S T A T E O F N E W Y O R K
________________________________________________________________________
501
2019-2020 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 9, 2019
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to requiring certain
group health insurance policies to provide coverage for hearing aids
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3221 of the insurance law is amended by adding a
new subsection (t) to read as follows:
(T) (1) EVERY GROUP HEALTH INSURANCE POLICY OFFERED IN THE LARGE GROUP
MARKET THAT IS ISSUED, AMENDED, OR RENEWED IN THIS STATE SHALL PROVIDE
COVERAGE FOR MEDICALLY NECESSARY HEARING AIDS PURCHASED FROM A HEARING
AID DISPENSER REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL
BUSINESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED
FIFTY-NINE OF THE EDUCATION LAW IN THE FOLLOWING MANNER:
(A) FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH INSURED
PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO THREE THOUSAND
DOLLARS EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS.
(B) FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO THOUSAND
DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
(I) THE HEARING OF THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
(II) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF
THE INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTI-
TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
(2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN
ANY WEARABLE INSTRUMENT OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03704-01-9
A. 501 2
RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
(B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL-
ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
(3) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
ENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE RESPEC-
TIVE PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND MAY
INCLUDE SUCH POLICY PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
§ 2. Section 4305 of the insurance law is amended by adding a new
subsection (n) to read as follows:
(N) (1) A GROUP CONTRACT ISSUED, AMENDED, OR RENEWED PURSUANT TO THIS
SECTION OFFERED IN THE LARGE GROUP MARKET SHALL PROVIDE COVERAGE FOR
MEDICALLY NECESSARY HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER
REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSINESS LAW OR
AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE
EDUCATION LAW IN THE FOLLOWING MANNER:
(A) FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH INSURED
PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO THREE THOUSAND
DOLLARS EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS.
(B) FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO THOUSAND
DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
(I) THE HEARING OF THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
(II) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF
THE INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTI-
TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
(2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN
ANY WEARABLE INSTRUMENT OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
(B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL-
ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
(3) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
ENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE RESPEC-
TIVE PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND MAY
INCLUDE SUCH POLICY PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
§ 3. This act shall take effect on the ninetieth day after it shall
have become a law and shall apply according to its terms to all poli-
cies, contracts and certificates issued, renewed, modified, altered or
amended on or after such date.