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Sen. Ira I. Silverstein
Filed: 3/5/2009
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| AMENDMENT TO SENATE BILL 68
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| AMENDMENT NO. ______. Amend Senate Bill 68 as follows:
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| on page 1, line 7, by replacing "Coverage for hearing aids for |
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| all" with "Audiological services."; and
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| on page 1, by deleting line 8; and
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| on page 2, by replacing line 1 through line 26 with the |
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| following: |
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| "(b) An individual or group policy of accident and health |
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| insurance or managed care plan that is amended, delivered, |
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| issued, or renewed after the effective date of this amendatory |
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| Act of the 96th General Assembly must provide coverage for |
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| audiological services, hearing instruments, and related |
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| services for children up to 18 years of age or 23 years of age |
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| if enrolled in a post secondary educational program when a |
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| hearing care professional prescribes, fits, and dispenses a |
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| hearing instrument to augment communication. |
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| (c) An insurer shall provide coverage, subject to all |
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| applicable co-payments, co-insurance, deductibles, and |
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| out-of-pocket limits for up to $2,000 per hearing impaired ear |
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| per coverage period subject to the following restrictions: |
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| (1) a policy or plan may limit the hearing aid benefit |
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| coverage period for each hearing-impaired ear to 36 months; |
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| (2) the coverage shall provide for a benefit of $2,000 |
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| per hearing-impaired ear per coverage period and |
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| guarantors shall be contractually allowed to pay the |
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| difference between the benefit amount and the health care |
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| professional's usual and customary charge for the device; |
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| (3) the benefit may be used to cover hearing aids, |
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| assistive-listening devices, hearing-aid accessories, |
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| hearing-aid repairs, earmolds, and remote controls that |
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| are prescribed and dispensed by a health care professional; |
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| (4) a policy or plan may provide for up to 4 additional |
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| ear molds per year at $50 each for children up to 5 years |
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| of age; and |
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| (5) for all insured individuals, any hearing aid may be |
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| replaced at any time regardless of the above restrictions |
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| if there is a significant change in the insured |
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| individual's hearing status; such significant change is |
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| defined as a change of 10 decibels HL on the |
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| three-frequency pure-tone average (500Hz, 1000 Hz and 2000 |
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| Hz) on a valid audiogram provided by a hearing care |