| 1 | | - | Substitute For HOUSE BILL NO. 4944 A bill to amend 1956 PA 218, entitled "The insurance code of 1956," (MCL 500.100 to 500.8302) by adding section 3406cc. the people of the state of michigan enact: Sec. 3406cc. (1) Subject to subsection (3), an insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall provide coverage for hearing aids for the treatment of hearing loss for a qualified enrollee that are selected by an audiologist after evaluation of the enrollee. The maximum required coverage under this subsection is $3,000.00 per hearing aid every 36 months. Beginning January 1, 2026 and each January 1 after that date, the department shall adjust the maximum coverage amount under this subsection in accordance with the Consumer Price Index as that term is defined in section 2080. (2) A qualified enrollee may choose to purchase a hearing aid that exceeds the maximum required coverage amount under subsection (1). If a qualified enrollee chooses to purchase a hearing aid that exceeds the maximum required coverage amount, the qualified enrollee is responsible for the difference. (3) An insurer may subject coverage under this section to applicable cost-sharing, including deductible, co-insurance, or co-pay provisions of the health insurance policy. (4) As used in this section: (a) "Audiologist" means that term as defined in section 16801 of the public health code, 1978 PA 368, MCL 333.16801. (b) "Hearing aid" means a wearable, nondisposable instrument or device, including any parts, attachments, or accessories, designed or offered to aid or compensate impaired human hearing. (c) "Qualified enrollee" means an enrollee to whom all of the following apply: (i) An audiologist has evaluated the enrollee for hearing loss. (ii) After an audiologist has evaluated the enrollee under subparagraph (i), an otolaryngologist has medically evaluated the enrollee, has determined that the enrollee is a candidate for a hearing aid, and has referred the enrollee to the audiologist for evaluation, selection, and fitting. (iii) The enrollee is less than 19 years of age. Enacting section 1. This amendatory act applies to health insurance policies delivered, executed, issued, amended, adjusted, or renewed in this state, or outside of this state if covering residents of this state, beginning January 1, 2026. Enacting section 2. This amendatory act does not take effect unless House Bill No. 4963 of the 102nd Legislature is enacted into law. |
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| 1 | + | HOUSE BILL NO. 4944 A bill to amend 1956 PA 218, entitled "The insurance code of 1956," (MCL 500.100 to 500.8302) by adding section 3406z. the people of the state of michigan enact: Sec. 3406z. (1) Subject to subsection (3), an insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall provide coverage for hearing aids for the treatment of hearing loss for a qualified enrollee that are selected by an audiologist after evaluation of the enrollee. The maximum required coverage under this subsection is $3,000.00 per hearing aid every 36 months. (2) A qualified enrollee may choose to purchase a hearing aid that exceeds the maximum required coverage amount under subsection (1). If a qualified enrollee chooses to purchase a hearing aid that exceeds the maximum required coverage amount, the qualified enrollee is responsible for the difference. (3) An insurer may subject coverage under this section to the deductibles and coinsurance of the health insurance policy. (4) As used in this section: (a) "Audiologist" means that term as defined in section 16801 of the public health code, 1978 PA 368, MCL 333.16801. (b) "Hearing aid" means a wearable, nondisposable instrument or device, including any parts, attachments, or accessories, designed or offered to aid or compensate impaired human hearing. (c) "Physician" means either of the following: (i) A physician licensed to engage in the practice of medicine under part 170 of the public health code, 1978 PA 368, MCL 333.17001 to 333.17097. (ii) A physician licensed to engage in the practice of osteopathic medicine and surgery under part 175 of the public health code, 1978 PA 368, MCL 333.17501 to 333.17556. (d) "Qualified enrollee" means an enrollee to whom both of the following apply: (i) A physician has medically evaluated the enrollee, has determined that the enrollee is a candidate for a hearing aid, and has referred the enrollee to an audiologist for evaluation, selection, and fitting. (ii) The enrollee is less than 19 years of age. Enacting section 1. This amendatory act applies to health insurance policies delivered, executed, issued, amended, adjusted, or renewed in this state, or outside of this state if covering residents of this state, beginning 180 days after the date this amendatory act is enacted into law. Enacting section 2. This amendatory act does not take effect unless Senate Bill No.____ or House Bill No.____ (request no. 03390'23) of the 102nd Legislature is enacted into law. |
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