This section adds a new section to an existing chapter 48.43. Here is the modified chapter for context.
A health carrier offering a health plan issued or renewed on or after January 1, 2022, must include coverage for hearing instruments, including bone conduction hearing devices, for persons who are 18 years of age or younger.
Coverage must include the hearing instrument, the initial assessment, fitting, adjustment, auditory training, and ear molds as necessary to maintain optimal fit.
The maximum benefit amount required by this section is $2,500 per ear with hearing loss every 36 months. This benefit is not subject to the covered individual's deductible.
A covered individual may choose a higher priced hearing instrument and pay the difference between the price of the hearing instrument and the benefit required under this section, without financial or contractual penalty to the covered individual or to the provider of the hearing instrument.
Coverage shall be available under this section only after a minor under 18 years of age has, within the preceding six months received medical clearance from:
An otolaryngologist for an initial evaluation of hearing loss; or
A licensed physician, which indicates there has not been a substantial change in clinical status since the initial evaluation by an otolaryngologist.
For the purposes of this section, "hearing instrument" and "hearing aid specialist" have the same meaning as defined in RCW 18.35.010.