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Hearing Aid Insurance Legislation Update - Part 1

Editor: As you know, the hearing loss community has made some progress on the battle to include hearing aid coverage in health insurance. But we're a long ways from where we need to be. Here's an update from Randy Kirsch of Quiet Corner SHHH. For more interesting stuff, please visit the Quiet Corner SHHH website.

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In the legislative year spanning parts of calendar years 2001 and 2002, several states introduced legislation to provide for insurance coverage for hearing aids. Kentucky was the only state that passed legislation requiring hearing aid insurance coverage in 2002. Kentucky joins Maryland, Oklahoma and Connecticut as the only states with some type of mandated (i.e., required) insurance coverage for hearing aids. There is a law in Rhode Island which provides that insurance companies must offer hearing aid insurance as an optional rider which an employer may elect to include in the group's coverage, but hearing aid insurance is not absolutely required in Rhode Island as it is in the states previously mentioned. The Kentucky Bill provides in pertinent part as follows:

"A health benefit plan shall provide coverage, subject to all applicable co-payments, coinsurance, deductibles, and out-of-pocket limits, for the full cost of one (1) hearing aid per hearing impaired ear up to one thousand four hundred dollars ($1,400) every thirty-six (36) months for hearing aids for insured individuals under eighteen (18) years of age and all related services which shall be prescribed by an audiologist licensed under KRS Chapter 334A and dispensed by an audiologist or hearing instrument specialist licensed under KRS Chapter 334. The insured may choose a higher priced hearing aid and may pay the difference in cost above the one thousand four hundred dollar ($1,400) limit as provided in this section without any financial or contractual penalty to the insured or to the provider of the hearing aid."

In July 2001, a Bill became effective in Louisiana which allows funds to be taken from the Telecommunications for the Deaf Fund for the purchase and distribution of hearing aids by the Louisiana Commission for the Deaf. The Telecommunications for the Deaf Fund is a fund that was created as part of the relay telecommunications system in Louisiana which taxes each telephone line $0.05 per month. Apparently the fund accumulated excess funds, and hidden in House Bill 1565 of the 2001 Louisiana Legislative Session is a provision, which provides that these excess funds will be distributed by the State to the Louisiana Commission for the deaf for the purchase and distribution of assistive hearing devices, including hearing aids. A review of the web site for the Louisiana Commission for the Deaf reveals no mention of this program of any nature. It was reported in The Hearing Journal, July 2002, that the requirements are that the hearing aid cannot cost more than $400, applicant must have a hearing loss of greater than 40dB, applicant must generally be over the age of 50 years and not be eligible for other aid of any sort, and income cannot exceed 250% of the Federal Poverty Level, which would be approximately $22,000 for an individual, and $29,000 for a couple.

Other states that introduced Hearing Aid Insurance Legislation ("HAIL") in 2002 include California, Colorado, Ohio (which appears to be stalled in Committee but legislative session does not end until 12/31/2002), New York, New Jersey (which legislation is still pending), Pennsylvania and Connecticut. The Bills introduced in all states, except New Jersey and Ohio as noted, died in committee or appear that they will in fact die in committee, meaning that they failed to be favorably voted upon by a committee of the legislature to which the bill was referred for consideration and action. The States of Oregon and Minnesota introduced bills in their 2001 legislative sessions and those bills died in committee.

The California Bill (Senate Bill 1638) provided for a reimbursement of $1,500.00 for children under the age of 18 years. The Bill did not provide for any time limits for additional reimbursement and could be read as requiring only a one-time reimbursement. The Bill went on to provide that, "Reimbursement shall be provided according to the respective principles and policies of the health care service plan. That language could cover a later reimbursement after the initial coverage is paid out although a very careful reading o each individuals health policy would be required to make that determination. Further, the Bill is silent as to whether the coverage is $1,500.00 per ear or is a total coverage for two ears.

In New Jersey, the legislation that is pending (Bill S864) provides for one hearing aid for each hearing-impaired ear every 48 months, and the insured cannot be required to pay more than 15% of the cost of each aid as a co-payment or a deductible. Hearing aids that are covered are those that are prescribed or recommended by an audiologist or a hearing aid dispenser.

Here's part two