S T A T E O F N E W Y O R K
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6586
2019-2020 Regular Sessions
I N A S S E M B L Y
March 12, 2019
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Introduced by M. of A. SEAWRIGHT -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to hearing aids
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 35 to read as follows:
(35) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR
MEDICAL CARE 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:
(I) 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.
(II) 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:
(1) THE HEARING OF THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
(2) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF THE
INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTITLED
TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
(B)(I) FOR THE PURPOSES OF THIS PARAGRAPH, "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.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10275-01-9
A. 6586 2
(II) FOR THE PURPOSES OF THIS PARAGRAPH, SERVICES FOR RECASING,
RESHELLING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE
POLICIES.
(C) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS PARAGRAPH AND SHALL BE LIABLE FOR THE
DIFFERENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE
RESPECTIVE 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. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 21 to read as follows:
(21) (A) EVERY SMALL GROUP POLICY THAT PROVIDES COVERAGE FOR HOSPITAL,
SURGICAL OR MEDICAL CARE 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:
(I) 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.
(II) 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:
(1) THE HEARING OF THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
(2) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF THE
INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTITLED
TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
(B)(I) FOR THE PURPOSES OF THIS PARAGRAPH, "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.
(II) FOR THE PURPOSES OF THIS PARAGRAPH, SERVICES FOR RECASING,
RESHELLING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE
POLICIES.
(III) FOR PURPOSES OF THIS PARAGRAPH, "SMALL GROUP" SHALL MEAN A GROUP
OF ONE HUNDRED OR FEWER EMPLOYEES OR MEMBERS EXCLUSIVE OF SPOUSES AND
DEPENDENTS.
(C) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS PARAGRAPH AND SHALL BE LIABLE FOR THE
DIFFERENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE
RESPECTIVE 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. Section 4303 of the insurance law is amended by adding a new
subsection (ss) to read as follows:
(SS) (1) EVERY INDIVIDUAL AND SMALL GROUP CONTRACT THAT PROVIDES
COVERAGE FOR HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE COVERAGE
FOR MEDICALLY NECESSARY HEARING AIDS PURCHASED FROM A HEARING AID
DISPENSER REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSI-
NESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE
OF THE EDUCATION LAW IN THE FOLLOWING MANNER:
A. 6586 3
(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 SUBSECTION, SERVICES FOR RECASING,
RESHELLING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE
POLICIES.
(C) FOR PURPOSES OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP
OF ONE HUNDRED OR FEWER EMPLOYEES OR MEMBERS EXCLUSIVE OF SPOUSES AND
DEPENDENTS.
(D) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS SUBSECTION AND SHALL BE LIABLE FOR THE
DIFFERENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE
RESPECTIVE PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND MAY
INCLUDE SUCH POLICY PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
§ 4. 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.