Relates to insurance coverage of up to one thousand five hundred dollars for hearing aids for people under age sixteen

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 $1,500 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 $1,500 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 (1) 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 $1,500 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 $1,500 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 for 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 $1,500 for each hearing aid every 2 years for up to 2 hearing aids.

Justification

Isabella Pager is a 9-year-old girl from Dutchess County, New York with a severe hearing impairment. Currently, her parents are forced to pay for her hearing aids out of pocket. Isabella's parents and other parents throughout New York State cannot afford the thousands of dollars needed to purchase hearing aids for their children. Isabella and every other child in New York State deserves the chance to learn how to speak and to hear their parents tell them that they are loved. Children out-grow hearing aids frequently and children with progressive hearing loss require stronger hearing aids as they grow. This becomes more and more costly to parents as time goes on. We owe all of our children a chance to live fuller lives by giving them the gift of hearing.

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

Legislative history

This is a new bill.

Fiscal implications

Unknown

Effective date

This act shall take effect July 1, 2015 and sections one, two and three of this act shall apply to all policies issued, modified or renewed on and after such date.