SENATE BILL 529
48th legislature - STATE OF NEW MEXICO - first session, 2007
INTRODUCED BY
Nancy Rodriguez
AN ACT
RELATING TO INSURANCE; REQUIRING INSURANCE COVERAGE FOR HEARING AIDS FOR ELIGIBLE CHILDREN.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. A new section of the Health Care Purchasing Act is enacted to read:
"[NEW MATERIAL] HEARING AID COVERAGE FOR CHILDREN REQUIRED.--
A. Group health care coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aids.
B. Each insurer that delivers, issues for delivery or renews under the Health Care Purchasing Act any group health care coverage, including any form of self-insurance, shall make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section.
C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies.
E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same group health care coverage, including any form of self-insurance.
F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children."
Section 2. A new section of the New Mexico Insurance Code, Section 59A-22-34.5 NMSA 1978, is enacted to read:
"59A-22-34.5. [NEW MATERIAL] HEARING AID COVERAGE FOR CHILDREN REQUIRED.--
A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid.
B. An insurer that delivers, issues for delivery or renews in this state an individual or group health insurance policy, health care plan or certificate of health insurance shall make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section.
C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies.
E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.
F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children."
Section 3. A new section of the New Mexico Insurance Code, Section 59A-23-7.6 NMSA 1978, is enacted to read:
"59A-23-7.6. [NEW MATERIAL] HEARING AID COVERAGE FOR CHILDREN REQUIRED.--
A. A blanket or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid.
B. An insurer that delivers, issues for delivery or renews in this state a blanket or group health insurance policy, health care plan or certificate of health insurance shall make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section.
C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies.
E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.
F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children."
Section 4. A new section of the New Mexico Insurance Code, Section 59A-46-38.5 NMSA 1978, is enacted to read:
"59A-46-38.5. [NEW MATERIAL] HEARING AID COVERAGE FOR CHILDREN REQUIRED.--
A. An individual or group health maintenance organization contract delivered, issued for delivery or renewed in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid.
B. An insurer that delivers, issues for delivery or renews in this state an individual or group health maintenance organization contract shall make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section.
C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies.
E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.
F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children."
Section 5. A new section of the New Mexico Insurance Code, Section 59A-47-37.1 NMSA 1978, is enacted to read:
"59A-47-37.1. [NEW MATERIAL] HEARING AID COVERAGE FOR CHILDREN REQUIRED.--
A. An individual or group health insurance policy, health care plan or certificate of health insurance delivered or issued for delivery in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid.
B. An insurer that delivers, issues for delivery or renews in this state an individual or group health insurance policy, health care plan or certificate of health insurance shall make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section.
C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico.
D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies.
E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate.
F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children."
Section 6. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2007.
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