Requires all insurance policies and medical assistance to provide coverage for medically necessary hearing aids for children under 16 years of age

Summary of provisions

Section 1. This Act shall be known and may be cited as "Isabella's law".

Subsection (1) of section 3216 of the insurance law is amended by adding a new paragraph 30 Every health insurance policy issued or delivered in this state shall provide coverage for medically necessary hearing aids purchased from a hearing aid dispenser registered under article 37A of the general business law or an audiologist licensed under article 159 of the education law for an insured person who is less than 16 years of age, such insured person shall be entitled to reimbursement of up to $1,000 for each hearing aid every 2 years for expenses related to the purchase of up to 2 hearing aids. When it is demonstrated that (1) the insured child's hearing has changed significantly within a 2-year period and (2) the existing hearing aid will no longer correct the child's hearing loss, such insured person shall be entitled to reimbursement for additional hearing aid expenses. (ii) the insured personal shall be entitled to spend more than $1,000 on each hearing aid, but shall only be allowed reimbursement up to the amount provided in clause (i) of this subparagraph. 28 (B) (i) For the purpose of this paragraph "hearing aid" shall mean any wearable instrument or devices designed for hearing and any parts, attachments or accessories but excluding batteries and cords or accessories thereto. (ii) For the purpose of this section, services for recasing, reshelling and acquiring new molds shall be included as part of the policies. (C) Coverage provided pursuant to this paragraph shall not be subject to deductibles, coinsurance or co-payments.

Section 3221 of the insurance law is amended by adding a new subsection (s) (I) (A), (B), (2A), (B) and (3) that reads exactly as the new (A) (i) to Subsection (i) of section 3216 of the insurance law.

Section 4303 of the insurance law is amended by adding a new subsection (jj) (1) (A) which reads, every contract issued or delivered in this state by a health service corporation or hospital service corporation shall provide coverage for hearing aids purchased from a hearing aid dispenser registered under article 37-A of the general business law or an audiologist licensed under article 159 of the education law for an insured person who is less than 16 years of age, such insured person

shall be entitled to reimbursement of up to $1,000 for each hearing aid every 2 years for expenses related to the purchase of up to 2 hearing aids. When it is demonstrated that (i) the insured child's hearing has changed significantly within a 2-year period and (ii) the existing hearing aid will no longer correct the child's hearing loss, such insured person shall be entitled to reimbursement for additional hearing aid expenses. (B) the insured person shall be entitled to spend more than $1,000 on each hearing aid, but shall only be allowed reimbursement up to the amount provided in subparagraph (A) of this paragraph. (2) (A), For the purpose of this paragraph "hearing aid" shall mean any wearable instrument or devices designed for hearing and any parts, attachments or accessories but excluding batteries and cords or accessories thereto. (B) For the purpose of this section, services for recasing, reshelling and acquiring new molds shall be included as part of the Policies. (3) Coverage provided pursuant to this paragraph shall not be subject to deductibles, coinsurance or co-payments.

Subdivision 6 of section 2511 of the public health law is amended by adding a new paragraph (c-1), standards requiring coverage fox medically necessary hearing aids in accordance with subsection (s) of section 3221 of the insurance law.

Section 5, Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (aa), the purchase of medically necessary hearing aids from a hearing aid dispenser registered under article 37-A of the general business law or an audiologist licensed under article 159 of the education law for any child who is less than 16 years of age. Such assistance shall be limited to $1,000 for each hearing aid every 2 years for up to 2 hearing aids.

Justification

Isabella Fager is a 6-year-old little girl from New York with a severe hearing impairment and currently her parents are forced to pay for her hearing aids out of their own pockets. In the event that Isabella's parents and other parents in their position could not afford the thousands of dollars needed to purchase hearing aids Isabella may have never had the chance to learn how to speak or be able to hear her morn and dad tell her that they love her. This bill is especially important because children out-grow hearing aids frequently and in cases of children with progressive hearing loss, they will require stronger hearing aids as time goes on, making replacement hearing aids necessary and costly to the parents.

The state of New Jersey passed a similar measure in 2005.

Legislative history

2011-12: S.3379 - Referred to Insurance

Fiscal implications

Unknown.

Effective date

This act shall take effect July 1, 2016 and sections one, two and three of this act shall apply to all policies issued, modified or renewed on and after such date.