Washington State Rep. Tina Orwall Proposes Hearing Aid Coverage Bill

By Cynthia Stewart, HLAA-WA Legislative Liaison

Update, May 2023: Two hearing aid coverage bills passed and were signed by Governor Inslee!

Beginning January 1, 2024, thanks to House Bill 1222, all fully insured large-group health plans in Washington State, plus state and school (PEBB and SEBB) employee plans will offer hearing benefits. The new coverage requirement is for no less than $3,000 per ear every 36 months.

Senate Bill 5338 directs the state to request that hearing aids be added as an Essential Health Benefit; this would apply to private individual and small-group plans. The benefit will likely take effect in 2026.

Hearing aids are very expensive. In some cases, the expense prevents individuals with hearing loss from getting the instrument they need.  For children, a lack of hearing loss treatment can lead to lifelong consequences in speech, learning, and future earning capacity. For adults of employment age, it can lead to an inability to function well in the workplace. For seniors, it can lead to increased risk of dementia.  For all, the impacts of no treatment of hearing loss typically include withdrawal from social interactions, isolation, and depression.

Children covered by Medicaid in Washington State are currently eligible for hearing aids, cochlear implants, and bone-anchored hearing aids, but children who are not in the Medicaid system are not covered by insurance for these treatments.  Some adult health care plans include hearing aids, but most do not. Many families who are not Medicaid-eligible do not have the resources to provide hearing instruments for their children or adult family members who need them.

To address these problems, Representative Tina Orwall, Washington State Legislative District 33, is submitting a bill to the 2023 legislature that will require group health plans to provide coverage for hearing aids as of January 1, 2024.  The coverage would be limited to $2,500 per ear with hearing loss every 36 months.  And health plans for groups of 50 or fewer employees would be exempted from this requirement.

The coverage would include the cost of the hearing instrument, the initial assessment, fitting, adjustment, auditory training, and ear molds. If someone in one of these plans chooses a higher-priced hearing instrument, they would have to pay the difference in cost out-of-pocket.

Over-the-Counter (OTC) hearing aids, for which adults with mild to moderate hearing loss are eligible but children are not, would not be covered; however, hearing assessment would be covered for those who purchase OTC hearing aids.

A similar bill was submitted in 2021 but was limited to coverage for children. Amendments were made in 2022 to include coverage for adults. However, the bill did not get a hearing in committee in time to move through the legislative process.

Please contact your legislators and ask them to support this bill, titled, “An act relating to requiring coverage for hearing instruments.” After the legislative session begins on January 9, 2023, we will provide updates on the progress of the bill and how you can help further.

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