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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Insurance Code is amended by | ||||||
5 | changing Section 356z.30 as follows: | ||||||
6 | (215 ILCS 5/356z.30) | ||||||
7 | Sec. 356z.30. Coverage for hearing aids for individuals | ||||||
8 | under the age of 18 . | ||||||
9 | (a) As used in this Section: | ||||||
10 | "Hearing care professional" means a person who is a
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11 | licensed hearing instrument dispenser, licensed audiologist, | ||||||
12 | or licensed physician. | ||||||
13 | "Hearing instrument" or "hearing aid" means any wearable
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14 | non-disposable, non-experimental instrument or device designed | ||||||
15 | to aid or
compensate for impaired human hearing and any parts, | ||||||
16 | attachments, or accessories for the instrument or device, | ||||||
17 | including
an ear mold but excluding batteries and cords. | ||||||
18 | (b) An individual or group policy of accident and health
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19 | insurance or managed care plan that is amended, delivered,
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20 | issued, or renewed after the effective date of this amendatory | ||||||
21 | Act of the 103rd General Assembly August 22, 2018 (the | ||||||
22 | effective date of Public Act 100-1026) must provide coverage | ||||||
23 | for
medically necessary hearing instruments and related |
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1 | services for all individuals under the age of 18
when a hearing | ||||||
2 | care professional prescribes a hearing instrument to augment | ||||||
3 | communication. | ||||||
4 | (c) An insurer shall provide coverage, subject to all | ||||||
5 | applicable co-payments, co-insurance, deductibles, and | ||||||
6 | out-of-pocket limits, subject to the following restrictions: | ||||||
7 | (1) one hearing instrument shall be covered for each | ||||||
8 | ear every 36 months; | ||||||
9 | (2) related services, such as audiological exams and | ||||||
10 | selection, fitting, and adjustment of ear molds to | ||||||
11 | maintain optimal fit shall be covered when deemed | ||||||
12 | medically necessary by a hearing care professional; and | ||||||
13 | (3) hearing instrument repairs may be covered when | ||||||
14 | deemed medically necessary. | ||||||
15 | (d) If, at any time before or after the effective date of | ||||||
16 | this amendatory Act of the 103rd General Assembly August 22, | ||||||
17 | 2018 (the effective date of Public Act 100-1026) , the | ||||||
18 | Secretary of the United States Department of Health and Human | ||||||
19 | Services, or its successor agency, promulgates rules or | ||||||
20 | regulations to be published in the Federal Register, publishes | ||||||
21 | a comment in the Federal Register, or issues an opinion, | ||||||
22 | guidance, or other action that would require the State, | ||||||
23 | pursuant to any provision of the Patient Protection and | ||||||
24 | Affordable Care Act (Pub. L. 111–148), including, but not | ||||||
25 | limited to, 42 U.S.C. 18031(d)(3)(B) or any successor | ||||||
26 | provision, to defray the cost of coverage for medically |
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1 | necessary hearing instruments and related services for any | ||||||
2 | individual individuals under the age of 18 , then this Section | ||||||
3 | is inoperative with respect to all such coverage other than | ||||||
4 | that authorized under Section 1902 of the Social Security Act, | ||||||
5 | 42 U.S.C. 1396a, and the State shall not assume any obligation | ||||||
6 | for the cost of coverage for medically necessary hearing | ||||||
7 | instruments and related services for any individual subject to | ||||||
8 | federally defrayed cost of coverage individuals under the age | ||||||
9 | of 18 .
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10 | (Source: P.A. 100-1026, eff. 8-22-18; 101-81, eff. 7-12-19.)
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11 | (215 ILCS 5/356z.30a rep.) | ||||||
12 | Section 10. The Illinois Insurance Code is amended by | ||||||
13 | repealing Section 356z.30a. | ||||||
14 | Section 99. Effective date. This Act takes effect January | ||||||
15 | 1, 2025.
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