Hearing instruments.
A "hearing instrument" is defined as any wearable prosthetic instrument or device designed for or represented as aiding, improving, compensating for, or correcting defective human hearing and any parts, attachments, or accessories of such an instrument or device, excluding batteries and cords, ear molds, and assistive listening devices.  The fitting and dispensing of hearing instruments must be performed by a licensed hearing aid specialist, a licensed audiologist, or an audiologist holding an interim permit from the Department of Health.
 
A hearing aid specialist or audiologist may not sell a hearing instrument unless the prospective patient or client has presented a written statement signed by a licensed physician that states that the patient's or client's hearing loss has been medically evaluated and the patient or client may be considered a candidate for a hearing instrument.  The medical evaluation must have taken place within the preceding six months.  A hearing aid specialist or audiologist may allow the prospective patient or client 18 years of age or older to waive the medical evaluation requirement, if the hearing aid specialist or audiologist:

• informs the prospective patient or client that the exercise of the waiver is not in the patient or client's best health interest;
• does not in any way actively encourage the prospective patient or client to waive the medical evaluation;
• offers the prospective patient or client the opportunity to sign the following statement:  I have been advised the Food and Drug Administration has determined that my best health interest would be served if I had a medical evaluation before purchasing a hearing instrument; and
• provides the prospective patient or client with a copy of the signed waiver statement.

 
Hearing Instrument Coverage.
Beginning January 1, 2019, health plans offered to Medicaid enrollees and to Public Employee Benefits Board (PEBB) covered employees must include coverage for hearing instruments.  For PEBB covered employees, coverage must include a new hearing instrument every five years, and services and supplies such as the initial assessment, fitting, adjustment, and auditory training.  For Medicaid enrollees, coverage must include, when medically necessary, a new hearing instrument every five years, a new hearing instrument when alterations to the existing hearing instrument cannot meet the needs of the patient, and services and supplies such as the initial assessment, fitting, adjustment, and auditory training.  The hearing instrument must be recommended and dispensed by a licensed audiologist, hearing aid specialist, or physician or osteopathic physician specializing in otolaryngology.

A health carrier offering a health plan issued or renewed on or after January 1, 2023, must include coverage for hearing instruments, including bone conduction hearing devices.  The 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 is $2,500 per ear with hearing loss every 36 months.  A covered individual may choose a higher priced hearing instrument and pay the difference between the price of the hearing instrument and the benefit.  This benefit is not subject to the covered individual's deductible.