Bill Text: NC H589 | 2010 | Regular Session | Enrolled
Bill Title: Ins. & St. Hlth Plan Cover/Hearing Aids
Spectrum: Moderate Partisan Bill (Democrat 23-4)
Status: (Passed) 2010-06-07 - Ch. SL 2010-2 [H589 Detail]
Download: North_Carolina-2010-H589-Enrolled.html
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2009
HOUSE BILL 589
RATIFIED BILL
AN ACT TO REQUIRE HEALTH BENEFIT PLANS AND THE STATE HEALTH PLAN TO COVER HEARING AIDS AND REPLACEMENT HEARING AIDS.
The General Assembly of North Carolina enacts:
SECTION 1. Article 3 of Chapter 58 of the General Statutes is amended by adding the following new section to read:
"§ 58‑3‑285. Coverage for hearing aids.
(a) Every health benefit plan, including the State Health Plan for Teachers and State Employees, shall provide coverage for one hearing aid per hearing‑impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22 years subject to subsection (b) of this section. The coverage shall include all medically necessary hearing aids and services that are ordered by a physician or an audiologist licensed in this State. Coverage shall be as follows:
(1) Initial hearing aids and replacement hearing aids not more frequently than every 36 months.
(2) A new hearing aid when alterations to the existing hearing aid cannot adequately meet the needs of the covered individual.
(3) Services, including the initial hearing aid evaluation, fitting, and adjustments, and supplies, including ear molds.
(b) The same deductibles, coinsurance, and other limitations as apply to similar services covered under the health benefit plan apply to hearing aids and related services and supplies required to be covered under this section.
(c) Nothing in this section prevents an insurer from applying utilization review criteria to determine medical necessity as defined by G.S. 58‑50‑61 as long as it does so in accordance with all requirements for utilization review programs and medical necessity determinations specified in that section, including the offering of an insurer appeal process and where applicable, health benefit plans external review as provided in Part 4 of Article 50 of Chapter 58 of the General Statutes."
SECTION 2. G.S. 135‑45.8(13), as amended by Section 2(d) of Session Law 2009‑16, reads as rewritten:
"§ 135‑45.8. General limitations and exclusions.
The following shall in no event be considered covered expenses nor will benefits described in G.S. 135‑45.6 through G.S. 135‑45.11 be payable for:
…
(13) Charges for routine eye
examinations, eyeglasses or other corrective lenses (except for cataract lenses
certified as medically necessary for aphakia persons) andand, except
as authorized under G.S. 58‑3‑280, hearing aids or
examinations for the prescription or fitting thereof.
.…"
SECTION 3. This act is effective January 1, 2011 and applies to health benefit plans that are delivered, issued for delivery, or renewed on and after that date.
In the General Assembly read three times and ratified this the 27th day of May, 2010.
_____________________________________
Walter H. Dalton
President of the Senate
_____________________________________
Joe Hackney
Speaker of the House of Representatives
_____________________________________
Beverly E. Perdue
Governor
Approved __________.m. this ______________ day of ___________________, 2010
