Full Text of SB0068 96th General Assembly
SB0068sam002 96TH GENERAL ASSEMBLY
|
Sen. Ira I. Silverstein
Filed: 3/5/2009
|
|
09600SB0068sam002 |
|
LRB096 03606 RPM 23022 a |
|
| 1 |
| AMENDMENT TO SENATE BILL 68
| 2 |
| AMENDMENT NO. ______. Amend Senate Bill 68 as follows:
| 3 |
| on page 1, line 7, by replacing " Coverage for hearing aids for | 4 |
| all " with " Audiological services. "; and | 5 |
| on page 1, by deleting line 8; and | 6 |
| on page 2, by replacing line 1 through line 26 with the | 7 |
| following: | 8 |
| " (b) An individual or group policy of accident and health | 9 |
| insurance or managed care plan that is amended, delivered, | 10 |
| issued, or renewed after the effective date of this amendatory | 11 |
| Act of the 96th General Assembly must provide coverage for | 12 |
| audiological services, hearing instruments, and related | 13 |
| services for children up to 18 years of age or 23 years of age | 14 |
| if enrolled in a post secondary educational program when a | 15 |
| hearing care professional prescribes, fits, and dispenses a |
|
|
|
09600SB0068sam002 |
- 2 - |
LRB096 03606 RPM 23022 a |
|
| 1 |
| hearing instrument to augment communication. | 2 |
| (c) An insurer shall provide coverage, subject to all | 3 |
| applicable co-payments, co-insurance, deductibles, and | 4 |
| out-of-pocket limits for up to $2,000 per hearing impaired ear | 5 |
| per coverage period subject to the following restrictions: | 6 |
| (1) a policy or plan may limit the hearing aid benefit | 7 |
| coverage period for each hearing-impaired ear to 36 months; | 8 |
| (2) the coverage shall provide for a benefit of $2,000 | 9 |
| per hearing-impaired ear per coverage period and | 10 |
| guarantors shall be contractually allowed to pay the | 11 |
| difference between the benefit amount and the health care | 12 |
| professional's usual and customary charge for the device; | 13 |
| (3) the benefit may be used to cover hearing aids, | 14 |
| assistive-listening devices, hearing-aid accessories, | 15 |
| hearing-aid repairs, earmolds, and remote controls that | 16 |
| are prescribed and dispensed by a health care professional; | 17 |
| (4) a policy or plan may provide for up to 4 additional | 18 |
| ear molds per year at $50 each for children up to 5 years | 19 |
| of age; and | 20 |
| (5) for all insured individuals, any hearing aid may be | 21 |
| replaced at any time regardless of the above restrictions | 22 |
| if there is a significant change in the insured | 23 |
| individual's hearing status; such significant change is | 24 |
| defined as a change of 10 decibels HL on the | 25 |
| three-frequency pure-tone average (500Hz, 1000 Hz and 2000 | 26 |
| Hz) on a valid audiogram provided by a hearing care |
|
|
|
09600SB0068sam002 |
- 3 - |
LRB096 03606 RPM 23022 a |
|
| 1 |
| professional. "; and
| 2 |
| on page 3, by deleting line 1.
|
|