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23LSO-0346
2023
STATE OF WYOMING
23LSO-0346
Numbered
2.0
SENATE FILE NO. SF0089
Insurance coverage for hearing aids.
Sponsored by: Senator(s) Furphy, Baldwin, Barlow, Landen and Nethercott and Representative(s) Brown, Provenza, Sherwood and Zwonitzer, Dn
A BILL
for
AN ACT relating to insurance; requiring health insurance and disability insurance plans to provide coverage for hearing aids and hearing aid professional services as specified; allowing for hearing aid coverage limitations; requiring that the cost of hearing aid coverage be equitable to other services provided under a health insurance plan; providing definitions; specifying applicability; and providing for an effective date.
Be It Enacted by the Legislature of the State of Wyoming:
Section 1
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W.S. 26
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20
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901 is created to read:
ARTICLE 9
HEARING AID COVERAGE
26
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20
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901.
Hearing aid coverage required.
(a)
As used in this section:
(i)
"Health insurance plan" means all individual and group health insurance policies providing coverage on an expense incurred basis, individual and group service or indemnity type contracts issued by any insurer including any nonprofit corporation and individual and group service contracts issued by a health maintenance organization;
(ii)
"Hearing aid" means as defined by W.S. 33
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35
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102(a)(ii);
(iii)
"Hearing aid professional" means an audiologist, hearing aid specialist or hearing aid dealer licensed under W.S. 33
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35
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103, physician, physician assistant or advanced practice registered nurse working within the professional's scope of practice.
(iv)
"Hearing aid professional services" means the practice of fitting, selecting, dispensing, selling or servicing hearing aids, or a combination, including:
(A)
Evaluation for a hearing aid;
(B)
Fitting for a hearing aid;
(C)
Programming for a hearing aid;
(D)
The making of impressions for ear molds; and
(E)
Auditory rehabilitation and training.
(b)
A health insurance plan shall provide coverage for one (1) hearing aid for each ear and the associated hearing aid professional services when the hearing aid or aids are deemed medically necessary pursuant to W.S. 26
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40
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102(a)(iii) and prescribed, fitted and dispensed by one (1) or more hearing aid professionals who are in network with the health insurance plan.
(c)
The coverage required by this section shall be subject to a deductible, co
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payment or coinsurance provision that is equal to or less than the deductible, co
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payment or coinsurance provisions that apply generally to other services under the health insurance plan.
(d)
A health insurance plan may limit coverage to not more than one (1) hearing aid per ear every three (3) years at a cost of not more than two thousand dollars ($2,000.00) per ear, except that a plan shall cover the cost of one (1) or more new hearing aids for a covered individual prior to the expiration of the three (3) year period based on a hearing aid professional's determination that a new hearing aid for one (1) or both ears is medically necessary pursuant to W.S. 26
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40
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102(a)(iii).
(e)
Subject to subsection (d) of this section, the coverage provided for hearing aids and associated hearing aid professional services shall be limited only by medical necessity pursuant to W.S. 26
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40
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102(a)(iii). A covered individual may select additional hearing aids that exceed the limits set forth in this subsection and subsection (d) of this section and pay the additional cost.
Section 2.
This act is effective July 1, 2024.
(END)
1
SF0089