Washington State Hearing Aid Law: Coverage, Sales Rules, and Rights

Washington state hearing aid law regulates prescription hearing aids through licensing of sellers, mandatory written disclosures, a 30-day right to cancel, and insurance coverage mandates that expand significantly for plans issued or renewed on or after January 1, 2026.¹ These rules apply to prescription devices dispensed by a licensed professional. Over-the-counter hearing aids sold since the FDA opened that market in 2022 are governed by federal rules, so the state’s licensing, evaluation, and rescission provisions do not apply to an OTC purchase you make off the shelf.²

What Insurance Must Cover Starting January 1, 2026

The biggest change for Washington consumers takes effect for health plans issued or renewed on or after January 1, 2026. Under RCW 48.43.135, most regulated health plans in the state must cover hearing instruments, including bone conduction devices, for enrollees with hearing loss. The law eliminates any lifetime or annual dollar cap on that coverage.¹

Under the 2026 rules, plans must cover:

Replacement of hearing instruments every 36 months per ear.
The initial assessment, fitting, adjustment, auditory training, and ear molds needed to maintain a proper fit.
Professional services connected to a hearing aid even when the enrollee chooses an over-the-counter device instead of a prescription instrument.

Services and instruments covered by the law are generally not subject to the enrollee’s deductible. The one exception is a qualifying high-deductible plan tied to a health savings account, and even then the carrier can only apply a deductible at the minimum level needed to preserve the HSA’s tax status. Carriers can still require prior authorization and other utilization review for medically necessary devices.

Coverage for anyone under 18 requires medical clearance within the preceding six months. The initial evaluation must come from an ear, nose, and throat specialist; follow-up clearance can come from a licensed physician confirming no substantial clinical change since that first evaluation.

Before 2026, the coverage floor was $3,000 per ear every 36 months and applied only to nongrandfathered large-group plans starting January 1, 2024.³ Which version applies to you depends on your plan’s issue or renewal date, so check that date before assuming what your benefit is worth.

Apple Health Coverage

Washington’s Medicaid program, Apple Health, covers hearing aids for both children and eligible adults. Adults 21 and older who meet the program’s hearing loss criteria are covered for one hearing aid every five years, with a second aid available when clinical criteria are met. Apple Health also pays for repairs, replacements, related services and supplies, and repairs to external components of cochlear implants and bone-anchored hearing devices.⁴ Children enrolled in Apple Health also receive hearing aid coverage.⁵

The Apple Health replacement cycle and criteria differ from private insurance. If you qualify for both, compare each side by side before you buy.

Who Can Legally Sell You a Prescription Hearing Aid

Anyone who fits or dispenses a prescription hearing instrument in Washington must be licensed as a hearing aid specialist or an audiologist, or hold an interim permit from the Department of Health. The establishment where they work must also be bonded as required by law.⁶ Military and federal government personnel are exempt, along with students in board-approved programs working under direct supervision.

A store cannot simply stock prescription hearing aids and let you pick one. A licensed professional has to handle device selection, fitting, and follow-up. If you buy from someone without a valid license, that seller is exposed to disciplinary action and civil fines, and your transaction may be built on a legal violation from the start.

What the Provider Must Do Before Selling

Before dispensing a prescription hearing instrument, the licensed provider must complete a specific evaluation. State rules require a documented case history, a physical examination of the ear that checks for impacted wax, foreign objects, discharge, inflammation, and perforation, and hearing testing that includes pure tone air and bone conduction testing for each ear plus speech audiometry (speech reception threshold, most comfortable listening level, uncomfortable level, and word recognition score).⁷

For a patient under 18, a provider cannot sell a hearing instrument without a written statement from a licensed physician confirming that the hearing loss has been medically evaluated within the preceding six months.²

Disclosures and Receipt You’re Entitled To

Every purchase agreement for a prescription hearing instrument must come with a receipt spelling out the transaction. The provider must give you:

The seller’s name, signature, license or permit number, business address, and phone number.
The device’s make, model, circuit options, and whether it is used or reconditioned.
Itemized costs: the cost of testing and fitting, the actual cost of the hearing instrument, the cost of any ear molds, and terms of the sale. Together these make up the total purchase price.
A statement of your right to cancel, with your acknowledgment that you have read and understand those rights.

When the device is delivered, you also receive its serial number.⁸ Beyond the receipt, every retail agreement must include a “Notice to Buyer” printed in at least 12-point font that summarizes your rescission rights. You sign the notice to confirm you received it, and the seller signs as well.⁹

Your 30-Day Right to Cancel

Washington gives buyers of prescription hearing instruments 30 days after delivery to rescind the transaction, but only for “reasonable cause.” This is not a no-questions-asked return.

To cancel, you must send written notice by certified mail with return receipt requested to the establishment where you bought the device, postmarked within 30 days of delivery.¹⁰ Reasonable cause includes a material misstatement by the provider about the hearing instrument or the services being provided, when you relied on that misstatement in agreeing to the purchase.¹¹ Changing your mind or disliking how the device looks does not qualify.

If the device develops a problem during the 30 days that prevents you from properly evaluating it, and you notify the provider in writing, the deadline extends by the number of days the device was out of your hands for inspection or repair. The buyer and seller can also agree in writing to extend the 30 days.

When you rescind, the hearing instrument must go back in its original condition, with normal wear and tear excepted. The provider may keep a reasonable portion of the purchase price for services already rendered, but only if those fees were disclosed to you upfront.¹⁰

Tax-Advantaged Ways to Pay

The IRS treats hearing aids, batteries, repairs, and maintenance as deductible medical expenses. If your total medical expenses exceed 7.5 percent of your adjusted gross income, you can deduct the excess on your federal return. Hearing aid costs are also eligible expenses under health savings accounts, flexible spending accounts, and health reimbursement arrangements.¹² For anything insurance doesn’t cover, these accounts can meaningfully reduce your out-of-pocket cost.

Where to Complain If Something Goes Wrong

Different agencies handle different problems.

The Washington State Department of Health takes complaints about licensing and professional misconduct. If a provider skipped required disclosures, gave you an inadequate evaluation, or is dispensing without a proper license, that complaint goes to the DOH’s Health Systems Quality Assurance Division. Unlicensed practice can draw civil fines of up to $1,000 per day, and the Board of Hearing and Speech can suspend or revoke a license for repeat or fraudulent conduct.

The Washington State Office of the Insurance Commissioner handles coverage disputes. If your insurer denies coverage that state law requires, applies an incorrect cap, or refuses to pay for professional services connected to a hearing aid, file with the OIC.

The Attorney General’s Consumer Protection Division handles deceptive or unfair sales practices. Under Washington’s Consumer Protection Act, civil penalties can reach $7,500 per violation.¹³ You also have your own right to sue for actual damages, court costs, and reasonable attorney fees if a deceptive practice cost you money.¹⁴

1
Washington State Legislature. RCW 48.43.135 Hearing Instruments – Coverage
2
Washington State Legislature. Washington State Register WSR 24-01-087
3
Legal Information Institute. Washington Admin. Code 284-43-5937 Hearing Instrument Coverage
4
Washington State Health Care Authority. Adult Hearing Benefit
5
Washington State Health Care Authority. Hearing Hardware Billing Guide
6
Washington State Legislature. Chapter 18.35 RCW Hearing and Speech Services
7
Washington State Legislature. Chapter 246-828 WAC
8
Washington State Legislature. Chapter 18.35 RCW Hearing and Speech Services – Section 18.35.030
9
Legal Information Institute. Washington Admin. Code 246-828-290 Purchaser Rescission Rights and Right to Notice of Hearing Assistive Technologies
10
Washington State Legislature. Washington Code 18.35.185 – Rescission of Transaction – Requirements – Notice
11
Legal Information Institute. Washington Admin. Code 246-828-350 Reasonable Cause for Rescission
12
Internal Revenue Service. Publication 502 (2025) Medical and Dental Expenses
13
Washington State Legislature. RCW 19.86.140 Civil Penalties
14
Washington State Legislature. Washington Code 19.86.090 – Civil Action for Damages – Treble Damages Authorized – Action by Governmental Entities