STATE OF NEW YORK ________________________________________________________________________ 5789 2025-2026 Regular Sessions IN SENATE March 3, 2025 ___________ Introduced by Sen. SEPULVEDA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring insurance policies to provide coverage for medically necessary hearing aids purchased from hearing aid dispensers The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 40 to read as follows: 3 (40) (A) Every health insurance policy that provides medical, major 4 medical, or similar comprehensive type coverage issued or delivered in 5 this state shall provide coverage for medically necessary hearing aids 6 purchased from hearing aid dispensers registered under article 7 thirty-seven-A of the general business law or audiologists licensed 8 under article one hundred fifty-nine of the education law for an insured 9 person who is less than eighteen years of age. Coverage may be limited 10 to one hearing aid per each hearing-impaired ear every twenty-four 11 months unless it is demonstrated that: (i) the insured child's hearing 12 has changed significantly within a two-year period; and (ii) the exist- 13 ing hearing aid will no longer correct the child's hearing loss. 14 (B) (i) For the purposes of this paragraph, "hearing aid" shall mean 15 any wearable instrument or devices designed for hearing and any parts, 16 attachments or accessories but excluding batteries and cords or accesso- 17 ries thereto. A registered hearing aid dispenser or licensed audiologist 18 shall determine the type of device needed to correct the hearing loss. 19 (ii) For the purposes of this section, services for recasing, reshell- 20 ing and acquiring new molds shall be included as part of the policies. 21 (C) Coverage provided pursuant to this paragraph may be subject to 22 deductibles, coinsurance, or copayments. 23 § 2. Section 3221 of the insurance law is amended by adding a new 24 subsection (v) to read as follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD07100-01-5S. 5789 2 1 (v) (1) Every group health insurance policy that provides medical, 2 major medical, or similar comprehensive type coverage issued or deliv- 3 ered in this state shall provide coverage for hearing aids purchased 4 from hearing aid dispensers registered under article thirty-seven-A of 5 the general business law or audiologists licensed under article one 6 hundred fifty-nine of the education law for an insured person who is 7 less than eighteen years of age. Coverage may be limited to one hearing 8 aid per each hearing-impaired ear every twenty-four months unless it is 9 demonstrated that: (i) the insured child's hearing has changed signif- 10 icantly within a two-year period; and (ii) the existing hearing aid will 11 no longer correct the child's hearing loss, such insured person shall be 12 entitled to reimbursement for additional hearing aid expenses. 13 (2) (A) For the purposes of this subsection, "hearing aid" shall mean 14 any wearable instrument or devices designed for hearing and any parts, 15 attachments or accessories but excluding batteries and cords or accesso- 16 ries thereto. A registered hearing aid dispenser or licensed audiologist 17 shall determine the type of device needed to correct the hearing loss. 18 (B) For the purposes of this section, services for recasing, reshell- 19 ing and acquiring new molds shall be included as part of the policies. 20 (3) Coverage provided pursuant to this subsection may be subject to 21 deductibles, coinsurance, or copayments. 22 § 3. Section 4303 of the insurance law is amended by adding a new 23 subsection (ww) to read as follows: 24 (ww) (1) Every contract that provides medical, major medical, or simi- 25 lar comprehensive type coverage issued or delivered in this state by a 26 health service corporation or hospital service corporation shall provide 27 coverage for hearing aids purchased from hearing aid dispensers regis- 28 tered under article thirty-seven-A of the general business law or 29 audiologists licensed under article one hundred fifty-nine of the educa- 30 tion law for an insured person who is less than eighteen years of age. 31 Coverage may be limited to one hearing aid per each hearing-impaired ear 32 every twenty-four months unless it is demonstrated that: (i) the insured 33 child's hearing has changed significantly within a two-year period; and 34 (ii) the existing hearing aid will no longer correct the child's hearing 35 loss, such insured person shall be entitled to reimbursement for addi- 36 tional hearing aid expenses. 37 (2) (A) For the purposes of this subsection, "hearing aid" shall mean 38 any wearable instrument or devices designed for hearing and any parts, 39 attachments or accessories but excluding batteries and cords or accesso- 40 ries thereto. A registered hearing aid dispenser or licensed audiologist 41 shall determine the type of device needed to correct the hearing loss. 42 (B) For the purposes of this section, services for recasing, reshell- 43 ing and acquiring new molds shall be included as part of the policies. 44 (3) Coverage provided pursuant to this subsection may be subject to 45 deductibles, coinsurance, or copayments. 46 § 4. This act shall take effect on the first of January next succeed- 47 ing the date on which it shall have become a law and shall apply to all 48 policies issued, modified or renewed on and after such date.