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| | HB2443 Enrolled | | LRB103 30349 BMS 56779 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Insurance Code is amended by |
| 5 | | changing Section 356z.30 as follows:
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| 6 | | (215 ILCS 5/356z.30) |
| 7 | | Sec. 356z.30. Coverage for hearing aids for individuals |
| 8 | | under the age of 18. |
| 9 | | (a) As used in this Section: |
| 10 | | "Hearing care professional" means a person who is a
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| 11 | | licensed hearing instrument dispenser, licensed audiologist, |
| 12 | | or licensed physician. |
| 13 | | "Hearing instrument" or "hearing aid" means any wearable
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| 14 | | non-disposable, non-experimental instrument or device designed |
| 15 | | to aid or
compensate for impaired human hearing and any parts, |
| 16 | | attachments, or accessories for the instrument or device, |
| 17 | | including
an ear mold but excluding batteries and cords. |
| 18 | | (b) An individual or group policy of accident and health
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| 19 | | insurance or managed care plan that is amended, delivered,
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| 20 | | issued, or renewed after the effective date of this amendatory |
| 21 | | Act of the 103rd General Assembly August 22, 2018 (the |
| 22 | | effective date of Public Act 100-1026) must provide coverage |
| 23 | | for
medically necessary hearing instruments and related |
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| 1 | | services for all individuals under the age of 18
when a hearing |
| 2 | | care professional prescribes a hearing instrument to augment |
| 3 | | communication. |
| 4 | | (c) An insurer shall provide coverage, subject to all |
| 5 | | applicable co-payments, co-insurance, deductibles, and |
| 6 | | out-of-pocket limits, subject to the following restrictions: |
| 7 | | (1) one hearing instrument shall be covered for each |
| 8 | | ear every 36 months; |
| 9 | | (2) related services, such as audiological exams and |
| 10 | | selection, fitting, and adjustment of ear molds to |
| 11 | | maintain optimal fit shall be covered when deemed |
| 12 | | medically necessary by a hearing care professional; and |
| 13 | | (3) hearing instrument repairs may be covered when |
| 14 | | deemed medically necessary. |
| 15 | | (d) If, at any time before or after the effective date of |
| 16 | | this amendatory Act of the 103rd General Assembly August 22, |
| 17 | | 2018 (the effective date of Public Act 100-1026), the |
| 18 | | Secretary of the United States Department of Health and Human |
| 19 | | Services, or its successor agency, promulgates rules or |
| 20 | | regulations to be published in the Federal Register, publishes |
| 21 | | a comment in the Federal Register, or issues an opinion, |
| 22 | | guidance, or other action that would require the State, |
| 23 | | pursuant to any provision of the Patient Protection and |
| 24 | | Affordable Care Act (Pub. L. 111–148), including, but not |
| 25 | | limited to, 42 U.S.C. 18031(d)(3)(B) or any successor |
| 26 | | provision, to defray the cost of coverage for medically |
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| 1 | | necessary hearing instruments and related services for any |
| 2 | | individual individuals under the age of 18, then this Section |
| 3 | | is inoperative with respect to all such coverage other than |
| 4 | | that authorized under Section 1902 of the Social Security Act, |
| 5 | | 42 U.S.C. 1396a, and the State shall not assume any obligation |
| 6 | | for the cost of coverage for medically necessary hearing |
| 7 | | instruments and related services for any individual subject to |
| 8 | | federally defrayed cost of coverage individuals under the age |
| 9 | | of 18.
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| 10 | | (Source: P.A. 100-1026, eff. 8-22-18; 101-81, eff. 7-12-19.)
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| 11 | | Section 99. Effective date. This Act takes effect January |
| 12 | | 1, 2025.
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