BACKGROUND: To date, data on the prevalence and age at first management of permanent childhood hearing loss in Germany are lacking. OBJECTIVE: This study aims to depict how often and at what age children and adolescents receive their (first) hearing technology. MATERIALS AND METHODS: In this study, we analyzed claims data from a large German statutory health insurance company (BARMER). A cross-sectional study determined the provision of hearing devices and cochlear implants for children and adolescents aged under 18 years with permanent hearing loss from 2010 to 2020. A longitudinal analysis of a cohort of children born in 2010 was performed to gain insights about age at first management with hearing technology during the first 10 years of life. RESULTS: Between 2010 and 2020, approximately 2800 to 3600 children and adolescents per year were provided with hearing devices and 10 to 30 with cochlear implants. In the 2010 birth cohort, 1.22% of children received their first prescription for hearing devices before the age of 10. The proportionately highest number of first prescriptions was found between 3 and 6 years. In 2020, particularly few children gained access to hearing technology. CONCLUSION: The analysis of the prescribed hearing systems reveals inaccuracies in documentation but also a possible care gap in hearing loss management. For a large percentage of children and adolescents, management of hearing loss took place after the age of 1. The frequent initial provision of hearing technology at preschool age indicates that the proportion of hearing loss that is acquired, detected late, or treated late remained quite high even after the introduction of newborn hearing screening. There is an obvious need for comprehensive tracking of children who fail newborn hearing screening and for other screening and hearing tests. The data for 2020 suggest that hearing loss was diagnosed and treated later due to the COVID-19 pandemic.