Youngstown Daily Legal News

Proposed legislation would require health insurers to pay for hearing aid expenses

TIFFANY L. PARKS
Special to the Legal News
Published: September 26, 2014

A Toledo senator is sponsoring a bill that would require health insurers to offer coverage for hearing aids and related services.

The proposed legislation, Senate Bill 257, would apply to health insuring corporations, sickness and accident insurers and multiple employer welfare arrangements.

“Many insurance plans consider hearing aids as ‘elective’ forms of treatment and do not cover them as part of basic health coverage,” said Sen. Edna Brown, adding that the out-of-pocket costs for hearing aids can easily reach into thousands of dollars.

“The high costs of hearing aids are a significant barrier that can often prevent someone from receiving proper treatment. At the same time, studies have consistently shown that untreated hearing loss has serious negative consequences on children and adults alike.”

The bill requires that, for all health insurance plans offering basic coverage, health insurers must also offer coverage for hearing aids as a rider to such plans.

The benefit must include coverage of the purchase of related services and supplies, including the initial assessment, fitting, adjustments and auditory training that is provided.

The coverage shall be no less than $1,500 per ear over the course of three years and must be provided to individuals of all ages.

“Hearing disability affects persons of all ages and lessens the quality of life for all groups,” said Brown, D-Toledo.

The lawmaker highlighted data from the American Speech-Language Hearing Association that indicated up to 36 million Americans suffer from a loss of hearing.

“It is estimated that 20 percent of Ohio residents suffer from hearing loss related issues,” Brown said.

“Based on statistics from the Centers for Disease Control and Prevention, 5.4 percent of school-aged children suffer from hearing loss, greatly affecting their ability to learn. Without proper intervention, this can cost the education system $115,600 per child suffering from hearing loss.”

According to the Institute of Educational Sciences, Brown said the years 1999-2000 cost the United States $652 million for special education programs for children with hearing loss.

“Early hearing detection and intervention is vital to improving these children’s futures, as studies show that the most critical period for stimulating hearing centers in the brain is within the first few months of life,” she said.

For adults, hearing loss is typically noticed when they develop difficulty hearing in noisy environments, have trouble communicating with others and struggle with activities previously normal to them such as watching television programs.

“Difficulty in hearing has been linked to decreased socialization and eventually withdrawal, depression and decreased cognitive functions,” Brown said.

“For some adults, hearing loss is an impediment to obtaining or keeping employment. Unfortunately, of adults with hearing loss, only about 20 percent seek treatment and on average adults wait years to seek their initial contact with a specialist. Too often it is simply because they do not have the means to purchase hearing aid devices.”

Of the adults affected with hearing loss, 75 percent are over the age of 60.

“Because many older adults have fewer opportunities for social interaction, hearing loss can lessen the enjoyment of their remaining activities. This large percentage of Ohioans deserves treatment for a condition that isolates them from the rest of the population and poses a loss of their contributions to our society,” Brown said.

If enacted, SB 257 would not apply to public employee benefit plans or sickness and accident insurers that do not offer coverage for basic health care services.

The measure defines a “hearing aid” as any wearable instrument or device designed or offered for the purpose of aiding or compensating for impaired human hearing, including all attachments, accessories and parts thereof, excluding batteries and cords, that is distributed by a licensed hearing aid dealer.

The definition does not include cochlear implants, which are surgically implanted.

“I believe it is important to walk in another’s shoes to fully understand the impact of a disability, particularly in cases like hearing loss when the impacts of the disability are not immediately apparent,” Brown said.

“Given the prevalence of hearing loss, the inability of many families to receive proper treatment and the negative impacts of untreated hearing loss in children and adults, I believe it is time for Ohio to join the 20 other states that provide coverage for hearing aid devices and related services through standard insurance plans.”

The insurance benefit would not be subject to any deductible or copayment requirements but could be subject to coinsurance requirements.

SB 247 is before the Senate Insurance and Financial Institutions Committee.

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