Washington is one of the strongest states for hearing coverage — and it got stronger in 2026. Since January 1, 2024, most employer (large-group) and public-employee health plans must cover hearing instruments at no less than $3,000 per ear every 36 months, and starting with 2026 plans, individual and small-group plans cover hearing instruments too (one per ear every three years) through the state's updated essential health benefits. Apple Health (Medicaid) covers hearing aids for both children and adults. DVR, WATAP, and the Telecommunication Equipment Distribution program offer extra help.
By Lilly Seay · Updated July 2026
Apple Health restored the adult (21+) hearing aid benefit January 1, 2019; rules are in WAC 182-547. Adults qualify for one new monaural hearing aid every 5 years with an average hearing loss of 45 dB or greater in the better ear; binaural (two-ear) aids require prior authorization and specific clinical criteria. Also covered: batteries (including for cochlear implant and bone-anchored hearing aid processors), one replacement ear mold per year, two repairs per hearing aid per year (when the repair costs less than 50% of a new aid, with a minimum 90-day repair warranty), one replacement aid per 5-year period if lost or irreparably damaged through no fault of the client, and rental aids for up to two months during repairs. Most members are in Apple Health managed care plans — confirm process with your plan or HCA.
Federal EPSDT law (42 U.S.C. § 1396d(r)(4)) requires every state — Washington included — to cover hearing aids for Medicaid-enrolled children under 21 at no cost to the family. Clients age 20 and younger get more generous coverage under WAC 182-547-0800 and federal EPSDT — medically necessary hearing aids, exams, fittings, ear molds, batteries, and repairs, with its own prior-authorization rules (WAC 182-547-1000). Washington's children's coverage is Apple Health for Kids (Medicaid/CHIP combined); families apply through Washington Healthplanfinder or the Health Care Authority.
No age limit. Nongrandfathered large-group plans and public-employee (PEBB/SEBB) plans issued or renewed on or after January 1, 2024 must cover hearing instruments (including bone conduction devices) at no less than $3,000 per ear with hearing loss every 36 months, plus initial assessment, fitting, adjustment, auditory training, and ear molds. Coverage is not subject to the deductible (except HSA-qualified plans at the IRS minimum). Minors under 18 need medical clearance from an otolaryngologist or physician within the preceding 6 months. OTC hearing aids themselves are excluded, though related services are covered even for OTC users. Individual and small-group plans: following the essential health benefits review directed by SB 5338 (2023), Washington's updated EHB benchmark plan takes effect with 2026 plan years and includes hearing instruments — including bone conduction devices, assessment, fitting, adjustment, auditory training, and ear molds, limited to one hearing instrument per ear every three years — so those markets now have coverage as well (without the $3,000 floor language, since EHBs cannot carry dollar limits). ERISA self-funded plans remain exempt.
Statute: ESHB 1222, Chapter 245, Laws of 2023 (codified in ch. 48.43 RCW; public employees ch. 41.05 RCW)
Remember: state mandates only reach state-regulated ("fully insured") plans. Self-funded employer plans — covering about two-thirds of insured workers — are exempt under federal ERISA law. One question to HR settles which kind you have.
Washington pairs one of the nation's strongest hearing aid mandates with a crowded, competitive market: twelve insurers sell 2026 plans on Washington Healthplanfinder — all now covering hearing instruments under the state's updated essential health benefits — and five managed-care organizations serve Apple Health (Medicaid), which covers hearing aids for adults and children alike.
Premera and its affiliate LifeWise are two of the twelve carriers on Washington Healthplanfinder for 2026. Its state-regulated plans follow Washington's hearing instrument mandate — individual and small-group plans cover one hearing instrument per ear every three years starting with 2026 plans, and large-group plans carry the $3,000-per-ear floor.
The Regence family fields three Healthplanfinder entities for 2026 (Regence BlueShield, Regence BlueCross BlueShield of Oregon, and BridgeSpan). As state-regulated coverage, these plans include hearing instruments under Washington's essential health benefits and mandate rules.
Both Kaiser Foundation Health Plan of Washington and Kaiser's Northwest plan sell on Healthplanfinder for 2026. Its state-regulated Washington plans are subject to the hearing instrument coverage requirements; ask member services how to access the hearing benefit through Kaiser's audiology network.
Molina sells marketplace plans and is one of five Apple Health managed-care organizations. Apple Health members get the state Medicaid hearing benefit — hearing aids for adults and children — coordinated through their plan.
Centene's Coordinated Care Corporation sells Ambetter marketplace plans and serves Apple Health members as one of the five MCOs. Its 2026 individual plans include hearing instruments under Washington's updated essential health benefits.
The community-health-center-founded nonprofit is both a Healthplanfinder carrier and one of the five Apple Health MCOs, so many lower-income Washingtonians encounter it in both roles. Apple Health members access the state's adult and child hearing aid benefits through the plan.
UnitedHealthcare sells 2026 Healthplanfinder plans, runs UnitedHealthcare Community Plan for Apple Health, and is a leading Medicare Advantage carrier. It administers member hearing benefits through its UnitedHealthcare Hearing program, where coverage and device pricing depend on your specific plan.
The Elevance Health subsidiary (formerly Amerigroup) is one of the five Apple Health MCOs and joined Washington Healthplanfinder for 2026. Its state-regulated marketplace plans include hearing instruments under the updated essential health benefits.
Yes. Apple Health restored its adult hearing aid benefit on January 1, 2019, and the rules live in WAC 182-547. Adults 21 and over qualify for one new hearing aid every five years when their average hearing loss is 45 dB or greater in the better ear; two-ear (binaural) aids require prior authorization. The benefit also covers batteries, one replacement ear mold per year, two repairs per aid per year, a replacement if your aid is lost or damaged through no fault of your own, and even a rental aid during repairs. Most members are in managed-care plans, so start with your plan or the HCA.
Yes, for most state-regulated plans — Washington is one of the strongest states in the country on this. Since January 1, 2024, large-group and public-employee (PEBB/SEBB) plans must cover hearing instruments at no less than $3,000 per ear every 36 months, including fitting, adjustment, auditory training, and ear molds, with no age limit. And starting with 2026 plans, individual and small-group coverage includes hearing instruments too — one per ear every three years — through the state's updated essential health benefits. Self-funded employer (ERISA) plans remain exempt, so check with HR if your employer self-insures.
Washington gives you more paths than most states. If your income qualifies, Apple Health (Medicaid) covers hearing aids for both adults and children. If you have private insurance, most state-regulated plans now must cover hearing instruments — including every 2026 individual marketplace plan. Beyond insurance, the Division of Vocational Rehabilitation (DVR) can help fund hearing aids when hearing loss affects your work, the Washington Assistive Technology Act Program (WATAP) offers device demos and loans so you can try before you buy, and ODHH's Telecommunication Equipment Distribution program provides free amplified and captioned phones to qualifying residents.
Yes — this is new and worth celebrating. Following the essential health benefits review directed by SB 5338, Washington's updated benchmark plan takes effect with 2026 plan years, and it includes hearing instruments (even bone conduction devices) plus assessment, fitting, adjustment, auditory training, and ear molds, limited to one instrument per ear every three years. That applies across all twelve carriers on Washington Healthplanfinder, from Premera and Regence to Kaiser Permanente, Molina, and Coordinated Care's Ambetter plans. Because these are essential health benefits, no dollar cap applies. Check your specific plan's cost sharing before you schedule a fitting.
The devices themselves, no — Washington's mandate excludes OTC hearing aids from the required coverage. But here's the helpful part: the related professional services are still covered even if you choose an OTC device, so your plan can help pay for the hearing assessment and support around it. If you want the full benefit, prescription hearing instruments fitted through a professional are what the law covers — at least $3,000 per ear every 36 months on large-group plans, and one instrument per ear every three years on 2026 individual and small-group plans. One note for minors: kids under 18 need medical clearance from a physician first.
While you sort out coverage, the Hearing Buddy app gives you live captions on your phone — free, instantly.