State Insurance Mandates for Hearing Aids Author:    Posted under: Health InsuranceHealth Insurance Types

Mandates are benefits that each state requires from their health insurance agencies. Even though more mandates are favorable to patients because it forces insurance companies to pay for more services, in general, it increases the price in the coverage.

Every state differs from their mandatory insurance. Some states require health-care providers to pay for ambulance services, rehabilitation services, drug abuse treatment, second surgical opinions, breast reconstruction, and medical practices associated with autism and alcoholism; while others offer orthotics, prosthetics, and in vitro fertilization. Every state in the US has their own list of mandated insurance which contains hundreds of items in exact details what health insurance companies must cover.

One of these mandates that have been getting a lot of publicity lately is the mandate for hearing aids or cochlear implants. We all know that the high cost of hearing aids or cochlear implants is one of the biggest reasons why most people who need them are most likely subjected from accessing the needed technology. And although insurance or coverage for the said technology is already mandatory in a lot of states, it is still far from being universal. But this already is considered to be a good start by many.

There are said to be an estimated 28 million Americans who suffer from hearing loss.  Still, only 1 out of 5 people who could benefit from a hearing aid or cochlear implants actually wears one. This is why a mandatory insurance like this is very helpful to the citizens of these states:

Arkansas (HB 1930 / Act 1179) in effect 1/2010
requires insurance companies to offer coverage to employers in the state. Nevertheless, if the employer chooses to add this option, the health plan must provide no less than $1,400 per ear of hearing aid coverage, every three years for individuals regardless of age.

Connecticut (SB 136) in effect 10/2001
covers or provides children less 12 years of age health insurance policies with a limit of $1,000 total, every 24 months.

Colorado (CO SB 057) in effect 1/2009
when medically necessary, requires insurance providers to cover hearing aids for children under 18 years of age with a limit of 1 hearing aid per ear every 5 years, no limit on cost but deductibles and co-pays may apply.

Delaware (DE HB 355) in effect 1/2009
Children under 18 are covered requiring individual and group health insurance contracts to provide coverage for hearing aids of up to $1,000 per ear, every 36 months and children under 24 years of age are covered as a dependent by the policy holder.

Kentucky (KRS 304.17A-132) in effect 2002
Covers children under 18 health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for individuals less than 18 years of age as needed with a limit of $1,400 per aid, every 36 months. And also, their state employees were added to the coverage list as of last legislative session.

Louisiana (La R.S. 22:215.25) in effect 1/2004
Covers children less than 18 years of age with a limit $1,400 per aid, every 36 months.

Maine (ME LD 1514) in effect 1/2008, 1/2009, 1/2010
Covered – Children 5 and under took effect Jan. 1, 2008, children 6-13 takes effect Jan. 1, 2009, children 14-18 takes effect Jan. 1, 2010 a limit of $1,400 per aid, every 36 months.

Maryland (HB 160) in effect 2002
Covers children less than 18 years of age with a limit of $1,400 per aid, every 36 months.

Minnesota (Minn. Stat. 62Q.675) in effect 8/2003
Covers children less than 18 years of age with a limit of 1 hearing aid per ear, every 36 months, no limit on cost and no additional deductible nor similar restrictions.

Missouri (376.1220 R.S. Mo) in effect 2004
Newborns has coverage for screening, hearing aid purchases and audiological assessment with a
limit, although coverage amount varies per need of the newborn.

New Hampshire (HB 561) in effect 1/2011
Has no age restrictions with a limit of $1,500 per hearing aid, per ear, once every 60 months.

New Jersey (S. 467 / A. 1571) in effect 4/2009
Offers coverage for children 15 years old and younger with a limit of coverage for $1,000 per aid, once every 2 years.

New Mexico (SB 529) in effect 7/2007
Covers children 18 and under, or even those 21 and under if they are still enrolled in high school with a
limit of $2,200 per ear, once every 36 months.

North Carolina (HB 589) in effect 1/2011
Children under the age of 22 has coverage with a limit of up to $2,500 per hearing aid, per ear, once every 36 months.

Oklahoma (36 Okl. St. 6060.7) in effect 11/2002
Covers children under 18 and adds requirement of hearing aid prescription and dispensing by a licensed audiologist; allowing hearing aid benefit every 48 months without a dollar limit.

Oregon (HB 2589 / Chapter 553 – 2009 Laws) in effect 1/2010
Children under 18 and also dependents are covered with a limit – $4,000 per aid, once every 48 months.

Rhode Island (R.I. Gen. Stat. 27-19-51) in effect 1/2002
No age restrictions on coverage but with a limit increased in 2006 from $400 to $2,000, per hearing aid for people under 19. For all others, increased from $400 to $800, per hearing aid once every 36 months for both groups.

Wisconsin (SB 27 / 2009 Wisconsin Act 17) in effect 1/2010
Covers children under 18 (Hearing aids and cochlear implants) with no dollar limit covering the cost of one hearing aid per ear (once every 3 years), cochlear implants, and related therapy.


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