What's happening
This bill requires insurance coverage for medically necessary hearing aids for children under 16, up to $1,000 per aid every two years.
Why it matters
Removes cost-sharing barriers. By prohibiting deductibles, coinsurance, and copayments for covered hearing aids, the bill ensures families face minimal out-of-pocket costs, making access to hearing aids more equitable regardless of financial status.
Covers associated fitting and adjustment services. The legislation mandates insurance coverage for services like recasing, reshelling, and acquiring new molds, recognizing that children’s hearing needs and physical ear growth may require frequent adjustments.
Addresses medical necessity and adaptability. The bill allows for additional reimbursement if a child’s hearing changes significantly within two years, ensuring that insurance adapts to evolving medical needs rather than strictly adhering to a two-year replacement cycle.
Standardizes coverage across insurance types and public programs. By amending multiple laws (insurance, public health, social services), the bill seeks to guarantee consistent hearing aid benefits for children under 16, whether they are privately insured or covered by state assistance, reducing gaps in access.
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Who cares
Headline styles
Cover Kids' Hearing Aids
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
7099
IN SENATE (Prefiled)
January 8, 2020
Introduced by Sen. HOYLMAN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, the public health law and the social services law, in relation to requiring coverage for the purchase of medically necessary hearing aids for children under the age of sixteen years
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Short title. This act shall be known and may be cited as "Isabella's law".
§ 2. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 36 to read as follows:
(36) (A) (i) 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 thirtyseven-A of the general business law or an audiologist licensed under article one hundred fifty-nine of the education law for an insured person who is less than sixteen years of age, such insured person shall be entitled to reimbursement of up to one thousand dollars for each hearing aid every two years for expenses related to the purchase of up to two hearing aids. When it is demonstrated that (1) the insured child's hearing has changed significantly within a two 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) for the purposes of this paragraph, the insured person shall be entitled to spend more than one thousand dollars on each hearing aid, but shall only be allowed reimbursement up to the amount provided in clause (i) of this subparagraph.
(B)(i) For the purposes 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.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD08200-02-0
S. 7099 2
(ii) For the purposes 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 copayments.
§ 3. Section 3221 of the insurance law is amended by adding a new subsection (u) to read as follows:
(u) (1) (A) Every group health insurance policy issued or delivered in this state shall provide coverage for hearing aids purchased from a hearing aid dispenser registered under article thirty-seven-A of the general business law or an audiologist licensed under article one hundred fifty-nine of the education law for an insured person who is less than sixteen years of age, such insured person shall be entitled to reimbursement of up to one thousand dollars for each hearing aid every two years for expenses related to the purchase of up to two hearing aids. When it is demonstrated that (i) the insured child's hearing has changed significantly within a two 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) For the purposes of this subsection, the insured person shall be entitled to spend more than one thousand dollars 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 purposes of this subsection, "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 purposes 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 subsection shall not be subject to deductibles, coinsurance or copayments.
§ 4. Section 4303 of the insurance law is amended by adding a new subsection (ss) to read as follows:
(ss) (1) (A) 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 thirty-seven-A of the general business law or an audiologist licensed under article one hundred fifty-nine of the education law for an insured person who is less than sixteen years of age, such insured person shall be entitled to reimbursement of up to one thousand dollars for each hearing aid every two years for expenses related to the purchase of up to two hearing aids. When it is demonstrated that (i) the insured child's hearing has changed significantly within a two 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) For the purposes of this subsection, the insured person shall be entitled to spend more than one thousand dollars 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 purposes of this subsection, "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 purposes of this section, services for recasing, reshelling and acquiring new molds shall be included as part of the policies.
S. 7099 3
(3) Coverage provided pursuant to this subsection shall not be subject to deductibles, coinsurance or copayments.
§ 5. Subdivision 6 of section 2511 of the public health law is amended by adding a new paragraph (c-1) to read as follows:
(c-1) standards requiring coverage for medically necessary hearing aids in accordance with subsection (u) of section three thousand two hundred twenty-one of the insurance law;
§ 6. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (gg) to read as follows:
(gg) the purchase of medically necessary hearing aids from a hearing aid dispenser registered under article thirty-seven-A of the general business law or an audiologist licensed under article one hundred fifty-nine of the education law for any child who is less than sixteen years of age. Such assistance shall be limited to one thousand dollars for each hearing aid every two years for up to two hearing aids.
§ 7. This act shall take effect July 1, 2020 and sections two, three and four of this act shall apply to all policies issued, modified or renewed on and after such date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, the public health law and the social services law, in relation to requiring coverage for the purchase of medically necessary hearing aids for children under the age of sixteen years
Purpose or general idea of bill
"Isabella's Law" requires all insurance policies and medical assistance to provide coverage for medically necessary hearing aids for children less than 16 years of age.
Summary of specific provisions
Section 1. This Act shall be known and may be cited as "Isabella's Law".
Read the full memo (988 words)
Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph (35) (A) (1) 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 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 (1) the insured child's hearing has changed signif- icantly 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. (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 accessor ies but excluding batteries and cords or accessories thereto. (ii) For the purpose of this section, services for recasting, resheiling and acquir- ing 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 (t) (1) (A) Every group health insurance policy issued or delivered in this state shall provide coverage for hearing aids purchased from a hearing aid dispenser registered under article thirty-seven-A of the general business law or an audiologist licensed under article on hundred fifty-nine or the education law for an insured person who is less than sixteen years of age.
Section 4303 of the insurance law is amended by adding a new subsection (ss) (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 hear- ing 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 recasting, respelling and acquiring now 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.
Section 5; Subdivision 6 of section 2511 of the public health law is amended by adding a new paragraph (cl), standards requiring coverage for medically necessary hearing aids in accordance with subsection (t) of section 3221 of the insurance law.
Section 6, Subdivision 2 of section 365-a of the social services Law is amended by adding a new paragraph (ff), the purchase of medically neces- sary hearing aids from a hearing aid dispenser registered under article 37-A of the general business law or an audiologist licensed under arti- cle 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 was a 6-year-old little girl from New York with a severe hearing impairment and her parents were forced to pay for her hearing aids out of pocket. 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 mom and dad tell her that they love her. This bill is especially important because children outgrow hearing aids frequently and in cases of children with progres- sive 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 2008.
Prior legislative history
New bill in the Senate.
Fiscal implications
Yet to be determined
Effective date
This act shall take effect July 1, 2020 and sections one, two and three of this act shall apply to all policies issued, modified or renewed on and after such date.
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