FL
Florida House Bill H0079

Florida 2022 Regular Session

Florida House Bill H0079 Compare Versions

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1010 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
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1414 A bill to be entitled 1
1515 An act relating to insurance coverage for hearing aids 2
16-for children; creating s. 627.6413, F.S.; defining the 3
17-term "hearing aid"; requiring certain individual 4
18-health insurance policies to provide coverage for 5
19-hearing aids for certain children 18 years of age or 6
20-younger under certain circumstances; specifying 7
21-certain coverage requirements; providing an exception 8
22-to the requirements; providing that an insured is 9
23-responsible for certain costs that exceed the policy 10
24-limit; providing applicability; amending s. 641.31, 11
25-F.S.; requiring certain individual health maintenance 12
26-contracts to provide coverage for hearing aids for 13
27-certain children 18 years of age or younger und er 14
28-certain circumstances; specifying certain coverage 15
29-requirements; providing an exception to the 16
30-requirements; providing that a subscriber is 17
31-responsible for certain costs that exceed the contract 18
32-limit; defining the term "hearing aid"; providing 19
33-applicability; providing an effective date. 20
34- 21
35-Be It Enacted by the Legislature of the State of Florida: 22
36- 23
37- Section 1. 627.6413, Florida Statutes, is created to read: 24
38- 627.6413 Coverage for hearing aids for children. — 25
16+for children; creating s. 627.6413, F.S.; providing a 3
17+definition of the term "hearing aid"; requiring 4
18+certain individual health insurance policies to 5
19+provide coverage for hearing aids for children 21 6
20+years of age or younger under certain circumstances; 7
21+specifying health care providers who may prescribe, 8
22+fit, and dispense the h earing aids; specifying a 9
23+minimum coverage limit within a certain timeframe; 10
24+providing an exception; providing that an insured is 11
25+responsible for certain costs that exceed the policy 12
26+limit; providing applicability; amending s. 641.31, 13
27+F.S.; requiring certa in individual health maintenance 14
28+contracts to provide coverage for hearing aids for 15
29+children 21 years of age or younger under certain 16
30+circumstances; specifying health care providers who 17
31+may prescribe, fit, and dispense the hearing aids; 18
32+specifying a minimum coverage limit within a certain 19
33+timeframe; providing an exception; providing that a 20
34+subscriber is responsible for certain costs that 21
35+exceed the contract limit; providing a definition of 22
36+the term "hearing aid"; providing applicability; 23
37+providing an effective date. 24
38+ 25
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4747 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
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51- (1) As used in this section, the term " hearing aid" means 26
52-any wearable instrument or device designed for, offered for the 27
53-purpose of, or represented as aiding persons with or 28
54-compensating for impaired hearing, and includes ear molds. The 29
55-term does not include a cochlear implant. 30
56- (2) A health insurer issuing an individual policy that 31
57-provides major medical or similar comprehensive coverage for a 32
58-dependent child of the insured must provide coverage for a 33
59-hearing aid for any such child 18 years of age or younger 34
60-diagnosed with hearing loss by a p hysician licensed under 35
61-chapter 458 or chapter 459 or by an audiologist licensed under 36
62-part I of chapter 468 and for whom the hearing aid is prescribed 37
63-as medically necessary. Coverage for a hearing aid prescribed to 38
64-a child 18 years of age or younger must require the hearing aid 39
65-to be prescribed, fitted, and dispensed by a physician licensed 40
66-under chapter 458 or chapter 459 or an audiologist licensed 41
67-under part I of chapter 468. 42
68- (3) The policy must provide benefits in any 24 -month 43
69-period of at least $3,5 00 per ear. The policy may limit coverage 44
70-for ear molds to six ear molds in any 24 -month period. However, 45
71-if a child experiences a significant and unexpected change in 46
72-his or her hearing or a medical condition requiring an 47
73-unexpected change in the prescrip tion for the hearing aid before 48
74-the existing 24-month period expires and alterations to the 49
75-existing hearing aid do not or cannot meet the needs of the 50
51+Be It Enacted by the Legislature of the State of Florida: 26
52+ 27
53+ Section 1. Section 627.6413, Florida Statutes, is created 28
54+to read: 29
55+ 627.6413 Coverage for hearing aids for children. — 30
56+ (1) As used in this section, the term "hearing aid" means 31
57+any wearable instrument or device designed for, offered for the 32
58+purpose of, or represented as aiding persons with or 33
59+compensating for, impaired hearing. 34
60+ (2) A health insurer issuing an individual policy that 35
61+provides major medical or similar comprehensi ve coverage to an 36
62+insured or a family member of an insured must provide coverage 37
63+for a hearing aid for an insured child 21 years of age or 38
64+younger who is diagnosed with hearing loss by a licensed 39
65+physician or a licensed audiologist and for whom the hearing aid 40
66+is prescribed as medically necessary. Coverage for a hearing aid 41
67+prescribed to a child younger than 18 years of age must require 42
68+the hearing aid to be prescribed, fitted, and dispensed by a 43
69+licensed physician or a licensed audiologist. Coverage for a 44
70+hearing aid prescribed to a child between 18 and 21 years of 45
71+age, inclusive, must require the hearing aid to be fitted and 46
72+dispensed by a licensed physician, a licensed audiologist, or a 47
73+licensed hearing aid specialist. 48
74+ (3) The policy must provide a mini mum coverage limit of 49
75+$3,500 per ear within a 24 -month period. However, if a child 50
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8484 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
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88-child, a new 24-month period must begin with full benefits and 51
89-coverage. 52
90- (4) An insured is responsible for the cost of hearing aids 53
91-and related services which exceeds the coverage limit provided 54
92-by his or her policy. 55
93- (5) This section applies to a policy issued or renewed on 56
94-or after January 1, 2023. 57
95- Section 2. Subsection (48) is added to section 641. 31, 58
96-Florida Statutes, to read: 59
97- 641.31 Health maintenance contracts. — 60
98- (48)(a) A health maintenance organization issuing an 61
99-individual contract that provides major medical or similar 62
100-comprehensive coverage for a dependent child of the subscriber 63
101-must provide coverage for a hearing aid for any such child 18 64
102-years of age or younger diagnosed with hearing loss by a 65
103-physician licensed under chapter 458 or chapter 459 or by an 66
104-audiologist licensed under part I of chapter 468 and for whom 67
105-the hearing aid is pre scribed as medically necessary. Coverage 68
106-for a hearing aid prescribed to a child 18 years of age or 69
107-younger must require the hearing aid to be prescribed, fitted, 70
108-and dispensed by a physician licensed under chapter 458 or 71
109-chapter 459 or an audiologist lice nsed under part I of chapter 72
110-468. 73
111- (b) The contract must provide benefits in any 24 -month 74
112-period of at least $3,500 per ear. The contract may limit 75
88+experiences a significant and unexpected change in his or her 51
89+hearing or a medical condition requiring an unexpected change in 52
90+the hearing aid before the existing 24 -month period expires, and 53
91+if alterations to the existing hearing aid do not or cannot meet 54
92+the needs of the child, a new 24 -month period must begin with 55
93+full benefits and coverage. 56
94+ (4) An insured is responsible for the cost of hearing aids 57
95+and related services which exceeds the coverage limit provided 58
96+by his or her policy. 59
97+ (5) This section applies to a policy issued or renewed on 60
98+or after January 1, 2023. 61
99+ Section 2. Subsection (48) is added to section 641.31, 62
100+Florida Statutes, to read: 63
101+ 641.31 Health maintenance contracts.— 64
102+ (48)(a) A health maintenance organization issuing an 65
103+individual contract that provides major medical or similar 66
104+comprehensive coverage to a subscriber or a family member of a 67
105+subscriber must provide coverage for a hearing aid for a co vered 68
106+child 21 years of age or younger who is diagnosed with hearing 69
107+loss by a licensed physician or a licensed audiologist and for 70
108+whom the hearing aid is prescribed as medically necessary. 71
109+Coverage for a hearing aid prescribed to a child younger than 18 72
110+years of age must require the hearing aid to be prescribed, 73
111+fitted, and dispensed by a licensed physician or a licensed 74
112+audiologist. Coverage for a hearing aid prescribed to a child 75
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121121 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
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125-coverage for ear molds to six ear molds in any 24 -month period. 76
126-However, if a child experiences a significa nt and unexpected 77
127-change in his or her hearing or a medical condition requiring an 78
128-unexpected change in the prescription for the hearing aid before 79
129-the existing 24-month period expires and alterations to the 80
130-existing hearing aid do not or cannot meet the n eeds of the 81
131-child, a new 24-month period must begin with full benefits and 82
132-coverage. 83
133- (c) A subscriber is responsible for the cost of hearing 84
134-aids and related services which exceeds the coverage limit 85
135-provided by his or her contract. 86
136- (d) As used in this section, the term "hearing aid" means 87
137-any wearable instrument or device designed for, offered for the 88
138-purpose of, or represented as aiding persons with or 89
139-compensating for impaired hearing, and includes ear molds. The 90
140-term does not include a cochlear impl ant. 91
141- (e) This subsection applies to a contract issued or 92
142-renewed on or after January 1, 2023. 93
143- Section 3. This act shall take effect January 1, 2023. 94
125+between 18 and 21 years of age, inclusive, must require the 76
126+hearing aid to be fitted and dispensed by a licensed physician, 77
127+a licensed audiologist, or a licensed hearing aid specialist. 78
128+ (b) The contract must provide a minimum coverage limit of 79
129+$3,500 per ear within a 24 -month period. However, if a child 80
130+experiences a significa nt and unexpected change in his or her 81
131+hearing or a medical condition requiring an unexpected change in 82
132+the hearing aid before the existing 24 -month period expires, and 83
133+if alterations to the existing hearing aid do not or cannot meet 84
134+the needs of the child , a new 24-month period must begin with 85
135+full benefits and coverage. 86
136+ (c) A subscriber is responsible for the cost of hearing 87
137+aids and related services which exceeds the coverage limit 88
138+provided by his or her contract. 89
139+ (d) As used in this subsection, the term "hearing aid" 90
140+means any wearable instrument or device designed for, offered 91
141+for the purpose of, or represented as aiding persons with or 92
142+compensating for impaired hearing. 93
143+ (e) This subsection applies to a contract issued or 94
144+renewed on or after Janua ry 1, 2023. 95
145+ Section 3. This act shall take effect January 1, 2023. 96