Cochlear implants for children and adults: what the state funds and how to get started

What is a cochlear implant and who needs one?

A cochlear implant is an electronic device which, in severe or profound sensorineural hearing loss, bypasses the damaged part of the inner ear and stimulates the auditory nerve directly. It has two parts. The internal part is placed by a surgeon during an operation, with an electrode in the cochlea. The external part, the speech processor, is worn behind the ear or on the head; it picks up sound and converts it into a signal. An implant differs from an ordinary hearing aid in that it does not amplify sound but delivers it to the nerve as an electrical impulse.

The device does not "restore" hearing by itself: the brain has to learn to perceive the new signal. That is why the operation is followed by a long stage of frequent processor fitting and work with a speech therapist. In children, the age at which the intervention takes place has a major effect on the outcome, and this is exactly why timing is built into the state programme's rules.

Where the route begins: newborn hearing screening

For a child, the first step usually happens at the maternity hospital. The "Maternal and Child Health" state programme (Annex 8 of the 2026 programmes) funds diagnostic hearing tests for newborns. Primary screening data are recorded in an electronic system; children with a suspected impairment are followed up and referred for repeat screening and, where needed, for in-depth tests: tympanometry and computer audiometry. The programme also keeps a register of children with hearing impairments, recording the degree of impairment and further needs.

Repeat screening for newborns born in Adjara is funded by the Government of the Autonomous Republic of Adjara from the local budget. If the screening result is unclear when you are discharged from the maternity hospital, confirm the date of the repeat test there and then and keep all results: these very papers later become the basis of the implantation documents.

For an adult, the route starts elsewhere: with a family doctor or an ENT specialist, who orders an audiological assessment. How outpatient visits are funded is explained in the Universal Healthcare guide.

Who gets a state implant in 2026?

Provision of cochlear implants is a separate annex of the Universal Healthcare Programme (Government Resolution No. 36 of 2013, Annex 1.10). Its mechanism differs from the other components: the state buys implants and processors through public procurement, and the National Health Agency hands them over free of charge to the medical facility that performs the operation, in line with the number of planned operations. The patient pays no co-payment for the procured goods.

The bilateral implant group was added by Government Resolution No. 301 of 3 July 2026 and took effect on publication. The Ministry of Health announced this change in June 2026.

In practice, the age-4 limit means the family should discuss the option of bilateral implants with the doctor early: what matters is not the date of the operation but when the request reaches the agency. Check the request form and attachments with the agency and keep proof of submission.

What happens if an implant has been allocated but the operation does not take place

The annex's transitional provisions show that the state monitors the period within which an allocated implant is used: for implants handed over in 2014-2019, if they were not used in time, the decision was cancelled and the device went back to the agency for another beneficiary. Time limits for current decisions are governed by the agency's acts, so if the operation is postponed, inform the agency of the reason in writing.

Who pays for the operation and the hospital stay?

The text of Annex 1.10 describes the procurement of the device, that is, the implant and the processor. How the surgery itself, the anaesthesia and the stay in hospital are funded, as well as your co-payment share, should be clarified before the operation is scheduled. According to the Ministry's 2026 statement, unilateral implantation is available to patients of all ages on clinical need and a doctor's referral, and bilateral implantation is fully available to children under 4.

So put three questions in writing to the clinic offering the operation: will it accept an implant handed over by the agency; under which programme and at what share are the operation and hospital stay funded; and what costs remain with the family, for example additional tests or medicines. You need the answer in writing so that, if you apply to the referral commission or the municipality for the remaining amount, you can attach a cost estimate to the application.

Because the devices come through public procurement and are distributed to clinics according to planned operations, you may have to wait until a particular clinic receives the implant. In that case, ask the clinic for the expected timeframe and whether the operation could be done sooner with another provider. If the wait threatens the child's age limit or the deadline given by the doctor, inform the agency of this in writing and attach the doctor's opinion. Families with private insurance should also check the policy terms: some policies exclude hearing devices, while others cover part of the operation.

In what order should you act, from diagnosis to switch-on?

Families often lose time not at the medical stages but at the organisational ones: a document stays in one place, the request goes in late, and the rehabilitation centre is only found after the operation. The sequence below is designed to avoid these delays.

1. Confirm the diagnosis

   Collect the full set of audiological tests and the ENT specialist's opinion in one folder. Form 100 should clearly state the degree of hearing loss and the ICD-10 code.

2. Talk to the implant team

   Ask the doctor whether a unilateral or bilateral implant is indicated and, if the child is under 4, discuss the deadline for a bilateral implant request right away.

3. Request to the agency and confirmation from the clinic

   Record the date the request was submitted. Get written confirmation from the clinic that it will use the implant handed over by the agency, and an explanation of how the operation and hospital stay are funded.

4. The operation and discharge documents

   On discharge, ask for the device type, serial number and expected switch-on date together with the discharge summary. You will need these details for the warranty and for a future processor.

5. Start rehabilitation

   Choose the rehabilitation centre before the operation and check whether it works with the agency's voucher, so that the 18-month period does not start running unused.

Rehabilitation after the operation: what does the 18-month voucher cover?

Rehabilitation of implant recipients is a separate component of the "Referral Services" state programme, run by the National Health Agency. Beneficiaries are people who received an implant under the state programme described above. The course is delivered by suitably qualified specialists for no more than 18 months and has two parts: periodic fitting and adjustment of the implant after the operation, and the services of a speech therapist, up to 24 sessions per quarter.

The table is based on Table No. 1 of Annex 19 of the 2026 programmes; it also lists pure-tone hearing threshold measurement and acoustic impedance testing, once each. Payment is made at actual cost through a non-materialised voucher, meaning you do not receive a separate paper voucher.

The 18-month limit is counted from the operation, so sessions missed in the first months cannot be "made up" later. It helps the family to ask the rehabilitation centre from the outset for a quarterly schedule and a record of the sessions held. For therapy needed after 18 months, look at municipal programmes or private funds.

The processor, accessories and municipal assistance

The processor is a part that wears out: it breaks, gets lost and becomes technologically outdated, while batteries, cables and protective parts are a regular expense. The state programme issues a new processor once, after five years, on the treating doctor's justification. Municipalities fill part of this gap, though each by its own rules.

For example, Zugdidi Municipality's 2026 healthcare programme co-funds the cost of a hearing aid or processor once a year, up to 15,000 GEL per child, for operated children aged 0-18 who have a cochlear implant or grade III-IV hearing loss, and allocates up to 600 GEL per beneficiary for implant accessories. The documents are Form No. IV-100/a, an invoice and a certificate from the relevant facility confirming the suitability of the implant or accessories, and the guarantee letter is valid for 90 calendar days. In other municipalities the amount and conditions differ; how to find yours is explained in the municipal assistance guide.

Before going to City Hall, get two documents from the supplier in advance: an invoice for the processor or accessory, stating the manufacturer and model, and a certificate of suitability from the relevant facility confirming that the new part is compatible with your implant. Both are mandatory under the Zugdidi rules; for another municipality, check its list with City Hall in advance.

When do families consider a foreign clinic?

Implantation takes place in Georgia and the state device is handed over to a local clinic, so an operation abroad usually falls outside this mechanism and the cost of the device also falls on the family or another source. Families usually turn to a foreign centre in special circumstances: complex anatomy or a coexisting condition, implant malfunction and revision surgery, or to get a second opinion. In such cases, bear one important detail in mind: later fitting and processor replacement require a system from the same manufacturer, so ask the clinic who will service the device after you return to Georgia.

For an assessment, a foreign clinic usually needs: the latest audiogram and an auditory brainstem response (ABR) test, CT and MRI reports of the temporal bone, an ENT specialist's opinion, Form 100 and, for a child, a speech therapist's assessment. If an existing implant is involved, also state the device type and serial number. How to request a second opinion is set out in the second opinion guide, and our clinic search service can help you choose a centre.

The document package and funding sources in one table

For local programmes, the main document is Form No. IV-100/a, stating the diagnosis with its ICD-10 code and the degree of hearing loss, and for a child also the birth certificate and a copy of the parent's ID. For a foreign clinic, the same package must be translated into English or the language of the country: we translate Form 100 through our Form 100 translation service, and audiological and imaging tests as part of test report translation. A foreign invoice must be translated into Georgian if you submit it to the commission or the municipality.

Solidaroba.ge does not provide funding and has no influence on the agency's decision. Our role is practical: translating documents, preparing the application and cost estimate and, if there is a refusal, bringing in an Advocat.Ge lawyer through our funding search service.

Frequently asked questions about cochlear implants