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A1941
ASSEMBLY, No. 1941
STATE OF NEW JERSEY
222nd LEGISLATURE
�
PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION
Sponsored by:
Assemblywoman ANNETTE QUIJANO
District 20 (Union)
Assemblywoman VERLINA REYNOLDS-JACKSON
District 15 (Hunterdon and Mercer)
SYNOPSIS
���� Requires health insurers to provide coverage for
hearing aids.
CURRENT VERSION OF TEXT
���� Introduced Pending Technical Review by Legislative
Counsel.
��
An Act
concerning health insurance coverage for hearing aids
and supplementing
Titles 17 and 26 of the Revised Statutes and Title 17B
of the New Jersey Statutes.
����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:
���� 1.��� A hospital service
corporation contract that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State, or approved for issuance
or renewal in this State by the Commissioner of Banking and Insurance, on or after
the effective date of this act, shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those hospital service corporation contracts in which the hospital service
corporation has reserved the right to change the premium.
���� 2.��� A medical service
corporation contract that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State, or approved for issuance
or renewal in this State by the Commissioner of Banking and Insurance, on or after
the effective date of this act, shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those medical service corporation contracts in which the medical service
corporation has reserved the right to change the premium.
���� 3.��� A health service
corporation contract that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State, or approved for issuance
or renewal in this State by the Commissioner of Banking and Insurance, on or after
the effective date of this act, shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those health service corporation contracts in which the health service
corporation has reserved the right to change the premium.
���� 4.��� A group health insurance
policy that provides hospital or medical expense benefits and is delivered,
issued, executed or renewed in this State, or approved for issuance or renewal
in this State by the Commissioner of Banking and Insurance, on or after the
effective date of this act, shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those insurance policies in which the insurer has reserved the right to
change the premium.
���� 5.��� An individual health
insurance policy that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State, or approved for issuance
or renewal in this State by the Commissioner of Banking and Insurance, on or after
the effective date of this act, shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those insurance policies in which the insurer has reserved the right to
change the premium.
���� 6.��� A certificate of
authority to establish and operate a health maintenance organization in this
State shall not be issued or continued by the Commissioner of Health, on or
after the effective date of this act, unless the health maintenance
organization provides health care services coverage for the purchase of a
hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the enrollee for the hearing aid, including any copayments or
deductibles, shall not exceed 15 percent of the cost of the hearing aid.
���� c.��� The provisions of this
section shall apply to those contracts for health care services by health
maintenance organizations under which the right to change the schedule of
charges for enrollee coverage is reserved.
���� 7.��� An individual health
benefits plan that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to P.L.1992,
c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State,
on or after the effective date of this act, shall provide coverage for
medically necessary expenses incurred in the purchase of a hearing aid pursuant
to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those health benefits plans in which the carrier has reserved the right to
change the premium.
���� 8.��� A small employer health
benefits plan that provides hospital or medical expense benefits and is
delivered, issued, executed or renewed in this State pursuant to P.L.1992,
c.162 (C.17B:27A-17 et seq.) or approved for issuance or renewal in this State,
on or after the effective date of this act, shall provide coverage for
medically necessary expenses incurred in the purchase of a hearing aid pursuant
to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� c.��� This section shall apply
to those health benefits plans in which the carrier has reserved the right to
change the premium.
���� 9.��� The State Health
Benefits Commission shall provide coverage for medically necessary expenses
incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� 10.� The School Employees�
Health Benefits Commission shall provide coverage for medically necessary
expenses incurred in the purchase of a hearing aid pursuant to this section.
���� a.��� The coverage shall
include the purchase of one analog or digital hearing aid for each ear at least
every 48 months, as prescribed or recommended by a State licensed audiologist
or a hearing aid dispenser licensed pursuant to P.L.1973, c.19 (C.45:9A-1 et seq.).
���� b.��� The total cost sharing
responsibility of the covered person for the hearing aid, including any
copayments or deductibles, shall not exceed 15 percent of the cost of the
hearing aid.
���� 11.� This act shall take
effect on the 30th day after enactment.
STATEMENT
���� This bill would require
hospital, medical and health service corporations, commercial insurers, health
maintenance organizations, health benefits plans issued pursuant to the New
Jersey Individual Health Coverage and Small Employer Health Benefits Programs,
and plans provided by the State Health Benefits Commission and the School
Employees� Health Benefits Commission to provide coverage for medically
necessary expenses incurred in the purchase of a hearing aid.�
���� The coverage shall include the
purchase of one analog or digital hearing aid for each ear at least every 48
months, as prescribed or recommended by a State licensed audiologist or State
licensed hearing aid dispenser.� The total cost sharing responsibility of the
covered person for the hearing aid, including any copayments or deductibles,
shall not exceed 15 percent of the cost of the hearing aid.