Financial Assistance

Medicaid

The first step for financial assistance resources for hearing aids (and other technology) is to check with your health care insurance provider to find out if they carry hearing aid coverage. After that, check out the programs listed here to find out you might be eligible for services.

Coverage for Children

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program.
EPSDT is the child health component under Medicaid (42 U.S.C. 1396a(a)(10)(A); 1396d(a)(4)(B); 1396d(r)). EPSDT services are mandated for children from birth through age 21. A state must provide to Medicaid beneficiaries under age 21 hearing services, including appropriate screening, diagnostic, and treatment, including hearing aids. Specifically, EPSDT covers the following medically necessary audiological services for children who are at risk for hearing impairment:

  1. Audiological assessments;
  2. Hearing aid evaluation; and
  3. Medically necessary hearing aid services, including hearing aids and hearing aid accessories and services.

These hearing services must be provided periodically at intervals that meet reasonable standards of medical practice.

Because of this national requirement for coverage of children, the compilation below delineates only the Medicaid coverage for adults.

Coverage for Adults

State Medicaid Coverage of Hearing Services for Adults (21 and older).

CALIFORNIA
Covered services:

  1. Hearing exams and hearing aids, repair of hearing aids, and replacement of hearing aid parts;
  2. Replacement of lost, stolen or irreparably damaged hearing aids;
  3. Ear molds;
  4. Testing, exam, or follow-up for cochlear implants;
  5. Follow-up care for cochlear implants themselves is covered for pregnant women, or people who live in a nursing home or sub-acute facility.

Limitations:

  1. Hearing aids must be supplied by a hearing aid dispenser on the prescription of an otolaryngologist, or the attending physician.
  2. Prior authorization is required for the purchase or trial period rental of hearing aids and for repairs that cost more than $25 per repair service.
  3. Hearing aid batteries are not covered.
  4. Hearing exams and testing of hearing aids to see if they are working are not covered with the following exceptions:
    1. Pregnant women if it is part of their pregnancy-related care or for services to treat a condition that may cause problems in pregnancy; and
    2. People who live in a licensed nursing home such as a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), ICF for the Developmentally Disabled (ICF-DD) and Sub Acute Facility.

Website:  www.medi-cal.ca.gov

Contact:  800.541.5555