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CA Legislation Requiring Insurance Coverage of Pediatric Hearing Aids Heads to Senate Floor

CA Legislation Requiring Insurance Coverage of Pediatric Hearing Aids Heads to Senate Floor

September 09, 2019 Government Relations News

California AB 598, sponsored by Assemblyman Richard Bloom (D), would require insurance plans to cover the cost of hearing aids for children aged 18 and under. This bill cleared the senate appropriations committee by a unanimous vote last week and now will head to the senate floor.  The California legislature has until September 13 to pass legislation and Governor Gavin Newsome can sign bills through October 14th.  If passed, the insurance mandate would go into effect July 1, 2020 and California would be the 26th state to pass such a measure.

The maximum coverage amount would be three thousand dollars ($3,000) per individual hearing aid. An enrollee may choose to purchase a hearing aid that exceeds the maximum coverage amount, and shall be responsible for the difference between the cost of the hearing aid and the maximum coverage amount. Hearing aids covered pursuant to this section shall be subject to the cost sharing imposed by the plan contract for durable medical equipment and shall not be subject to more restrictive limitations on coverage or higher cost sharing than other items of durable medical equipment covered by the plan contract.  Coverage also includes an initial assessment, new hearing aids at least every four years, new earmolds, new hearing aids if alterations to existing hearing aids cannot meet the needs of the child, a new hearing aid if the existing one is no longer working, fittings, adjustments, auditory training, and maintenance of the hearing aids.  Related services would be provided by a contracted provider unless the plan has a provision for out-of-network services.

State advocates have maintained a PR campaign, “Let CA Kids Hear” to rally support for the bill and actress and singer Idina Menzel has joined other advocates to voice her support for the bill.

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