SECTION 1 (TITLE):
This act shall be known as the Hearing Enhancement Aid Reimbursement Act (HEAR) Act.
SECTION 2 (PURPOSE):
To provide coverage for hearing aids at annually-determined minimum coverage rates per hearing aid to all individuals with documented hearing loss.
SECTION 3 (PROVISIONS):
(a) All individual and group health policies, contracts, and certificates, and all health maintenance organization individual and group health insurance contracts must provide for coverage for the purchase of a hearing aid for each deaf or hard of hearing ear for an individual covered under the policy, contract, or certificate in accordance with the following:
- (i) The DEPARTMENT shall annually set and promulgate minimum coverage rates and coverage limits for adult and child hearing aids for each hard of hearing or deaf ear.
- (ii) At a minimum, the DEPARTMENT must provide rates that would allow for 100% coverage of reasonable and customary hearing aids.
- (iii) The DEPARTMENT shall every two years select and promulgate an approved list of audiologist and hearing aid dealers licensed in STATE for which health policies and contracts must provide coverage in accordance with this section.
- (iv) The hearing loss for which hearing aid coverage applies in each deaf or hard of hearing ear must be documented by a physician or audiologist licensed in STATE.
(b) A covered person may choose a higher priced hearing aid and may pay the difference in cost above the minimum coverage amount without any financial or contractual penalty to the covered person or to the provider of the hearing aid.
(c) The requirements for this Act apply to all policies, contracts, and certificates executed, delivered, issued for delivery, continued or renewed in this STATE on or after the effective date of this Act. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.