Florida Medicaid’s Covered Services and HCBS Waivers
Medicaid reimburses for hearing services that are designed to provide screening, assessment and testing services, and appropriate hearing devices to recipients in order to detect and mitigate the impact of hearing loss.
Medicaid reimburses for hearing services including:
- Diagnostic Audiological Tests
- When medically necessary by a physician’s examination or to document treatment outcome
- Bone Anchored Hearing Aids (BAHA)
- For recipients who have documented profound, severe hearing loss in one or both ears as follows:
- Implanted device for recipients age five years and older
- Non-implantation (softband) device for recipients under the age of five years
- Cochlear Implants
- For recipients age 12 months and older who have documented profound to severe, bilateral sensorineural hearing loss
- Hearing Aids
- For recipients who have moderate hearing loss or greater, including the following services:
- One new, complete, (not refurbished) hearing aid device per ear, every three years, per recipient
- Up to three pairs of ear molds per year, per recipient
- One fitting and dispensing service per ear, every three years, per recipient
- Hearing Assessment and Reassessment
- One hearing assessment every three years for the purpose of determining hearing aid candidacy and the most appropriate hearing aid
- Newborn and Infant Hearing Screening
- Up to two newborn hearing screenings for recipients under the age of 12 months. A second screening may be performed only if the recipient does not pass the initial hearing screening test in one or both ears
- Repairs and Replacements of Hearing Devices
- Repairs and replacement of both Medicaid and non-Medicaid provided hearing aids
- Up to two hearing aid repairs every 366 days, after the one year warranty period has expired
- Bone anchored hearing aid external components and cochlear implant components, including batteries, after the manufacturer’s warranty period or insurance protection plan coverage period has expired
This service is one of the minimum covered services for all Managed Medical Assistance plans serving Medicaid enrollees.
Florida Medicaid recipients requiring medically necessary hearing services.
Information on Medicaid health plans and services is available on the Statewide Medicaid Managed Care webpage.
The Florida Medicaid coverage policies, fee schedules, and Rule are available on the Agency Website.