Bill Text: NY A06586 | 2019-2020 | General Assembly | Introduced
Bill Title: Requires coverage of hearing aids in the individual and small group markets.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A06586 Detail]
Download: New_York-2019-A06586-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6586 2019-2020 Regular Sessions IN ASSEMBLY March 12, 2019 ___________ Introduced by M. of A. SEAWRIGHT -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to hearing aids The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 35 to read as follows: 3 (35) (A) Every policy that provides coverage for hospital, surgical or 4 medical care shall provide coverage for medically necessary hearing aids 5 purchased from a hearing aid dispenser registered under article thirty- 6 seven-A of the general business law or an audiologist licensed under 7 article one hundred fifty-nine of the education law in the following 8 manner: 9 (i) For an insured person sixteen years of age or older, such insured 10 person shall be entitled to reimbursement of up to three thousand 11 dollars every thirty-six months for expenses related to the purchase of 12 up to two hearing aids. 13 (ii) For an insured person who is less than sixteen years of age, such 14 insured person shall be entitled to reimbursement of up to two thousand 15 dollars every twenty-four months for expenses related to the purchase of 16 up to two hearing aids, when it is medically demonstrated that: 17 (1) the hearing of the insured person under the age of sixteen has 18 changed significantly within a two-year period; and 19 (2) the existing hearing aid will no longer correct the hearing of the 20 insured person under the age of sixteen; such person shall be entitled 21 to reimbursement for additional hearing aid expenses. 22 (B)(i) For the purposes of this paragraph, "hearing aid" shall mean 23 any wearable instrument or device designed for hearing and any parts, 24 attachments or accessories but excluding batteries and cords or accesso- 25 ries thereto. A registered hearing aid dispenser or licensed audiologist 26 shall determine the type of device needed to correct the hearing loss. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD10275-01-9A. 6586 2 1 (ii) For the purposes of this paragraph, services for recasing, 2 reshelling and acquiring new molds shall be included as part of the 3 policies. 4 (C) The insured person may choose a hearing aid exceeding the amount 5 of coverage required by this paragraph and shall be liable for the 6 difference in cost. Reimbursement shall be provided according to the 7 respective principles and policies of the health insurance plan and may 8 include such policy provisions as deductibles, coinsurance, allowable 9 charge limitations, and coordination of benefits. 10 § 2. Subsection (l) of section 3221 of the insurance law is amended by 11 adding a new paragraph 21 to read as follows: 12 (21) (A) Every small group policy that provides coverage for hospital, 13 surgical or medical care shall provide coverage for medically necessary 14 hearing aids purchased from a hearing aid dispenser registered under 15 article thirty-seven-A of the general business law or an audiologist 16 licensed under article one hundred fifty-nine of the education law in 17 the following manner: 18 (i) For an insured person sixteen years of age or older, such insured 19 person shall be entitled to reimbursement of up to three thousand 20 dollars every thirty-six months for expenses related to the purchase of 21 up to two hearing aids. 22 (ii) For an insured person who is less than sixteen years of age, such 23 insured person shall be entitled to reimbursement of up to two thousand 24 dollars every twenty-four months for expenses related to the purchase of 25 up to two hearing aids, when it is medically demonstrated that: 26 (1) the hearing of the insured person under the age of sixteen has 27 changed significantly within a two-year period; and 28 (2) the existing hearing aid will no longer correct the hearing of the 29 insured person under the age of sixteen; such person shall be entitled 30 to reimbursement for additional hearing aid expenses. 31 (B)(i) For the purposes of this paragraph, "hearing aid" shall mean 32 any wearable instrument or device designed for hearing and any parts, 33 attachments or accessories but excluding batteries and cords or accesso- 34 ries thereto. A registered hearing aid dispenser or licensed audiologist 35 shall determine the type of device needed to correct the hearing loss. 36 (ii) For the purposes of this paragraph, services for recasing, 37 reshelling and acquiring new molds shall be included as part of the 38 policies. 39 (iii) For purposes of this paragraph, "small group" shall mean a group 40 of one hundred or fewer employees or members exclusive of spouses and 41 dependents. 42 (C) The insured person may choose a hearing aid exceeding the amount 43 of coverage required by this paragraph and shall be liable for the 44 difference in cost. Reimbursement shall be provided according to the 45 respective principles and policies of the health insurance plan and may 46 include such policy provisions as deductibles, coinsurance, allowable 47 charge limitations, and coordination of benefits. 48 § 3. Section 4303 of the insurance law is amended by adding a new 49 subsection (ss) to read as follows: 50 (ss) (1) Every individual and small group contract that provides 51 coverage for hospital, surgical or medical care shall provide coverage 52 for medically necessary hearing aids purchased from a hearing aid 53 dispenser registered under article thirty-seven-A of the general busi- 54 ness law or an audiologist licensed under article one hundred fifty-nine 55 of the education law in the following manner:A. 6586 3 1 (A) For an insured person sixteen years of age or older, such insured 2 person shall be entitled to reimbursement of up to three thousand 3 dollars every thirty-six months for expenses related to the purchase of 4 up to two hearing aids. 5 (B) For an insured person who is less than sixteen years of age, such 6 insured person shall be entitled to reimbursement of up to two thousand 7 dollars every twenty-four months for expenses related to the purchase of 8 up to two hearing aids, when it is medically demonstrated that: 9 (i) the hearing of the insured person under the age of sixteen has 10 changed significantly within a two-year period; and 11 (ii) the existing hearing aid will no longer correct the hearing of 12 the insured person under the age of sixteen; such person shall be enti- 13 tled to reimbursement for additional hearing aid expenses. 14 (2)(A) For the purposes of this subsection, "hearing aid" shall mean 15 any wearable instrument or device designed for hearing and any parts, 16 attachments or accessories but excluding batteries and cords or accesso- 17 ries thereto. A registered hearing aid dispenser or licensed audiologist 18 shall determine the type of device needed to correct the hearing loss. 19 (B) For the purposes of this subsection, services for recasing, 20 reshelling and acquiring new molds shall be included as part of the 21 policies. 22 (C) For purposes of this subsection, "small group" shall mean a group 23 of one hundred or fewer employees or members exclusive of spouses and 24 dependents. 25 (D) The insured person may choose a hearing aid exceeding the amount 26 of coverage required by this subsection and shall be liable for the 27 difference in cost. Reimbursement shall be provided according to the 28 respective principles and policies of the health insurance plan and may 29 include such policy provisions as deductibles, coinsurance, allowable 30 charge limitations, and coordination of benefits. 31 § 4. This act shall take effect on the ninetieth day after it shall 32 have become a law and shall apply according to its terms to all poli- 33 cies, contracts and certificates issued, renewed, modified, altered or 34 amended on or after such date.