Pennsylvania Medicaid covers hearing aids only for enrollees under age 21. Adults 21 and older are not eligible for hearing aid coverage through the state’s Medical Assistance program, with one narrow exception for certain dual-eligible adults enrolled in Community HealthChoices.1PA House of Representatives. Rep. Hanbidge Email Archive on Hearing Aid Legislation Hearing aids typically cost between $1,000 and $4,000 per device, so the gap is a real one.2Pennsylvania General Assembly. Co-Sponsorship Memorandum on Hearing Aid Coverage Several state and nonprofit programs help adults who can’t afford the devices on their own, and a bill is pending that would require private insurers to pick up part of the cost.
Coverage for Children and Young Adults Under 21
For enrollees under 21, Medical Assistance provides thorough hearing aid coverage through the federal Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit. EPSDT entitles children on Medicaid to virtually all medically necessary services to treat an illness, condition, or disability, hearing aids included.3Disability Rights Pennsylvania. Medical Assistance for Children in Pennsylvania
The Pennsylvania Department of Health’s Hearing and Speech Program covers diagnostic and treatment services for eligible residents from birth through age 21. Covered devices include behind-the-ear aids, in-the-ear aids, body aids, and specialized devices such as programmable or digital aids, FM systems, and bone conduction aids, each considered case by case. Audiometric testing, ear molds, repairs, and family counseling are also covered.4Pennsylvania Department of Health. Hearing and Speech Program Guidelines
Through managed care plans like Keystone First and AmeriHealth Caritas, children under 21 can receive up to two hearing aids every five years, with prior authorization required under the Durable Medical Equipment benefit. Cochlear implants and bone-anchored hearing aids are also covered.5Keystone First. Audiology and Hearing Aids Reimbursement Policy A physician has to prescribe the device, and the provider submits an evaluation report, a letter of medical necessity, and prior authorization forms to the managed care plan.6Disability Rights Pennsylvania. How to Get Assistive Technology From an MA Managed Care Health Plan
Why Adults Aren’t Covered
Federal Medicaid law requires states to cover hearing aids for children under 21, but adult hearing aid coverage is an optional benefit each state chooses whether to offer. Pennsylvania has not chosen to offer it. Both Keystone First and AmeriHealth Caritas, two of the state’s largest Medicaid managed care organizations, explicitly list hearing aids for members 21 and older as “not a covered benefit under the Pennsylvania Medical Assistance program.”7Keystone First. href=”https://www.keystonefirstpa.com/content/dam/keystone-first/keystone-first-pa/pdf/member/eng/benefits/benefit-grid.pdf.coredownload.inline.pdf” target=”_blank” rel=”noopener”>Benefit Grid8AmeriHealth Caritas Pennsylvania. Quick Reference Guide to Benefits and Services
Diagnostic audiology services, hearing screenings, and preventive hearing services are still reimbursable for adults through qualified providers; it’s the hearing aids themselves that fall outside the benefit.5Keystone First. Audiology and Hearing Aids Reimbursement Policy An adult who believes they need a device not on the standard fee schedule can ask their doctor to request a “program exception,” though approval is not guaranteed.6Disability Rights Pennsylvania. How to Get Assistive Technology From an MA Managed Care Health Plan
The Community HealthChoices Exception
There is one partial exception for adults. Pennsylvania’s Community HealthChoices (CHC) program, which serves people eligible for both Medicare and Medicaid, as well as adults who need long-term services and supports, does provide some hearing aid coverage. Under CHC, hearing aids fall under “Specialized Medical Equipment and Supplies,” and purchases are allowed once every three years. The benefit requires a physician’s prescription and an evaluation from an ear, nose, and throat physician certified by the American Board of Otolaryngology.9PA Autism. How Participants in Community HealthChoices Can Access Assistive Technology
For dual-eligible participants, Medicare comes first. In a plan like UPMC for Life Complete Care, the Medicare Advantage side may cover hearing exams and hearing aids at no cost through a provider network such as Amplifon. CHC acts as secondary coverage and kicks in only after Medicare or other primary insurance benefits are exhausted.10UPMC Health Plan. UPMC for Life Complete Care D-SNP and CHC Participants need to work with their service coordinator to include the hearing aid request in their person-centered service plan, and should keep all denial notices from primary insurers in case the CHC managed care organization needs them during its review.9PA Autism. How Participants in Community HealthChoices Can Access Assistive Technology
Help Paying for Hearing Aids as an Adult
Because standard Medical Assistance doesn’t cover hearing aids for adults, several Pennsylvania programs help with the cost. The state’s Office for the Deaf and Hard of Hearing (ODHH) maintains a resource list but does not fund hearing aids directly.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
- The Pennsylvania Assistive Technology Foundation (PATF) offers zero-interest “mini-loans” of $100 to $7,000 with repayment terms of up to four years, and low-interest loans (3.75%) from $7,000 to $60,000 for larger purchases. Any Pennsylvania resident 18 or older with a disability, or any older adult, can apply, and PATF considers applicants with lower credit scores or higher debt-to-income ratios. A mini-grant program can reduce a mini-loan balance by up to 50% (maximum $1,000) for households at or below 200% of the federal poverty guidelines, when funds are available.12Pennsylvania Assistive Technology Foundation. Financial Loans13Pennsylvania Assistive Technology Foundation. Loan FAQs
- The Office of Vocational Rehabilitation (OVR) may help purchase hearing aids if they are needed for employment. Call 800-442-6351.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
- Keystone Deaf and Hard of Hearing Services (KDHHS) runs an income-based program providing low-cost hearing aids and repairs. Call 610-685-4523.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
- The Center for Hearing and Deaf Services (HDS) offers a grant program for income-eligible residents of Allegheny County and sells new, refurbished, and recycled hearing aids. Call 412-281-1375.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
- Easterseals Western and Central Pennsylvania provides hearing testing, digital hearing aids, and financial assistance through several regional foundations for patients in the Johnstown and Somerset areas. Call 814-535-5508.14Easterseals Western and Central Pennsylvania. Hearing Services
- Hear Now, a national program, provides new digital hearing aids customized to the recipient’s hearing loss for people who cannot afford them.15Pennsylvania Assistive Technology Foundation. Hear Now
- Help America Hear offers new hearing aids to people with limited financial resources; applicants are expected to exhaust other funding sources first. Call 888-580-8886.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
- The U.S. Department of Veterans Affairs provides hearing aids, repairs, and batteries at no charge to eligible veterans. Call 800-827-1000.11Pennsylvania Department of Labor & Industry. Hearing Aids and Assistive Devices – What You Need to Know
Over-the-Counter Hearing Aids as a Lower-Cost Option
Since the FDA’s rule on over-the-counter hearing aids took effect in December 2022, adults 18 and older with mild to moderate hearing loss can buy OTC devices without a prescription or professional fitting. OTC aids are generally much less expensive than prescription devices. Pennsylvania’s Department of Health has published guidance on OTC aids and recommends consulting a physician before buying to rule out underlying medical conditions, but the state has not addressed whether OTC devices interact with Medicaid benefits in any way.16Pennsylvania Department of Health. OTC Hearing Aid FAQs The Keystone First VIP Choice plan explicitly excludes OTC hearing aids from coverage.17Keystone First VIP Choice. Audiology and Hearing Aids Reimbursement Policy
Pending Legislation That Could Change the Picture
A bill working its way through Harrisburg would address the gap, though it targets private insurance rather than Medicaid. House Bill 1670, introduced on June 25, 2025, by Representatives Liz Hanbidge and Joseph Hohenstein with 27 co-sponsors, would amend the state’s Insurance Company Law to require health insurance policies to cover at least $2,500 in out-of-pocket costs for hearing aids.18Pennsylvania General Assembly. HB 16701PA House of Representatives. Rep. Hanbidge Email Archive on Hearing Aid Legislation Nothing in the bill would expand Medical Assistance itself, so Medicaid-only adults would still depend on the assistance programs above even if the law passes.