SB 27

This bill requires health insurance policies and plans to cover the cost of

hearing aids, which include any externally wearable instruments or devices

designed to enhance hearing, and cochlear implants, which include any implantable

instruments or devices designed to enhance hearing, that are prescribed by a

physician or audiologist in accordance with accepted professional medical or

audiological standards, for any child under 18 years of age who has coverage under

the policy or plan and who is certified as deaf or hearing impaired by a physician or

an audiologist. Treatment (defined as services, diagnoses, procedures, surgery, and

therapy provided by a health care professional) for such a child that is related to

hearing aids and cochlear implants is also required to be covered. Coverage for

hearing aids is not required to exceed the cost of one hearing aid per ear per child

more often than once every three years. The coverage requirement applies to both

individual and group health insurance policies and plans, including defined network

plans and cooperative sickness care associations; to health care plans offered by the

state to its employees, including a self-insured plan; and to self-insured health

plans of counties, cities, towns, villages, and school districts. The requirement

specifically does not apply to limited-scope benefit plans, medicare replacement or

supplement policies, long-term care policies, or policies covering only certain

specified diseases. The required coverage may be subject to any limitations,

cost-sharing provisions, or exclusions, other than a preexisting condition exclusion,

that apply generally under the policy or plan. An exception is that an individual

health insurance policy may impose a preexisting condition exclusion that does not

exceed one year with respect to coverage for cochlear implants and related

treatment. However, the bill requires an individual health insurance policy that

imposes a preexisting condition exclusion to cover the cost of cochlear implants and

related treatment during the preexisting condition exclusion period if certain

specified medical conditions occur during the period that make time of the essence

for a child to receive the implants and related treatment.