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Colorado, Connecticut, Delaware, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, New Jersey, New Mexico, Oklahoma, and Oregon require that health benefits plans in their state pay for hearing aids for children. Wisconsin requires coverage for both hearing aids and cochlear implants for children. Requirements vary state by state for
- ages covered
- amount of coverage
- benefit period
- provider qualifications
Rhode Island requires coverage for both children and adults.
Existing laws in these fifteen states are summarized below with a link to each statute:
Requires insurance providers to cover hearing aids for children under 18 years of age when medically necessary. Coverage must include a new hearing aid every five years, a new hearing aid when alterations to the existing hearing aid cannot meet the needs of the child, and services and supplies such as the initial assessment, fitting, adjustments, and auditory training.
Citation: SB 57 of 2008 [PDF]
Requires individual and group health insurance policies to provide coverage for hearing aids for children 12 years old or younger; classifies hearing aids as durable medical equipment and allows policies to limit the benefit to $1,000 every 24 months.
Citation: Conn. Gen. Statute 38a-490b and 38a-516b (Use number indicated and select "Statutes - Section Text" as search options at Connecticut General Assembly)
Requires individual and group health insurance contracts to provide coverage for hearing aids of up to $1,000 per ear, every 3 years, for children under 24 years of age, covered as a dependent by the policy holder.
Citation: House Bill 355 of 2008
Kentucky
Requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for individuals under 18 years of age as needed, and all related services necessary to assess, select, and fit the hearing aid. The insured may choose a higher price hearing aid and pay the difference in cost; the hearing aid must be prescribed by a licensed audiologist and dispensed by a licensed audiologist or hearing instrument specialist.
Citation: KRS 304.17A-132 [PDF]
Louisiana
Requires individual and group insurers to provide coverage for hearing aids for a child under the age of 18 if the hearing aids are fitted and dispensed by a licensed audiologist or licensed hearing aid specialist following medical clearance by a physician licensed to practice medicine and an audiological evaluation medically appropriate to the age of the child. The insurer may limit the benefit payable to $1,400 per hearing aid for each hearing-impaired ear every 36 months. The insured may purchase a hearing aid priced higher than the benefit payable and pay the difference to the hearing aid provider.
Citation: La. R.S. 22:1038 [PDF]
Maine
Requires health insurance policies to provide coverage for hearing aids for children up to age 18; coverage may be limited to $1,400 per hearing aid every 36 months. The mandate will be phased in by age groups: policies issued or renewed as of January 1, 2008 must provide hearing aid coverage for children from birth to 5 years of age, beginning in January 2008; for children 6 to 13 years old, coverage begins in January 2009; and for those 14 to 18 years old, coverage begins in January 2010.
Citation: 24-A M.R.S.A. § 33-2762
Maryland
Requires insurers to provide coverage for hearing aids for a minor child if the hearing aids are prescribed, fitted, and dispensed by a licensed audiologist; coverage may be limited to $1,400 per hearing aid for each hearing-impaired ear every 36 months; insured may choose a more expensive hearing aid and pay the difference.
Citation: Maryland Code §15-838 (Select "Code" and then enter "§15-838")
Minnesota
Requires health plans to cover hearing aids for children under the age of 18 year for hearing loss due to functional congenital malformation of the ears that is not correctable by other covered procedures. The coverage is limited to one hearing aid per ear every three years.
Citation: Minn. Stat. 62Q.675
Missouri
Requires health insurance and Medicaid coverage for infant hear screening, re-screening (if necessary), audiological assessment and follow-up, and initial amplification, including hearing aids.
Citation: §376.1220 R.S. Mo.
Requires health insurers, State Health Benefits Program and NJ FamilyCare to provide coverage for medically necessary expenses incurred in the purchase of a hearing aid for covered children 15 years of age or younger. Coverage includes the $1,000 per hearing aid for each hearing-impaired ear every 24 months when medically necessary and prescribed or recommended by a licensed physician or audiologist . The insured may choose a more expensive hearing aid and pay the difference between the price of the hearing aid and the benefit.
Citation: P.L. 2008, Chapter 126
Requires individual and group health insurance policies to cover $2,200 per hearing aid every three years for children under 18 years of age, or under 21 years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost. Coverage includes fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
Citation: S.B. 529 of 2007 [PDF]
Oklahoma
Effective November 1, 2002, requires any group health insurance or health benefit plan to provide coverage for audiological services and hearing aids for children up to 18 years of age; adds requirement of hearing aid prescription and dispensing by a licensed audiologist; allows hearing aid benefit every 48 months without a dollar limit.
Citation: 36 Okl. St. §6060.7 (Select "Oklahoma Statutes & Constitution", then enter 36-6060.7 in "Search Oklahoma Statutes")
Requires health benefits plans to cover one hearing aid per hearing impaired ear for enrollees under 18 years of age, or 18 years of age or older if eligible as a dependent under the plan and enrolled in an accredited educational institution. Hearing aids must be prescribed, fitted and dispensed by a licensed audiologist with the approval of a licensed physician and the maximum benefit amount is $4,000 every 48 months; however, an enrollee may purchase a hearing aid priced higher than the benefit amount and pay the difference in cost.
Citation: House Bill 2589 of 2009 [PDF]
Rhode Island
Requires individual and group insurance policies to provide coverage for $1,500 per individual hearing aid, every three years, for children under the age of 19, and $700 per individual hearing aid for those over 19 years of age.
Citation: R.I. Gen. Laws § 27-18-60
Wisconsin
Requires health insurance plans and policies to pay for cochlear implants, hearing aids and related treatment that are prescribed by a physician or audiologist for any child under the age of 18. Coverage for hearing aids includes the cost of one hearing aid per ear per child once every three years.
Citation: SB 27 of 2009 [PDF]
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