Summary: Chapter 233 of the Acts of 2012 (HB 52)

The Children’s Hearing Aid Bill*

H52, the Children’s Hearing Aid Bill, applies to any minor child age twenty-one or younger covered under the Group Insurance Commission (GIC), accident and sickness insurance policies, or HMOs, as well as to any minor child age twenty-one or younger covered under contracts with non-profit hospital service corporations or certificates under medical service agreements if they are residents of or have principal employment in Massachusetts.

The bill assures that individuals covered under the aforementioned policies shall be eligible for assistance from their insurance company in attaining hearing aids.

HB52 mandates coverage for:

•• One hearing aid per hearing impaired ear every 36 months upon a written statement of medical necessity by the minor’s treating physician. Hearing aids are described as ‘a wearable aid or device designed for or offered for the purpose of aiding or compensating for hearing loss.' This definition explicitly excludes surgical implants,including abutments or cochlear implants; however, devices inserted directly into the ear or worn with an ear mold, as well as air conduction receivers and bone oscillator attachments (equipment only) are included. Coverage is limited to $2000 per device.

•• All related services prescribed by a licensed audiologist or hearing instrument specialist, including an initial evaluation, fitting and adjustments, and related supplies

including ear molds and batteries. These services and supplies are not subject to a coverage cap.

•• The insured is permitted to choose a higher priced hearing aid device and “may pay the difference in cost above the two thousand dollar ($2000) limit as provided without any financial or contractual penalty to the insured or to the provider of the hearing aid.”

*This summary is excerpted from a report prepared on behalf of the Division of Health Care Finance and Policy by Compass Health Analytics

Timeline: Check with your health insurance provider; depending upon the annual renewal date, the start date for hearing aid coverage may vary.

 


This information is provided by the Massachusetts Commission for the Deaf and Hard of Hearing.