HB 79 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0079-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to insurance coverage for hearing aids 2
for children; creating s. 627.6413, F.S.; providing a 3
definition of the term "hearing aid"; requiring 4
certain individual health insurance policies to 5
provide coverage for hearing aids for children 21 6
years of age or younger under certain circumstances; 7
specifying health care providers who may prescribe, 8
fit, and dispense the h earing aids; specifying a 9
minimum coverage limit within a certain timeframe; 10
providing an exception; providing that an insured is 11
responsible for certain costs that exceed the policy 12
limit; providing applicability; amending s. 641.31, 13
F.S.; requiring certa in individual health maintenance 14
contracts to provide coverage for hearing aids for 15
children 21 years of age or younger under certain 16
circumstances; specifying health care providers who 17
may prescribe, fit, and dispense the hearing aids; 18
specifying a minimum coverage limit within a certain 19
timeframe; providing an exception; providing that a 20
subscriber is responsible for certain costs that 21
exceed the contract limit; providing a definition of 22
the term "hearing aid"; providing applicability; 23
providing an effective date. 24
25
HB 79 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0079-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Be It Enacted by the Legislature of the State of Florida: 26
27
Section 1. Section 627.6413, Florida Statutes, is created 28
to read: 29
627.6413 Coverage for hearing aids for children. — 30
(1) As used in this section, the term "hearing aid" means 31
any wearable instrument or device designed for, offered for the 32
purpose of, or represented as aiding persons with or 33
compensating for, impaired hearing. 34
(2) A health insurer issuing an individual policy that 35
provides major medical or similar comprehensi ve coverage to an 36
insured or a family member of an insured must provide coverage 37
for a hearing aid for an insured child 21 years of age or 38
younger who is diagnosed with hearing loss by a licensed 39
physician or a licensed audiologist and for whom the hearing aid 40
is prescribed as medically necessary. Coverage for a hearing aid 41
prescribed to a child younger than 18 years of age must require 42
the hearing aid to be prescribed, fitted, and dispensed by a 43
licensed physician or a licensed audiologist. Coverage for a 44
hearing aid prescribed to a child between 18 and 21 years of 45
age, inclusive, must require the hearing aid to be fitted and 46
dispensed by a licensed physician, a licensed audiologist, or a 47
licensed hearing aid specialist. 48
(3) The policy must provide a mini mum coverage limit of 49
$3,500 per ear within a 24 -month period. However, if a child 50
HB 79 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0079-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
experiences a significant and unexpected change in his or her 51
hearing or a medical condition requiring an unexpected change in 52
the hearing aid before the existing 24 -month period expires, and 53
if alterations to the existing hearing aid do not or cannot meet 54
the needs of the child, a new 24 -month period must begin with 55
full benefits and coverage. 56
(4) An insured is responsible for the cost of hearing aids 57
and related services which exceeds the coverage limit provided 58
by his or her policy. 59
(5) This section applies to a policy issued or renewed on 60
or after January 1, 2023. 61
Section 2. Subsection (48) is added to section 641.31, 62
Florida Statutes, to read: 63
641.31 Health maintenance contracts.— 64
(48)(a) A health maintenance organization issuing an 65
individual contract that provides major medical or similar 66
comprehensive coverage to a subscriber or a family member of a 67
subscriber must provide coverage for a hearing aid for a co vered 68
child 21 years of age or younger who is diagnosed with hearing 69
loss by a licensed physician or a licensed audiologist and for 70
whom the hearing aid is prescribed as medically necessary. 71
Coverage for a hearing aid prescribed to a child younger than 18 72
years of age must require the hearing aid to be prescribed, 73
fitted, and dispensed by a licensed physician or a licensed 74
audiologist. Coverage for a hearing aid prescribed to a child 75
HB 79 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0079-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
between 18 and 21 years of age, inclusive, must require the 76
hearing aid to be fitted and dispensed by a licensed physician, 77
a licensed audiologist, or a licensed hearing aid specialist. 78
(b) The contract must provide a minimum coverage limit of 79
$3,500 per ear within a 24 -month period. However, if a child 80
experiences a significa nt and unexpected change in his or her 81
hearing or a medical condition requiring an unexpected change in 82
the hearing aid before the existing 24 -month period expires, and 83
if alterations to the existing hearing aid do not or cannot meet 84
the needs of the child , a new 24-month period must begin with 85
full benefits and coverage. 86
(c) A subscriber is responsible for the cost of hearing 87
aids and related services which exceeds the coverage limit 88
provided by his or her contract. 89
(d) As used in this subsection, the term "hearing aid" 90
means any wearable instrument or device designed for, offered 91
for the purpose of, or represented as aiding persons with or 92
compensating for impaired hearing. 93
(e) This subsection applies to a contract issued or 94
renewed on or after Janua ry 1, 2023. 95
Section 3. This act shall take effect January 1, 2023. 96