W.S. 1-5 - Eligibility

(a) General Requirements

(i) All applicants must be eighteen (18) years of age or older at the time of submission of their application.

(ii) Submission of a complete application as determined by the Department within the designated timeframe.

(iii) Individual must have hearing loss of 35 decibels (dB) in one ear, or 30 dB in both ears to qualify for this Program.

(iv) Individual is not eligible to receive hearing aids through private insurance, Medicaid, Medicare or any other available third-party payor.

(A) If individual cost sharing exceeds $500 for hearing aids, this is not considered full coverage as defined by Statute, and the Department shall serve as a secondary payor.

(v) Applicants shall not receive more than one (1) hearing aid, monaural or set, under this Program in any five (5) year period.

(vi) Applicants must have a monthly modified adjusted gross family income at or below two hundred percent (200%) of the federal poverty level.

(b) Medical Criteria

(i) An audiogram or other form pre-approved by the Department that reports the hearing evaluation test or dB loss must include for both right and left ears:

(A) Hearing thresholds at 250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz for air conduction, and

(B) 500, 1000, 2000, and 4000 Hz for bone conduction.

(ii) If the hearing test shows an average hearing loss in one ear of 35 dB or greater, based on the standard pure-tone average (PTA) (500, 1000, 2000 Hz) for that ear, a monaural aid shall be allowed.

(iii) Binaural hearing aids are reimbursed by the Department only under one of two circumstances:

(A) Must be medically verified that the individual has an average hearing loss of 30 dB based on the standard PTA for both ears.

(B) The individual is blind, and it has been medically determined that a monaural hearing aid may be contraindicated.

(iv) Hearing loss that is correctable by other means is not eligible for a hearing aid under this Program.

Notes

W.S. 1-5

Adopted, Eff. 4/10/2025.