Source: http://www.wvlegislature.gov/legisdocs/chamber/2012/rs/com_amends/SB501%20H%20JUD%20AM%203-7%20_1.htm
Timestamp: 2018-01-19 17:32:49
Document Index: 407154777

Matched Legal Cases: ['§5', '§33', '§33', '§33', '§33', '§33', '§5']

SB501 H JUD AM 3-7 #1
“That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §5-16-7f; that said code be amended by adding thereto a new section, designated §33-15-4k; that said code be amended by adding thereto a new section, designated §33-16-3w; that said code be amended by adding thereto a new section, designated §33-24-7l; that said code be amended by adding thereto a new section, designated §33-25-8i; and that said code be amended by adding thereto a new section, designated §33-25A-8k, all to read as follows:
§5-16-7f. Required coverage for hearing aids.
(a) Any plan issued or renewed on or after July 1, 2012 shall provide coverage for the cost of hearing aids that are prescribed by a licensed physician or fitted and dispensed by a licensed audiologist for individuals covered under the policy or plan who are under eighteen years of age. Coverage shall be as follows:
(3) Services, including audiometric testing, hearing aid evaluations, fittings and adjustments.
(b) For purposes of this section, “hearing aid” means any wearable device or instrument or any combination thereof, designated for, represented as or offered for sale for the purpose of aiding, improving or compensating for defective or impaired human hearing and shall include earmolds, parts, attachments or other necessary accessories, but excluding batteries and cords.
(c) The same deductibles, coinsurance, network restrictions and other limitations for covered services found in the policy, provision, contract, plan or agreement of the covered individuals apply to hearing aids covered pursuant to this section. Required coverage is further limited to the cost of hearing aids including all covered services not to exceed an aggregate of $1,400 per hearing-impaired ear every thirty-six months. The parent, guardian or custodian of the covered individual may choose a higher priced hearing aid and may pay the difference in cost above the $1,400 limit as provided in this section without any financial or contractual penalty to the insured or to the provider of the hearing aid.
(d) To the extent that the provisions of this section require benefits that exceed the essential health benefits specified under section 1302(b) of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended, the specific benefits that exceed the specified essential heath benefits shall not be required of insurance plans offered by the public employees insurance agency.
(a) Notwithstanding any provision of any policy, provision, contract, plan or agreement applicable to this article, any entity regulated by this article shall, on or after July 1, 2012, provide coverage for the cost of hearing aids that are prescribed by a licensed physician or fitted and dispensed by a licensed audiologist for individuals covered under the policy or plan who are under eighteen years of age. Coverage shall be as follows:
(b) For purposes of this section, “hearing aid” means any wearable device or instrument or any combination thereof, designated for, represented as or offered for sale for the purpose of aiding, improving or compensating for defective or impaired human hearing and shall include ear molds, parts, attachments or other necessary accessories, but excluding batteries and cords.
(c) The same deductibles, coinsurance, network restrictions and other limitations for covered services found in the policy, provision, contract, plan or agreement of the covered individuals apply to hearing aids covered pursuant to this section. Required coverage is further limited to the cost of hearing aids including all covered services not to exceed an aggregate of $1,400 per hearing-impaired ear every thirty-six months. The insured may choose a higher priced hearing aid and may pay the difference in cost above the $1,400 limit as provided in this section without any financial or contractual penalty to the insured or to the provider of the hearing aid.
(a) Notwithstanding any provision of any policy, provision, contract, plan or agreement applicable to this article, any entity regulated by this article shall, on or after July 1, 2012, provide coverage for the cost of hearings aids that are prescribed by a licensed physician or fitted and dispensed by a licensed audiologist for individuals covered under the policy or plan who are under eighteen years of age. Coverage shall be as follows:
(d) To the extent that the provisions of this section require benefits that exceed the essential health benefits specified under section 1302(b) of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended, the specific benefits that exceed the specified essential heath benefits shall not be required of a health benefit plan when the plan is offered by a health care insurer in this state.”