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PDFWAC 182-547-0800

CoverageClients age twenty years and younger.

(1) The medicaid agency covers new, nonrefurbished, monaural or binaural hearing aid(s), which includes the ear molds, for eligible clients age twenty and younger. In order for the provider to receive payment, the hearing aid must meet the client's specific hearing needs and carry a manufacturer's warranty for a minimum of one year.
(2) The agency pays for the following replacements as long as the need for replacement is not due to the client's carelessness, negligence, recklessness, deliberate intent, or misuse in accordance with WAC 182-501-0050:
(a) Hearing aid(s), which includes the ear molds, when:
(i) The client's hearing aid(s) are:
(A) Lost;
(B) Beyond repair; or
(C) Not sufficient for the client's hearing loss; and
(ii) All warranties are expired.
(b) Ear mold(s) when the client's existing ear mold is damaged or no longer fits the client's ear.
(3) The agency pays for repairs of hearing aids that are less than five years old as follows:
(a) A maximum of two repairs, per hearing aid, per year, when the repair is less than fifty percent of the cost of a new hearing aid. To receive payment, all of the following must be met:
(i) All warranties are expired; and
(ii) The repair warranty is for a minimum of six months.
(b) A rental hearing aid(s) for up to thirty days while the client's own hearing aid is being repaired. In the case of a rental hearing aid(s), the agency pays separately for an ear mold(s).
(4) The agency pays for cochlear implant device and bone-anchored hearing aid replacement parts when:
(a) The manufacturer's warranty has expired;
(b) The part is for immediate use, not a back-up part; and
(c) The part needs to be replaced due to normal wear and tear and is not related to misuse or abuse of the item (see WAC 182-501-0050).
(5) The agency covers external sound processors for cochlear implant devices, including maintenance and repair.
(6) The agency covers bone-anchored hearing aid speech processors, including maintenance and repair.
(7) The agency covers batteries for hearing aids, external sound processors for cochlear implant devices, and bone-anchored hearing aid sound processors.
[Statutory Authority: RCW 41.05.021, 41.05.160 and 2018 c 159. WSR 19-20-043, § 182-547-0800, filed 9/25/19, effective 11/1/19. Statutory Authority: RCW 41.05.021, 41.05.160. WSR 15-03-042, § 182-547-0800, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 41.05.021. WSR 13-20-013, § 182-547-0800, filed 9/20/13, effective 10/21/13. WSR 11-14-075, recodified as § 182-547-0800, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 11-11-015, § 388-547-0800, filed 5/9/11, effective 6/9/11. Statutory Authority: RCW 74.08.090 and 74.09.530. WSR 09-12-034, § 388-547-0800, filed 5/27/09, effective 7/1/09.]
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