COHEN/ROBERTS 'GRACE'S LAW' ADVANCES

Measure Would Require NJ Health Insurers to Provide Hearing Aid Coverage for Children Below Age 16

(TRENTON) - An Assembly panel today released legislation Assemblyman Neil M. Cohen and Assembly Speaker Joseph J. Roberts, Jr., sponsored to require health insurance plans to provide coverage of medical expenses incurred when purchasing hearing aids for children 15-years-old and younger.

"Nearly 10 percent of New Jersey's public school children have some form of hearing problem or hearing loss," said Cohen (D-Union) the chairman of the Assembly Financial Institutions and Insurance Committee.  "While many insurance providers in the state cover the cost of annual hearing tests, few, if any, cover the costs of purchasing hearing aids, even when medically necessary."

Currently, there are no state or federal mandates requiring the coverage of hearing aids by insurers.  However, riders are available for purchase by groups that provide limited benefits for hearing aids.

According to Cohen and Roberts, the measure (A-1571) is aimed at assisting the families of hearing-impaired children, who frequently require new hearing aids as they grow and their hearing continues to develop and change.

The measure - dubbed "Grace's Law" in honor of Grace Gleba, a New Jersey girl with a severe hearing impairment - would require hospitals, medical and health service corporations, commercial insurers, health maintenance organizations, health benefits plans issued pursuant to the NJ Individual Health Coverage and Small Employer Health Benefits Program, the State Health Benefits Program, and NJ FamilyCare to provide coverage of expenses for purchasing hearing aids for covered children 15 and younger.

"The treatment of hearing loss with hearing aids is not a luxury - like plastic surgery - but rather a medical necessity," said Roberts (D-Camden).  "It's unimaginable that anyone in New Jersey would refuse to cover the cost of purchasing hearing aids, effectively denying hearing-impaired children the opportunity to learn to hear, speak, and communicate like everyone else."

Under the bill, insurers would be required to extend coverage for purchasing a hearing aid for each ear, when medically necessary, as prescribed by a licensed physician or audiologist.  The insurer would be permitted to limit the maximum benefit to $1,000 per hearing aid for each impaired ear every 24 months.

However, the measure also provides that a covered person could choose a hearing aid priced higher than the maximum benefit, with the option of paying the difference between the two, without financial or contractual penalty to the provider of the hearing aid.

"Hearing aids are a critical first step in treating hearing loss," said Cohen.  "They can make a major difference in a child's ability to understand speech in their critical formative years."

The Assembly Financial Institutions and Insurance Committee passed the measure 5-0-2.  It now goes to the Assembly Appropriations Committee for further consideration.

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