Connecticut, Kentucky, Louisiana, Maryland, Minnesota, Missouri, and Oklahoma require that health benefits plans in their state pay for hearing aids for children. Requirements vary state by state for:
- ages covered
- amount of coverage
- benefit period
- provider qualifications
- type of hearing loss
Rhode Island requires coverage for both children and adults.
Existing laws in these eight states are summarized below with a link to each statute:
Connecticut
Requires individual and group health insurance policies to provide coverage for hearing aids for children 12 years old or younger; classifies hearing aids as durable medical equipment and allows policies to limit the benefit to $1,000 every 24 months.
Citation: Conn. Gen. Statute 38a-490b and 38a-516b (Use number indicated and select "Statutes - Section Text" as search options at Connecticut General Assembly)
Kentucky
Requires health benefit plans, including those provided to state employees or their dependents, to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid; payment capped at $1400 per hearing aid every 36 months; insured able to choose a higher price hearing aid and pay the difference in cost; hearing aid must be prescribed by a licensed audiologist and dispensed by a licensed audiologist or hearing instrument specialist.
Citation: KRS 304.17A-132 [PDF]
Louisiana
Requires any new health insurance policy after January 1, 2004, and any existing policy on or before its renewal date but no later than January 1, 2005, to cover hearing aids for children under 18 years of age if the aids are fitted and dispensed by a licensed audiologist or hearing aid specialist. May limit benefits to $1,400 per ear with hearing loss over a 36 month period. The insuree is able to purchase a more expensive hearing aid and pay the difference to the hearing aid provider.
Citation: La. R.S. 22:215.25
Maryland
Requires insurers to provide coverage for hearing aids for a minor child if the hearing aids are prescribed, fitted, and dispensed by a licensed audiologist; coverage may be limited to $1,400 per hearing aid for each hearing-impaired ear every 36 months; insured may choose a more expensive hearing aid and pay the difference.
Citation: Maryland Code §15-838 (Select "Code" and then enter "§15-838")
Minnesota
Requires coverage of hearing aids for children 18 years of age or younger if hearing loss is congenital and not correctable by other procedures covered in the policy, e.g., surgery; coverage limited to one hearing aid per affected ear every three years; may impose co-payment, co-insurance, or other limitations only if similar limitations apply to other coverages under the plan. Effective for policies issued on or after August 1, 2003.
Citation: Minn. Stat. 62Q.675
Missouri
Requires health insurance and Medicaid coverage for infant hear screening, re-screening (if necessary), audiological assessment and follow-up, and initial amplification, including hearing aids.
Citation: §376.1220 R.S. Mo.
Oklahoma
Effective November 1, 2002, requires any group health insurance or health benefit plan to provide coverage for audiological services and hearing aids for children up to 18 years of age; adds requirement of hearing aid prescription and dispensing by a licensed audiologist; allows hearing aid benefit every 48 months without a dollar limit.
Citation: 36 Okl. St. §6060.7 (Select "Oklahoma Statutes & Constitution", then enter 36-6060.7 in "Search Oklahoma Statutes")
Rhode Island
After January 1, 2006, requires every individual or group health insurance contract and hospital or medical expense insurance policy to provide $400 coverage per hearing aid per ear every three years for children and adults; the insurer may choose the provider of hearing aids with which to contract; the contract or policy shall also provide, as an optional rider, additional coverage for hearing aids.
Citation: http://www.rilin.state.ri.us/BillText/BillText05/HouseText05/H5742A.htm