A parent who keeps the television very loud, asks people to repeat themselves, or nods along in conversations they plainly have not followed may be dealing with hearing loss. It is easy to dismiss as a minor inconvenience of age. For a caregiver it is not minor: a person who cannot hear well may miss medication instructions, a doctor’s questions, a smoke alarm or a scam caller’s tricks, and may withdraw from the conversations that keep them connected.
Hearing aids can help, but the price puts many families off. This guide explains what the public programmes in California cover, where the cheaper routes are, and which free services exist that most families never hear about. It is general information; coverage details change, so confirm with the plan or agency before buying.
Start With a Hearing Test, Not a Purchase
Before buying anything, get the hearing checked. A sudden change in hearing, hearing loss in one ear only, pain, discharge or dizziness should be seen by a doctor promptly, because those can signal a medical problem rather than ordinary age-related loss. Earwax build-up, which is easy to treat, can also look like hearing loss.
A primary care doctor can refer to an audiologist or an ear, nose and throat specialist for a full hearing evaluation. That evaluation is also what most coverage routes below require.
Medicare: The Gap Most People Do Not Expect
Original Medicare does not cover hearing aids, or exams for the purpose of fitting them. Medicare Part B does cover a diagnostic hearing and balance exam when it is ordered to help diagnose or treat a medical condition, and some direct-access audiology visits within limits.
Medicare Advantage plans often include some hearing benefit, such as an allowance toward hearing aids or access to discounted devices through a network. The amounts and conditions vary widely from plan to plan. If hearing aids are a priority, compare hearing benefits when choosing a plan; our guide to Medicare open enrollment explains how to compare plans and when changes can be made. Free, independent help is available from HICAP, the Health Insurance Counseling and Advocacy Program.
Medi-Cal: Hearing Aids Are a Covered Benefit
For adults with Medi-Cal, hearing aids are a covered benefit when they are medically necessary and prescribed after an audiological evaluation, subject to limits and prior authorisation rules set by the Department of Health Care Services. Medi-Cal also covers audiology services, and in many cases batteries, repairs and replacement of lost or broken aids within the programme’s limits.
Practical points:
- Use a provider who takes Medi-Cal. Ask the audiologist or hearing aid dispenser directly whether they are enrolled in Medi-Cal before the appointment. If the person is in a Medi-Cal managed care plan, call the plan’s member services line for a list of providers.
- People with both Medicare and Medi-Cal may be able to get hearing aids through Medi-Cal, since Medicare does not cover them, or through their Medicare Advantage or dual-eligible plan. Ask the plan which pays first.
- If a request is denied, the person has the right to appeal and, after the plan’s appeal, to request a State Hearing. Our guide to durable medical equipment through Medi-Cal and Medicare explains how prior authorisation and appeals work for equipment, and the same principles apply.
Over-the-Counter Hearing Aids
Since a 2022 rule from the Food and Drug Administration, hearing aids for adults aged 18 and over with perceived mild to moderate hearing loss can be sold over the counter, without a prescription, exam or fitting by a professional. They are sold in pharmacies, electronics shops and online.
For some people they are a sensible, lower-cost option. Things to weigh:
- They are designed for mild to moderate loss only. People with more severe loss, loss in one ear, or a medical cause need a professional evaluation and usually a prescription device.
- Fitting and adjustment are up to the user, often through a phone app. A parent who struggles with technology may need a family member to set them up and adjust them.
- Check the return policy and warranty before buying. A trial period matters, because it can take weeks to know whether a device works in real life.
- Personal sound amplification products are not hearing aids, even if they look similar. They are made to amplify sound for people with normal hearing in particular situations.
Whatever route you choose, keep the receipts. Hearing aids and batteries are generally a qualifying medical expense for tax purposes and for health savings or flexible spending accounts, and for an older or disabled household on CalFresh, out-of-pocket medical costs can raise the benefit. Our guide to the CalFresh medical expense deduction explains how to claim it.
Free Phones and Devices: California’s DDTP
Many families pay for amplified or captioned phones without knowing California provides them free to eligible residents. The Deaf and Disabled Telecommunications Program, run under the California Public Utilities Commission and known to the public as California Phones (formerly the California Telephone Access Program), provides specialised phones and related equipment at no cost to Californians who have difficulty using a standard phone because of hearing loss or certain other disabilities.
- Equipment can include amplified phones, captioned phones, phones with loud ringers or flashing lights, and other devices depending on need.
- Eligibility generally requires California residency and a certification of the disability signed by a qualified professional, such as a doctor or audiologist, on the programme’s application. There is no income test for the basic equipment programme.
- Apply through the programme’s website, by phone or at one of its service centres. Ask about home visits and installation help for people who cannot travel.
California Relay Service is also free: dialling 711 connects a call through a relay operator, including captioned telephone services, so a person with hearing loss can make and receive calls.
Children and Young Adults
Children have stronger coverage than adults.
- Children with Medi-Cal are entitled to hearing screenings, audiology and hearing aids under Medi-Cal’s coverage for those under 21.
- The Hearing Aid Coverage for Children Program, run by the Department of Health Care Services, covers hearing aids and related services for children and young people under 21 who are not eligible for full-scope Medi-Cal and whose private insurance does not cover hearing aids, within income limits set by the programme. Check the programme’s page for current eligibility.
- California Children’s Services may cover care for a child whose hearing loss is linked to an eligible medical condition.
Veterans and Workers
- Veterans enrolled in VA health care can usually get hearing evaluations and, when needed, hearing aids through VA audiology. Ask at the local VA medical centre.
- People who need hearing aids to keep or find a job may be able to get help through the California Department of Rehabilitation, which provides services, sometimes including assistive devices, to people with disabilities working toward employment.
Communication Rights at the Doctor and at Work
A person with hearing loss has a right to effective communication, and a caregiver can insist on it.
- Health care providers are generally required under the Americans with Disabilities Act and Section 1557 of the Affordable Care Act to provide auxiliary aids and services, such as a sign language interpreter, written materials or real-time captioning, when needed for effective communication, at no cost to the patient. Ask when making the appointment.
- Employers in California with five or more employees must provide reasonable accommodation for a known disability under the Fair Employment and Housing Act, unless it would cause undue hardship. For hearing loss that can include amplified or captioned phones, written communication or a seat where the person can see the speaker.
- A family member should not be the default interpreter for medical conversations. Providers should arrange a qualified interpreter when one is needed.
Everyday Tips for Caregivers
- Face the person when you speak, in good light, and get their attention first.
- Speak clearly and at a normal pace; shouting distorts speech.
- Turn off the television or move away from background noise for important conversations.
- Write down medication instructions, appointment times and anything that must not be misunderstood.
- Check smoke and carbon monoxide alarms. Alarms with strobe lights or bed shakers are available for people who cannot hear a standard alarm.
- Be alert to phone scams. People with hearing loss can be easier targets for callers who pressure them into agreeing to something they did not fully hear.
The Short Version
Get a proper hearing evaluation first. Original Medicare does not pay for hearing aids, but many Medicare Advantage plans include an allowance, and Medi-Cal covers medically necessary hearing aids for adults through enrolled providers. Over-the-counter aids are an option for adults with mild to moderate loss. Free amplified and captioned phones are available through California Phones, the state’s Deaf and Disabled Telecommunications Program, and 711 relay calls are free. Children have additional coverage through Medi-Cal and the Hearing Aid Coverage for Children Program. Doctors and employers must make communication work for a person with hearing loss.
This guide is general information, not medical or legal advice. Coverage rules and programme details change; confirm with the plan, the Department of Health Care Services or California Phones before relying on it.