CS/HB 79 2022
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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.; defining the 3
term "hearing aid"; requiring certain individual 4
health insurance policies to provide coverage for 5
hearing aids for certain children 18 years of age or 6
younger under certain circumstances; specifying 7
certain coverage requirements; providing an exception 8
to the requirements; providing that an insured is 9
responsible for certain costs that exceed the policy 10
limit; providing applicability; amending s. 641.31, 11
F.S.; requiring certain individual health maintenance 12
contracts to provide coverage for hearing aids for 13
certain children 18 years of age or younger und er 14
certain circumstances; specifying certain coverage 15
requirements; providing an exception to the 16
requirements; providing that a subscriber is 17
responsible for certain costs that exceed the contract 18
limit; defining the term "hearing aid"; providing 19
applicability; providing an effective date. 20
21
Be It Enacted by the Legislature of the State of Florida: 22
23
Section 1. 627.6413, Florida Statutes, is created to read: 24
627.6413 Coverage for hearing aids for children. — 25
CS/HB 79 2022
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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
(1) As used in this section, the term " hearing aid" means 26
any wearable instrument or device designed for, offered for the 27
purpose of, or represented as aiding persons with or 28
compensating for impaired hearing, and includes ear molds. The 29
term does not include a cochlear implant. 30
(2) A health insurer issuing an individual policy that 31
provides major medical or similar comprehensive coverage for a 32
dependent child of the insured must provide coverage for a 33
hearing aid for any such child 18 years of age or younger 34
diagnosed with hearing loss by a p hysician licensed under 35
chapter 458 or chapter 459 or by an audiologist licensed under 36
part I of chapter 468 and for whom the hearing aid is prescribed 37
as medically necessary. Coverage for a hearing aid prescribed to 38
a child 18 years of age or younger must require the hearing aid 39
to be prescribed, fitted, and dispensed by a physician licensed 40
under chapter 458 or chapter 459 or an audiologist licensed 41
under part I of chapter 468. 42
(3) The policy must provide benefits in any 24 -month 43
period of at least $3,5 00 per ear. The policy may limit coverage 44
for ear molds to six ear molds in any 24 -month period. However, 45
if a child experiences a significant and unexpected change in 46
his or her hearing or a medical condition requiring an 47
unexpected change in the prescrip tion for the hearing aid before 48
the existing 24-month period expires and alterations to the 49
existing hearing aid do not or cannot meet the needs of the 50
CS/HB 79 2022
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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
child, a new 24-month period must begin with full benefits and 51
coverage. 52
(4) An insured is responsible for the cost of hearing aids 53
and related services which exceeds the coverage limit provided 54
by his or her policy. 55
(5) This section applies to a policy issued or renewed on 56
or after January 1, 2023. 57
Section 2. Subsection (48) is added to section 641. 31, 58
Florida Statutes, to read: 59
641.31 Health maintenance contracts. — 60
(48)(a) A health maintenance organization issuing an 61
individual contract that provides major medical or similar 62
comprehensive coverage for a dependent child of the subscriber 63
must provide coverage for a hearing aid for any such child 18 64
years of age or younger diagnosed with hearing loss by a 65
physician licensed under chapter 458 or chapter 459 or by an 66
audiologist licensed under part I of chapter 468 and for whom 67
the hearing aid is pre scribed as medically necessary. Coverage 68
for a hearing aid prescribed to a child 18 years of age or 69
younger must require the hearing aid to be prescribed, fitted, 70
and dispensed by a physician licensed under chapter 458 or 71
chapter 459 or an audiologist lice nsed under part I of chapter 72
468. 73
(b) The contract must provide benefits in any 24 -month 74
period of at least $3,500 per ear. The contract may limit 75
CS/HB 79 2022
CODING: Words stricken are deletions; words underlined are additions.
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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
coverage for ear molds to six ear molds in any 24 -month period. 76
However, if a child experiences a significa nt and unexpected 77
change in his or her hearing or a medical condition requiring an 78
unexpected change in the prescription for the hearing aid before 79
the existing 24-month period expires and alterations to the 80
existing hearing aid do not or cannot meet the n eeds of the 81
child, a new 24-month period must begin with full benefits and 82
coverage. 83
(c) A subscriber is responsible for the cost of hearing 84
aids and related services which exceeds the coverage limit 85
provided by his or her contract. 86
(d) As used in this section, the term "hearing aid" means 87
any wearable instrument or device designed for, offered for the 88
purpose of, or represented as aiding persons with or 89
compensating for impaired hearing, and includes ear molds. The 90
term does not include a cochlear impl ant. 91
(e) This subsection applies to a contract issued or 92
renewed on or after January 1, 2023. 93
Section 3. This act shall take effect January 1, 2023. 94