Well, Doug, I'm not a expert at this, but from my observance is if you've been deaf from birth or child then you're automatically assigned free hearing aids and so on but then when they turn 26, depending on their circumstances, they'd have to buy HAs from now on and every time they go to Hearing Service they would have to pay for hearing test, earmoulds, repairs and such.
I met a deaf/usher person who was over 26 at the time and I noticed she had hearing aids on and I asked her how much did it cost her. She said it was free because of her condition. I can understand that.
If one's on pension or SSI as you call it then they're entitled to free HAs, test, earmoulds, batteries and minor repair.
As for the quality of HAs they'd provide, I'd have to say they have a budget to work within so they cannot go off and outfit every deaf person with the most expensive HAs. I assume they're middle ranges.
They tend to give us Siemens. I don't know if it's a brand popular in the US.