An Act To Require All Health Insurers To Cover the Costs of Hearing Aids LR 0989(03)
Maine Legislature, Session 121, LD 1087
Committee Amendment CA_B_S394 (Senate)
Amends: 24-A MRSA §2761, 24-A MRSA §4252

COMMITTEE AMENDMENT "~,, to S.P. 359, L.D. 1087, Bill, "An 
Act To Require All Health~surers To Cover the Costs of Hearing 
Aids" 
Amend the bill by striking out everything after the enacting 
clause and before the summary and inserting in its place the 
following: 
'Sec. 1. 24 MRS A §2317-B, sub-§12-B is enacted to read: 
12-B. Title 24-A, sections 2761, 2847-L and 4252. 
Coverage 
for hearing aids, Title 24-A, sections 2761, 2847-L and 4252; 
Sec. 2. 24-A MRSA §2761 is enacted to read: 
§2761. 
Coverage for hearing aids 
1. Bearing aid: definition. 
For purposes of this section, 
"hearing aid" means any nonexperimental. wearable instrument or 
device designed for the ear and offered for the purpose of aiding 
or compensating for impaired human hearing, excluding batteries 
and cords and other assistive listening devices, including, but 
not limited to, frequency modulation systems. 
2. 
Regyired coverage. 
All individual health policies and 
contracts must provide coverage for the purchase of a hearing aid 
for each ear for an individual covered under the pOlicy who is 18 
years 
of 
age 
or 
under 
in 
accordance 
with 
the 
following 
requirements. 
A. 
The hearing loss must be documented by a physician or 
audiologist licensed pursuant to Title 32, chapter 77. 
Page l-LR0989(3) 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ~' to S.P. 359, L.D. 1087 
B. 
The hearing aid must be purchased from an audiologist 
licensed pursuant to Title 32, chapter 77 or a hearing aid 
dealer licensed pursuant to Title 32, chapter 23-A. 
C. The pOlicy, contract or certificate may limit coverage to 
$1. 400 per hearing aid for each hearing-impaired ear every 
months. 
D. 
An individual may choose a hearing aid that is priced 
higher than the coverage reguired under this section and may 
pay the difference between the price of the hearing aid and 
the maximum payment available under this section. 
3. 
Limits; coinsurance; deductibles. 
Except as otherwise 
provided in this section, any policy, contract or certificate 
that provides 
coverage 
for 
services 
under 
this 
section may 
contain 
prov~s~ons for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductib1es and exclusions to the extent 
that these provisions are not inconsistent with the reguirements 
of this section. 
Sec.3. 24·A MRSA §2847·L is enacted to read: 
§2847-L. 
Coverage for hearing aids 
1. 
Hearing aid: definition. 
For purposes of this section, 
"hearing aid" means any nonexperimental, wearable instrument or 
device designed for the ear and offered for the purpose of aiding 
or compensating for impaired human hearing, excluding batteries 
and cords and other assistive listening deyices, including, but 
not limited to, freguency modulation systems. 
2. 
Regyired 
coverage. 
All 
group 
insurance 
policies, 
contracts and certificates must provide coverage for the purchase 
of a hearing aid for each ear for an individual covered under the 
policy, contract or certificate who is 18 years of age or under 
in accordance with the following reguirements. 
A. 
The hearing loss must be documented by a physician or 
audiologist licensed pursuant to Title 32, chapter 77. 
B. 
The hearing aid must be purchased from an audiologist 
licensed pursuant to Title 32, chapter 77 or a hearing aid 
dealer licensed pursuant to Title 32, chapter 23-A. 
C. 
The policy, contract or certificate may limit coverage 
to $1,400 per hearing aid for each hearing-impaired ear 
every 36 months. 
COMMITTEE AMENDMENT 
.. ,. 
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3S 
COMMITTEE AMENDMENT ~. to S.P. 359, L.D. 10S7 
D. 
An individual may choose a hearing aid that is priced 
higher than the coverage required under this section and may 
pay the difference between the price of the hearing aid and 
the maximum payment available under this section. 
3. 
Limits: coinsurance: deductib1es. 
Except as otherwise 
provided in this section, any policy, contract or certificate 
that provides 
coverage 
for 
services 
under 
this 
section 
may 
contain 
prov~s~ons for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements 
of this section. 
Sec.4. 24-A MRSA §4252 is enacted to read: 
§4252. 
Coverage for hearing aids 
1. 
Hearing aid: definition. 
For purposes of this section, 
"hearing aid" means any nonexperimental, wearable instrument or 
device designed for the ear and offered for the purpose of aiding 
or compensating for impaired human hearing, excluding batteries 
and cords and other assistive listening devices, including, but 
not limited to, frequency modulation systems. 
2. 
Regyired coverage. 
All health maintenance organization 
individual 
and group contracts and certificates must provide 
coverage for the purchase of a hearing aid for each ear for an 
individual covered under the policy, contract or certificate who 
is IS years of age or under in accordance with the following 
requirements. 
A. 
The hearing loss must be documented by a physician or 
audiologist licensed pursuant to Title 32, chapter 77. 
B. 
The hearing aid must be purchased from an audiologist 
licensed pursuant to Title 32, chapter 77 or a hearing aid 
dealer licensed pursuant to Title 32, chapter 23-A. 
C. 
The policy, contract or certificate may limit coverage 
to $1,400 per hearing aid for each hearing-impaired ear 
every 36 months. 
D. 
An individual may choose a hearing aid that is priced 
higher than the coverage required under this section and may 
pay the difference between the price of the hearing aid and 
the maximum payment available under this section. 
3. 
Limits: coinsurance: deductib1es. 
Except as otherwise 
provided in this section, 
any policy, contract or certificate 
that provides 
coverage 
for 
services 
under 
this 
section may 
COMMITTEE AMENDMENT 
.... ' 
"" 
COMMITTEE AMENDMENT ':l3' to S.P. 359, L.D. 1087 
contain provisions 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements 
of this section. 
Sec. 5. Applicability. 
The requirements of this Act apply to 
all policies, contracts 
and certificates executed, 
delivered, 
issued for delivery, continued or renewed in this State on or 
after January 1, 2005. 
For purposes of this Act, all contracts 
are 
deemed 
to 
be 
renewed 
no 
later 
than 
the 
next 
yearly 
anniversary of the contract date.' 
Sec. 6. Expenditures in excess of allocations. 
Expenditures of 
funds 
required by this Act other than the General 
Fund and 
Highway Fund are authorized to exceed legislative allocations 
during 
the 
fiscal 
year 
ending 
June 
30, 
2005. 
Appropriate 
adjustments 
to 
basic 
work 
programs 
facilitating 
these 
expenditures in excess of allocations must be recommended by the 
State Budget Officer and approved by the Governor. 
Sec. 
7. 
Appropriations 
and 
allocations. 
The 
following 
appropriations and allocations are made. 
ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF 
Salary Plan 
Initiative: 
Appropriates and allocates funds for the additional 
costs 
of health 
insurance 
to 
the State 
resulting 
from 
the 
requirement to provide coverage for hearing aids for persons age 
and under. 
General Fund 
2003-04 
2004-05 
Personal Services 
$0 
$7,146 
General Fund Total 
$0 
$7,146 
Highway Fund 
2003-04 
2004-05 
Personal Services 
$0 
$2,813 
Highway Fund Total 
$0 
$2,813 
SUMMARY 
This amendment replaces the bill and is the majority report 
of 
the 
committee. 
It 
requires 
health 
insurance 
policies, 
contracts and certificates to provide coverage for hearing aids 
for persons 18 years of age and under. 
The amendment allows 
insurance policies to limit coverage to $1,400 per hearing aid 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ~" to S.P. 359, L.D. 1087 
every 36 months. 
The provisions apply to all policies, contracts 
and certificates issued or renewed on or after January 1, 2005. 
The 
amendment 
adds 
language 
authorizing 
additional 
expenditures if costs of providing coverage of hearing aids to 
state 
employees 
and 
their 
dependents 
exceed 
legislative 
allocations. 
The 
amendment 
also 
adds 
an 
appropriations 
section 
for 
additional General Fund and Highway Fund amounts needed to cover 
additional costs for the state employee health insurance program. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Net Cost (Savings) 
General Fund 
Highway Fund 
Appropriations/Allocations 
General Fund 
Highway Fund 
Fiscal Detail and Notes 
Approved: 02111/04 frac. 
Office of Fiscal and Program Review 
LD 1087 
An Act To Require All Health Insurers To Cover the Costs of Hearing 
Aids 
LR 0989(03) 
Fiscal Note for Bill as Amended by Committee Amendment 'f> 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Majority Report 
Fiscal Note 
Projections 
Projections 
2003-04 
2004-05 
2005-06 
2006-07 
$0 
$7,146 
$32,014 
$35,856 
$0 
$2,813 
$12,604 
$14,117 
$0 
$7,146 
$32,014 
$35,856 
$0 
$2,813 
$12,604 
$14,117 
Adding hearing aid coverage to persons age 18 and under with a limit of $1,400 per hearing aid for each hearing-
impaired ear every 36 months will increase premium costs by 0.05% for the state employee health plan effective with 
the contract beginning April 1,2005. The additional employer costs across all funds to the state employee health 
insurance program will be $15,605 in fiscal year 2004-05, $69,910 in fiscal year 2005-06 and $78,299 in fiscal year 
2006-07. 
General Fund appropriations of $7,146 and Highway Fund allocations of $2,813 in fiscal year 2004-05 are included in 
the bill for the salary plan reserve accounts to fund the increases for General Fund and Highway Fund employees. The 
costs for employees paid by other funds, including a small amount for the Fund for a Healthy Maine, is estimated to be 
$5,646 and may require increased allotments as recommended by the State Budget Officer and approved by the 
Governor. 
Any additional costs to the Department of Professional and Financial Regulation in implementing this legislation can 
be absorbed by the department within existing resources. This fiscal note does not reflect the additional costs to the 
private insurance market as a result of this legislation.