Medicaid Managed Care plans, which cannot be more restrictive than the state policy and sometimes add expanded benefits — Sunshine Health, for example, lists expanded adult hearing benefits (a hearing aid assessment/fitting every 2 years and a hearing aid per ear every 2 years). No adult benefit cuts identified in 2024-2026.

Georgia Medicaid does not cover hearing aids for adults — hearing aids are covered only for members under 21 through EPSDT. Adult members get limited diagnostic/medical ear care but not devices; Georgia's own DHS policy manual (PAMMS 2928) confirms Medicaid provides hearing aids only to minors and points adults 18+ to the state hearing aid distribution program instead. Care is delivered through Georgia Families managed care (CMOs including Wellpoint — formerly Amerigroup — CareSource, and Peach State Health Plan); some plans offer small value-added extras, so it is worth asking your plan. No adult benefit was added in 2024-2026.

Med-QUEST (QUEST Integration) covers hearing services for adults and children, delivered entirely through managed care plans (HMSA, AlohaCare, Kaiser Permanente, 'Ohana, UnitedHealthcare Community Plan). The state's QUEST Integration plan contract requirements (RFP-MQD-2021-008) say plans must cover hearing aids once every 24 months, analog or digital, with a warranty and a trial or rental period. Adults also get a fitting or hearing aid check once every 3 years and an initial evaluation once a year. Prior authorization is required for all hearing aid devices. These are contract requirements, and a plan's current contract may differ slightly, so confirm details with your QUEST health plan.

Idaho Medicaid does not cover hearing aids for participants 21 and older — coverage of non-implantable and implantable hearing aids is limited to under-21 (IDAPA 16.03.09.742; Idaho Medicaid Audiology Services / DMEPOS provider handbooks). Adults do get covered diagnostic audiology (audiometric and auditory function testing, cochlear implant evaluation/programming) when medically necessary. 2025-2026 changes: the Governor's FY2027 budget proposed eliminating adult audiology services entirely amid a cited $500 million shortfall, but after advocacy (2,400+ letters) the legislature's final budget excluded that cut — confirmed April 2, 2026 — so adult audiology exams remain covered; a January 2026 prior-authorization policy for therapy services after 20 sessions remains in effect. Services are fee-for-service (Idaho has no comprehensive Medicaid managed care for this benefit).

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.

Indiana Health Coverage Programs (IHCP) covers hearing aids for adults, but prior authorization is required for every hearing aid purchase (405 IAC 5-19-13). Coverage requires documented medical necessity; a hearing aid is denied for an ear with a pure-tone average of 30 dB or better, calculated across 500/1,000/2,000/3,000 Hz (an aid for the worse ear can still qualify). Covered types: conventional, bone-anchored, CROS/BiCROS, programmable (canal aids are not covered). Replacements require PA and are limited to once every 5 years (per provider module with policies as of Oct. 1, 2025). Repairs covered once every 12 months without PA (not while under warranty); batteries, sound hooks, tubing and cords covered without PA; audiological assessment covered once every 3 years; dispensing/fitting fee once per 5 years. Delivered through fee-for-service and managed care (Healthy Indiana Plan, Hoosier Care Connect, Hoosier Healthwise, PathWays for Aging).

Iowa Medicaid covers hearing aids for adults under Iowa Admin. Code r. 441-78.14, including testing to establish need, hearing aid evaluation, ear molds, batteries and repairs (in-house, manufacturer and dealer). Prior approval is required to replace a hearing aid less than 4 years old and for hearing aids costing over $650 (approved for documented educational/vocational need with comparison testing). Binaural (two-ear) coverage requires meeting criteria such as educational/vocational need, blindness, marked restriction of daily activities, or safety. Adults 18+ may waive the physician exam by signing an informed consent statement. Payment includes acquisition cost plus a six-month dispensing fee. Most members are served through Iowa Health Link managed care organizations (Iowa Total Care, Molina, Wellpoint).

KanCare (Kansas Medicaid) covers hearing aids for adults with no age limit, along with hearing tests, dispensing fees, and batteries (6 a month for one aid, 12 for two), per the KMAP Professional Fee-for-Service Provider Manual (updated March 2026, Audiology section 8400). A replacement is allowed every 4 years when a medical exam confirms the need, and a lost or broken aid can be replaced once in 4 years with prior authorization. Adults get two aids only if they are legally blind with hearing loss in both ears, already used two aids, or need two for their job. Prior authorization is required for replacements and bone-anchored (BAHA) processors; the manual does not say whether a first aid needs it. Benefits come through KanCare managed care plans (Healthy Blue, Sunflower State Health Plan, UnitedHealthcare Community Plan), so confirm the steps with your plan.

Kentucky Medicaid covers hearing aids for adults, a benefit added through Gov. Beshear's dental/vision/hearing expansion (all audiology codes billable for adults and children effective Jan 1, 2023, and still active in the July 1, 2025 fee schedule). The 2025 KY Medicaid Audiology Fee Schedule limits hearing aids to a maximum of $1,200 per ear per 36 months, with a manufacturer's invoice required (submitted with a paper claim), plus covered dispensing fees, fittings (6 per year), hearing aid checks and electroacoustic evaluations (1 per year for adults over 20), repairs ($115), batteries (12 per ear per month, effective 5/1/2024), and ear molds. Hearing exams are limited to 1 per calendar year for adults over 21 (4 per year for under 21), and a physician referral to the audiologist is required. Most members receive services through Medicaid managed care plans (e.g., Humana Healthy Horizons, WellCare, Passport).

The official LDH Medicaid Services Chart limits hearing aid coverage to beneficiaries 0 through 20 years of age; the state plan does not cover hearing aids for adults 21+. Adults do get covered hearing exams through Healthy Louisiana managed-care plans, and some MCOs add hearing aids as a value-added benefit — e.g., Louisiana Healthcare Connections covers members 21+ for one hearing exam per year and one hearing aid every two years, including earpieces and batteries. LDH circulated a draft managed-care hearing aid clinical policy in December 2025 (Humana LA.CLI.045.001), so plan-level rules may continue to evolve; confirm with your specific plan.

MaineCare covers hearing aids for adults 21+ with full MaineCare benefits (not those with only MSP-QMB coverage); prior authorization is required for hearing aids for adults over 21. Historically the benefit was effectively one (monaural) hearing aid, but under P.L. 2025 ch. 446 (LD 167, 'An Act to Provide 2 Hearing Aids to MaineCare Members with Diagnosed Hearing Loss'), binaural/two hearing aids are covered for members with diagnosed hearing loss — DHHS issued temporary billing guidance for dates of service Nov 15, 2025 - June 30, 2026, with routine claims and PA processes effective July 1, 2026. Hearing loss must be documented by a primary care provider or licensed audiologist, the aid must be dispensed by a licensed audiologist or hearing aid dealer, and severity criteria apply. MaineCare is largely fee-for-service (no MCOs).

Since July 1, 2018, Maryland Medicaid covers hearing aids, cochlear implants, and auditory osseointegrated devices (BAHAs) for adults 21+. Clinical criteria: a unilateral hearing aid requires a pure tone average of 40 dB or greater (500-3000 Hz) in the better ear, audiologist recommendation/fitting, and physician medical clearance within 6 months for the initial aid; bilateral aids require additional criteria (statutory blindness, prior successful bilateral use, or documented hearing-related disability in educational/vocational/community settings with demonstrated bilateral benefit). Services are delivered through HealthChoice managed-care plans, whose medical-necessity policies apply. The clinical criteria document does not state a fixed statewide replacement interval — replacements are based on medical necessity, so confirm with your MCO.

MassHealth covers hearing aids, exams, fittings, earmolds, batteries, and repairs for adults when medically necessary. A prior-authorization check is required for any member who received a hearing aid within the past 60 months (5 years), and replacements always need prior authorization with documentation (audiological evaluation, medical clearance obtained within 6 months, and justification for loss/damage/medical change). Providers verify hearing aid history in real time through the Provider Online Service Center. Most members are enrolled in MassHealth ACOs/MCOs, which must cover the benefit; rules are in the MassHealth Hearing Instrument Specialist Manual and 130 CMR 416/426. No 2024-2026 cuts identified.

The MDHHS Medicaid Provider Manual (Hearing Services and Devices chapter, October 1, 2026 version) covers hearing aids, repairs, earmolds, batteries, supplies, and accessories for all eligible beneficiaries, with no adult age cutoff. Limits: one (monaural) or two (binaural) hearing aids once every 5 years, medical clearance based on an evaluation by a physician/PA/APRN within 6 months before dispensing, aids purchased through the MDHHS volume-purchase contract, replacement earmolds once per 12 months for adults 21+ (more often for children), supplies/accessories up to the maximums on the MDHHS Hearing Aid Dealers Fee Schedule, and conformity evaluations and fitting/checking visits up to 2 per year each without prior authorization. No prior authorization is needed for one or two contract aids within these limits; it applies to replacement aids within 5 years, non-contract aids, and certain items. New for 2025: effective Oct 1, 2025 (policy 2530-Hearing), disposable batteries increased to 144 per year per aid (max 72 dispensed per day) with no physician order required, reimbursed at $1.42 per battery. Most beneficiaries are in Medicaid Health Plans (MCOs), which must cover at least the fee-for-service benefit. Note: some third-party websites claim adult coverage ended in 2009, but that is not supported by the current provider manual.

Minnesota Health Care Programs (Medical Assistance and MinnesotaCare) cover hearing aids for adults when prescribed as medically necessary by an audiologist, along with exams, fittings, batteries, and accessories. DHS purchases aids through a state volume-purchase Hearing Aid Contract (contracted vendors, models, and prices are published by DHS), and providers must use contract vendors. Adults 21 and older can get one hearing aid or one set of two aids every 5 years (MHCP Provider Manual, Hearing Aid Services). Authorization is needed for non-contract aids and for replacements within 5 years. Members of limited-benefit programs, such as Emergency Medical Assistance and Alternative Care, are excluded. Many members are in managed care plans (e.g., Blue Plus, UCare), which must cover the benefit. No 2024-2026 cuts identified.

Mississippi Medicaid's Hearing Services rules (Title 23, Part 218) cover cochlear implants (unilateral and, in defined circumstances, bilateral) and implantable auditory osseointegrated devices (bone-anchored devices, only for beneficiaries age 5 and older with qualifying conditions) plus non-implantable AODs with prior authorization, along with batteries/repairs for those devices — but conventional hearing aids are not a covered adult benefit; hearing aid coverage flows only through EPSDT for beneficiaries under 21. Multiple recent surveys list Mississippi among the states with no adult Medicaid hearing aid coverage. Some home- and community-based waiver participants may get hearing-related assistive devices through waiver services. Delivered partly through MississippiCAN managed care. No 2024-2026 expansion identified.

Since August 28, 2025, SB 79 amended RSMo 208.152 so MO HealthNet covers hearing aids for adults, not just children, pregnant women, and blind participants as before. The adult benefit is limited. The April 2026 MO HealthNet Hearing Aid Provider Manual allows adults one new hearing aid plus related services once every 4 years, and two aids (one for each ear) for adults 21 and older only in cases of blindness. Every hearing aid and dispensing fee needs prior authorization, and repairs plus post-fitting adjustments are capped at 3 per rolling year. MO HealthNet Managed Care plans must cover hearing aid services too, so members can use the benefit through their plan.

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 plus a documented school or work need to understand speech. The first (monaural) aid has no such requirement. 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.

Nebraska Medicaid covers hearing aids and related services for adults under 471 NAC 8. Adults 21 and older can get no more than one aid per ear every 4 years, only when medically necessary and prescribed by a physician (Form DM-5H documents the hearing loss), with an audiologist evaluation. Prior authorization is needed only for aids or assistive listening devices billed at $500.01 or more, accessories or repairs of $150 or more, and any replacement of a lost or stolen aid. A published Medicaid fee schedule sets rates, and if a member chooses a costlier model, they pay the difference. For nursing facility residents, batteries are covered only with the first fitting. Most members receive benefits through Heritage Health managed care plans.

Nevada Medicaid (Medicaid Services Manual Chapter 2000, Audiology Services) covers hearing testing, hearing aids, batteries, accessories, fittings, repairs, and replacements for adults. A hearing aid is covered once every 24 rolling months. Adults need a hearing loss of at least 30 dB (500 to 3000 Hz) and a physician exam within 6 months before the fitting, and a 12-month manufacturer warranty is required. Prior authorization (Form FA-1) is needed only for aids that cost more than $350 each, for any additional aid within 24 months, and for replacements outside the guidelines. Batteries are limited to one package of four per aid per month for adults 21 and older, and more needs prior authorization. Most members in Clark and Washoe counties get benefits through managed care plans, so authorizations may go through the plan.

NH Medicaid covers hearing aids for adults 21 and older under the state's rules (He-W 567). An adult qualifies for one aid with a hearing loss in both ears averaging 35 dBHL or worse (1,000 to 4,000 Hz), and that single aid does not need prior authorization. A second aid needs prior authorization and is covered only for college or job training, a job-related hearing need, or legal blindness. Medicaid pays for the least costly aid that meets your needs (or a pocket talker), a hearing aid evaluation once every 2 years, ear molds, and batteries. A replacement is covered when your hearing gets worse or the aid can't be repaired, but not when an adult's aid is lost. Most members get benefits through NH Medicaid Care Management plans.

NJ FamilyCare (Medicaid) covers hearing aids for adults. Per the state's DDHH Grace's Law guidance, NJ FamilyCare members of all ages are eligible for one hearing aid (or cochlear implant) per ear every 24 months with no monetary cap, with a prescription from a licensed physician or audiologist. Under N.J.A.C. 10:64-2.1, for beneficiaries 21+, a physician or advanced practice nurse must first determine that an audiological examination is medically necessary before a hearing aid is prescribed (an otologic exam always precedes a hearing aid prescription). Benefits are delivered through NJ FamilyCare managed-care plans, and benefit administration can vary by NJ FamilyCare plan letter, so members should confirm details with their plan. Recent change: the Grace's Law amendment signed January 16, 2024 (effective April 15, 2024) strengthened this benefit by removing age and dollar limits.

NM Medicaid covers medically necessary hearing aids for adults under rule 8.324.5 NMAC. Limits: one monaural or binaural hearing aid purchase per four-year period (exceptions for progressive hearing loss, post-surgical changes, traumatic injury, or a lost aid). Binaural (two-ear) aids are approved for recipients with bilateral loss who are attending an educational institution, seeking or holding employment, or have a documented history of binaural fitting. All hearing aid dispensing, purchase, rental, and replacement requires prior authorization, plus medical clearance from the member's primary care provider. The dispensing fee includes fitting, ear molds, and one package of batteries per aid; additional batteries are reimbursed separately, and repairs over $100 require prior authorization. Since July 1, 2024, benefits run through Turquoise Care managed-care plans (BCBSNM, Molina, Presbyterian, UnitedHealthcare) — a program rename/restructure replacing Centennial Care, not a benefit cut.

NY Medicaid covers hearing aids for adults 21 and older when hearing loss can't be corrected by medical or surgical means and the pure tone average (500, 1000, 2000 Hz) is 30 dB or greater in the better ear, per the eMedNY Hearing Aid/Audiology policy manual (effective July 1, 2026). Most hearing aids, including a single aid for an adult, are approved in real time through the automated Dispensing Validation System (DVS). Full prior approval is required for two aids for members 21 and older, replacements beyond the frequency limits, CROS/BiCROS aids, and repairs of $70 or more. Two aids for an adult also require a school or work need, use of two aids within the past 5 years, or significant vision loss. Coverage includes audiological exams, fitting and dispensing, ear molds, accessories, repairs, replacement parts, and batteries. FM systems, assistive listening devices, and tinnitus maskers are not covered. Most members receive the benefit through Medicaid managed-care plans.

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.

Adults 21+ qualify with average hearing loss ≥40 dB at 500/1000/2000 Hz (DME manual hearing aid policy, revised July 2024). Service authorization is required. Recent improvements: effective April 1, 2024 binaural (two-ear) hearing aids are covered for all ages (previously denied for 21+), and as of July 1, 2024 the CMN form requirement was dropped. Replacement no sooner than 5 years without an approved authorization showing changed hearing/need; lost aids are not replaced early. Purchase includes fitting, a 1-year warranty against loss or damage and first-year maintenance/servicing; dispensing fee paid once per aid (covers up to 3 fitting/programming visits); batteries covered without authorization (6/month monaural, 12/month binaural); repairs covered once warranties expire (authorization needed above $250 or for a second repair within 6 months). Delivered fee-for-service through ND Medicaid's DME program, not managed care.

Covered at all ages under Ohio Admin. Code 5160-10-11 (current version effective Jan. 1, 2024). Adults 21+ need a hearing loss of at least 31 dB; a Certificate of Medical Necessity (form ODM 01915) signed within 90 days of dispensing plus a hearing evaluation from the past 6 months is required. Binaural (two-ear) aids covered when medically necessary, including CROS/BiCROS options; one month of batteries included with purchase, and out-of-warranty repairs are covered when not routine maintenance. The rule sets no fixed replacement calendar — replacement is covered when medically necessary and the aid isn't under warranty or cheaper to repair. Most members receive the benefit through Ohio Medicaid Next Generation managed care plans.

The SoonerCare adult (21+) benefit list does not include hearing aids or hearing aid services — hearing aids appear only under additional services for children. Hearing exams tied to a medical condition may be covered for adults, and coverage rules run through OHCA Chapter 30 with medical necessity requirements. Some secondary sources hint at narrow exceptions (e.g., certain institutionalized members), but OHCA materials do not confirm a general adult hearing aid benefit — treat any exception as unverified. Since 2024 most children and many adults receive SoonerCare through SoonerSelect managed care plans; no 2024-2026 change adding an adult hearing aid benefit was found.

The Oregon Health Plan (OHP) covers hearing aids and related batteries, dispensing, fitting, and repair, plus hearing exams, for adults as well as children. Under OAR 410-129-0070 (effective January 1, 2024), adults 21 and older can get hearing aids for both ears no more often than every 5 years (every 3 years for children), with a hearing loss of 35 dB or more in at least two of 1000, 2000, 3000, and 4000 Hz. Prior authorization is required for hearing aids, repairs, and fitting and dispensing, and batteries are covered up to 60 a year. Adults who can't benefit from a hearing aid may be approved for an assistive listening device. Most members receive benefits through a Coordinated Care Organization (CCO), so confirm the steps with your CCO or OHP Care Coordination at 800-562-4620.

Hearing aids are not a covered benefit for adults 21 and older in Pennsylvania Medical Assistance. State regulation 55 Pa. Code 1123.57 pays for hearing aids only for members 20 and younger, and a September 19, 2025 DHS bulletin on prior authorization for children's hearing aids restates that 'wearable air conduction hearing aids are not covered for beneficiaries 21 years of age and older.' Some HealthChoices managed care plans may offer hearing services as an extra value-added benefit, so it is worth asking your specific plan.

Rhode Island Medicaid covers hearing aids for adults under the EOHHS Medicaid provider manual's Coverage Guidelines for Durable Medical Equipment, which set no age limit. Except in limited cases, such as a 15 dB change in hearing, a hearing aid is purchased only once every 5 years. Two aids are paid only when a physician explains why one aid cannot meet the medical need. Prior authorization, a physician certificate of medical necessity, and an audiogram from the past year are required, and nursing facility or ICF residents also need a statement from the Director of Nurses. Most members get care through managed care plans (e.g., Neighborhood Health Plan of RI), which handle prior authorization.

Hearing aids are not a standard Healthy Connections Medicaid benefit for adults 21+; audiological services are structured around the under-21 EPSDT benefit. The SCDHHS DME provider manual (April 2025) names one adult exception: members enrolled in the ID/RD waiver, served through an agreement with the Department of Public Health's Children's Rehabilitative Services. Important 2024 change: effective January 1, 2024, SCDHHS extended cochlear implants and related services (placement, replacement, maintenance) to full-benefit members 21+ with unilateral or bilateral severe-to-profound sensorineural hearing loss, with prior authorization through the state's quality improvement organization; MCOs handle this for managed care members. Some Medicaid MCOs (e.g., Humana Healthy Horizons) advertise hearing benefits. Check your specific plan, since one secondary source describes a 1-hearing-aid-per-3-years benefit with prior authorization that could not be confirmed in official SCDHHS materials.

SD Medicaid covers hearing aids for adults with hearing loss of 30 dB or more (average at 500/1,000/2,000 Hz, or 30 dB at 2,000 Hz and above), prescribed by a physician, other licensed practitioner, or certified clinical audiologist (DMEPOS manual, updated Jan 2026). Covers monaural, binaural, BAHA, and BiCROS aids; the rate includes earmold, fitting, follow-up, and cleaning over 24 months. Claims may not be submitted until 30 days after placement (trial period). Batteries are covered in monthly quantities (except for nursing home residents, where the facility supplies them). Replacement after a minimum of 3 years once the warranty has expired and the aid is no longer serviceable; broken aids for adults 21+ may be replaced sooner when the DME provider deems appropriate (not due to neglect or misuse); stolen aids need a police report. No prior authorization is needed: hearing aids are not on the DSS prior authorization list, and limits follow ARSD 67:16:29. Delivered fee-for-service (South Dakota has no Medicaid managed care organizations; some members need a referral from their care management provider). Change to know: South Dakota expanded Medicaid in July 2023, so adults 18-64 up to 138% FPL now qualify for this benefit.

TennCare does not cover hearing aids or routine audiology services for adults 21 and older; TennCare managed care plan policies restrict hearing aid coverage to members under 21. KFF's Medicaid benefits survey likewise lists Tennessee as not covering adult hearing aids. No 2024-2026 change adding an adult benefit was found. All TennCare benefits are delivered through managed care organizations (BlueCare, UnitedHealthcare Community Plan, Wellpoint). Medically necessary hearing services tied to a medical condition (e.g., cochlear implant surgery) may be handled separately by the MCO.

Per the TMHP Vision and Hearing Services Handbook (October 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. No prior authorization is needed for the first aid within these limits. 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.

Utah Medicaid does not cover hearing aids for non-pregnant adults 21 and older — the Speech-Language Pathology and Audiology Services provider manual (updated Sept 2025) covers audiology/hearing aid benefits as federally mandated only for EPSDT-eligible members (under 21) and pregnant members. For pregnant members: prior authorization is required; a monaural aid is authorized with a 35 dB+ average loss (500/1,000/2,000 Hz) in one ear, binaural with 30 dB+ average loss in both ears (or blindness, where a monaural aid is contraindicated); the global rate includes the initial earmold, fitting, follow-up, and battery provision for 12 months; replacement every 5 years when medically appropriate (exceptions for accident, surgery, disease); repairs need no prior authorization. Most physical-health services run through Accountable Care Organizations (managed care) along the Wasatch Front. No 2024-2026 change adding a general adult benefit was found.

Vermont Medicaid covers hearing aids at any age. 33 V.S.A. § 1901k (Act 108 of 2022) requires coverage of medically necessary hearing aids and audiology services, and the detailed rules are in Health Care Administrative Rule 4.213, Audiology Services (effective January 1, 2020). Adults qualify with a better-ear loss over 30 dB (average of 500, 1000, and 2000 Hz), a loss over 30 dB in one ear, or a better-ear loss over 40 dB at 2000, 3000, and 4000 Hz or word recognition under 72%. Repairs are capped at half the cost of a replacement aid. The rule sets no fixed replacement interval, and prior authorization follows the Vermont Medicaid fee schedule. Vermont Medicaid is run directly by the Department of Vermont Health Access (DVHA), not by managed-care companies. Confirm current prior-authorization rules with DVHA at 1-800-250-8427.

Virginia Medicaid does not cover hearing aids for adults 21 and over. The DMAS EPSDT Audiology and Hearing provider manual says 'Hearing aids are a benefit available exclusively to individuals under the age of 21.' HB 982 (2024) would have added adult hearing exams, hearing aids up to $1,500 per year, and up to 60 batteries per year, but it was left in committee in February 2024. In 2026, HB 328 (Acts 2026, chapter 1048) created a hearing aid requirement for commercial insurance, not Medicaid. A 2026 budget amendment to add adult Medicaid hearing aids ($1,500 every 4 years) was introduced, but the enacted 2026 budget contains no hearing aid language. Most members are enrolled in Cardinal Care managed care plans, and some plans advertise limited extra hearing benefits as value-adds, so check your specific plan.

Apple Health restored the adult (21+) hearing aid benefit January 1, 2019; rules are in WAC 182-547. Adults qualify for one new monaural hearing aid every 5 years with an average hearing loss of 45 dB or greater in the better ear; a single aid that meets these criteria needs no prior authorization. A second aid requires prior authorization, a 90-day trial with one aid, and a work, school, safety, or blindness reason. Also covered: batteries (including for cochlear implant and bone-anchored hearing aid processors), one replacement ear mold per year, two repairs per hearing aid per year (when the repair costs less than 50% of a new aid, with a minimum 90-day repair warranty), one replacement aid per 5-year period if lost or irreparably damaged through no fault of the client, and rental aids for up to two months during repairs. Most members are in Apple Health managed care plans, so confirm the process with your plan or HCA.

WV Medicaid provider manual Chapter 530 (Speech and Audiology Services, revised May 1, 2025) lists 'hearing aids, hearing aid evaluations, and fittings for members 21 years of age and older' as non-covered services. The only adult exception is replacement of cochlear implant external components/accessories (headset, headpiece, microphone, transmitting coil and cable) when WV Medicaid paid for the implant before the member turned 21. Adult members are otherwise limited to services like speech therapy evaluations for specific medical conditions. Most members are enrolled in Mountain Health Trust managed care (Aetna Better Health, The Health Plan, WellPoint, Highmark Health Options). No 2024-2026 expansion of an adult hearing aid benefit was found.

ForwardHealth (Wisconsin Medicaid and BadgerCare Plus) covers medically necessary hearing aids for adults. Prior authorization is required for the purchase of any hearing aid, and aids must be contracted models. ForwardHealth sets a hearing aid life expectancy of 5 years for adults (3 years for children 17 and under), so replacing an adult's aid within 5 years needs prior authorization, and a lost or irreparably damaged aid can be replaced with prior authorization at any time. Minor repairs are covered once every 6 months after the first 12 months, and major repairs once after the 24-month warranty. Adults get one earmold per aid per year. Hearing exams, fittings, and 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. Most members receive the benefit through BadgerCare Plus HMOs, which must cover at least what fee-for-service covers.

Wyoming Medicaid covers hearing aids for adults, per the Wyoming Medicaid CMS-1500 Provider Manual (version 20.0, October 1, 2026). Adults 19 and older qualify for one aid when one ear shows an average loss of 35 dB or more (500, 1000, 2000 Hz), and that single aid does not need prior authorization. Two aids need prior authorization and a 30 dB loss in both ears, or blindness. Aids are replaced no more than once every 5 years, and a practitioner referral and audiologist report are required. Since July 1, 2026, hearing aids are paid from a fee schedule; that is a billing change, not a coverage change. Benefits are delivered fee-for-service (Wyoming has no comprehensive Medicaid managed care), and services must come from Wyoming Medicaid-enrolled providers.