Frequently Asked Questions Regarding Hearing Aid Law for Children

  • Where can I find the text of the law? To read the text of the law, click on "Massachusetts Hearing Aid Law for Children" on the right side of this page under "Links." The citation for the law is: Part 1, Title XXII, Chapter 176B, Chapter 4EE.
  • What does the law provide? Chapter 233 provides insurance coverage for hearing aids for children 21 years old and younger up to $2,000 per hearing aid for each hearing impaired ear in each 36-month period.
  • When is the effective date of the law?The law applies to all health plans that are delivered, issued or renewed on or after January 1, 2013. This means that coverage becomes effective as policies are renewed throughout 2013. Following this year, coverage will remain continuous under health insurance policies. Before you begin the process of purchasing hearing aids, check with your health insurance carrier to verify the specific date on which your coverage will be effective. Example: Your health insurance plan renews on July 1st. Coverage becomes effective under your policy on July 1st. This means that you may not purchase hearing aids for your child or seek coverage for related services and supplies under this law until July 1st.
  • What does the $2,000 cap include?The $2,000 cap includes coverage for each hearing aid device. An insured may select a higher-priced hearing aid and pay the difference in cost above the $2,000 limit for the device. Plans must also cover all services related to a covered hearing aid device, including the initial hearing aid evaluation, fitting and adjustments and supplies, including ear molds. These amounts are not included in the $2,000 coverage limit that applies to the hearing aid device, but are covered separately and outright under your plan.
  • Are batteries covered? Yes. Coverage under this law includes related services, including the initial hearing aid evaluation, hearing aid fittings and adjustments and supplies. Batteries are covered under the "supplies" section of the law. A billing code already exists for hearing aid batteries- your dispensing audiologist should have this.
  • How about ear molds? Ear molds are covered under this law.
  • Who is covered? Children 21 years of age or younger who are covered under fully-insured plans.
  • Who is not covered?Children who are covered under self-insured plans are not covered by this law. A self-insured (or self-funded) plan is one in which the employer assumes the financial risk for providing health care benefits to its employees, even if an insurance company is used to process the claims. Self-insured plans are governed by federal ERISA laws and are not subject to state mandates or regulation by the state Division of Insurance. This means that self-insured employers will not be required to provide hearing aid coverage under Chapter 233.
  • How do I know if my plan is fully-insured?You may find out if your plan is fully-insured by contacting your insurance carrier or your Human Resources department at your place of employment.
  • What do I do if I find out that my plan is self-insured? You may advocate for your child! Contact your employer to explain why they should add this coverage to their insurance plan. Often employers will follow state mandates by adding similar coverage. One reason employers decide to self-insure is so that they may customize a plan to meet the specific needs of their workforce. If an employee is in need of specific coverage, an employer may consider adding the benefit. The final decision rests with your employer.
  • What if my plan has a high deductible? Chapter 233 allows carriers to apply deductibles, coinsurance, co-payments or out-of-pocket limits to hearing aid devices, supplies and services related to hearing aids, but they may not be greater than any applied to other benefits covered in the health plan. If you have a high deductible that would effectively cancel out the benefit afforded by this law, you may wish to shop around for another health insurance carrier. If this is not possible, consider appealing to your health insurance carrier to provide the coverage. Every health insurance carrier has a dispute resolution process and must consider your appeal.
  • Must I live in Massachusetts to be covered under this law?Not necessarily. If you work for an employer that is located in Massachusetts but reside outside of Massachusetts, you are most likely eligible for benefits under Chapter 233. To be sure, check with your Human Resources department.
  • What if I live in Massachusetts but work for an out-of-state employer? If your employer is located outside Massachusetts, you are most likely ineligible for benefits under Chapter 233 because your employer would be subject to insurance mandates and oversight by the state in which it is located. To be sure, check with your Human Resources department.
  • What do I do once I find out that my child is eligible to purchase hearing aids under this law? Once you determine that your child is covered by a fully-funded plan and are certain of your renewal date, you will need a written statement from your child’s treating physician that the hearing aids are necessary. Either your child’s pediatrician or ENT may provide this written statement. Then, your child’s audiologist will recommend a hearing aid that best fits your child.
  • Can my child be denied hearing aids depending on how the hearing loss occurred? No. Chapter 233 provides that a child must be afforded coverage for hearing aids if a treating physician or ENT issues a written statement that the hearing aids are necessary regardless of how the hearing loss occurred (e.g., at birth, late onset, accident, illness).
  • Is this law based on income levels? No. Any child 21 years of age or younger who resides in Massachusetts, is covered by a fully-insured health plan and meets the other requirements listed in the law is eligible to receive the benefit.
  • Is there anything that I need to know about talking to my health insurance company? Always get the full name, phone number and extension of the insurance representative with whom you speak in the event that you or someone else will need to follow up on the conversation. Take notes during your discussions and keep the notes in a file or notebook so that you may refer to them again, if necessary.
  • What if I am eligible for coverage under this law but my insurance company denies or delays coverage? If you are denied coverage or coverage is unduly delayed by your insurance company, you may file an appeal or grievance with your insurance company or you may contact the Bureau of Managed Care at the Division of Insurance in Boston to file a complaint by phone, fax or e-mail. You may also contact the Office of Patient Protection at the Department of Public Health in Boston.
  • Additional resources:Bureau of Managed Care Division of Insurance Office of Consumer Affairs and Business Regulations 1000 Washington Street, Suite 810 Boston, MA 02118 Tel: (617) 521-7372 Fax: (617) 521-7773 www.mass.gov/doi/ E-mail: bmc.mailbox@state.ma.us
  • Universal Newborn Hearing Screening Program Department of Public Health 250 Washington Street, 5th Floor Boston, MA 02108 Tel: 1-800-882-1435

Monday, July 30, 2012

Breaking news: H.52 is out of committee!!

We were just informed that House Bill 52 was voted favorably by the House Committee on Ways and Means this afternoon.   We fully expect that it will be voted upon tomorrow on the House floor and move to the Senate immediately thereafter.

This is truly GREAT news for all deaf/hard of hearing children in the Commonwealth!!

Saturday, July 28, 2012

Another great day....

On Friday, 3 D/HOH families, including siblings, cousins, aunts and grandmothers met at the State House to continue our show of support for H.52.
Based on the premise that the cost of covering pediatric hearing aids per YEAR is about the same as a postage stamp, we handed out postcards focused on that theme. Every Senator and Representative received a royal blue card with the question: "Is a child's ability to hear with hearing aids worth the cost of a single postage stamp?"
We need to keep the pressure and attention on House Bill 52 while our legislators continue intense discussions on larger bills. Our voices *are* being heard!!

Tuesday, July 24, 2012

FDA recall: Oto-Ease

FOR IMMEDIATE RELEASE - July 13,2012, Westone Laboratories, Inc. is initiating a voluntary nationwide recall of all sizes and packaging configurations of Oto-Ease® ear lubricant. The products have been found through a consumer complaint and the U.S. Food and Drug Administration (FDA) sample analysis to be potentially contaminated with pathogenic bacteria and mold. Use of the product as directed for easing the insertion of custom fit ear molds and hearing instruments (including hearing aids) could result in infectious complications of the ear canal and surrounding tissues.
Westone Laboratories is notifying its distributors and customers through direct letter and issuance of this news release and is arranging for the disposal or return of all recalled products 1-800-357-3240 between the hours of 8:00am and 5:00pm MST or email. Consumers with questions may contact Westone Laboratories at at otoeaserecall@westone.com.
http://www.fda.gov/Safety/Recalls/ucm311978.htm?source=govdelivery

Sunday, July 22, 2012

CALL TO ACTION: Make your voice heard so children can hear!!

MassHAFCC has been working feverishly over the past few weeks to keep House Bill 52 on the forefront of legislators and decision makers alike. Last week alone, we visited the State House twice, met with staff from the Governor's office and updated our social media outlets (Facebook, LinkedIn, blog) numerous times with the most current developments and discoveries.
As we head into the home stretch, we ask for a show of solidarity behind House Bill 52 from the citizens + families in the Commonwealth. Even if you have contacted your Representative and State Senator's office in the past, please contact them again as soon as possible.
Ask them to call Leadership to express support from their district and to request this bill be moved favorably out of committee (House Ways and Means) for a vote on both floors before session ends on 31 July. That should only take a few minutes of your time to impact a child for a lifetime.
Follow this link to find your legislators’ names and contact information: http://www.malegislature.gov/
While you have the phone in hand, please place companion phone calls to the offices of Senate President Therese Murray and Speaker Robert DeLeo and Governor Deval Patrick and ask them to pass House Bill 52 *this* session.
· Senate President Murray:  617-722-1500
· House Speaker DeLeo: 617-722-2500
· Governor Patrick: 617.725.4005 (Boston) 413.784.1200 (Springfield)
As always, please return to this blog http://masshafcc.blogspot.com/ for the most current information.  *Many* heartfelt thanks for your continued support, especially during these last weeks of session. 
Be sure to forward to all friends + families who chose to have their voices heard so our children can hear.

Saturday, July 21, 2012

Editorial in the Disability Policy Consortium Weekly Update

The editorial in the 7/16 Disability Policy Consortium Weekly Update focused on House Bill 52 "An Act to provide access to hearing aids for children".
Bill Allan highlights what supporters of the bill have done right so far which include 1) the focus is children; 2) there is an impressive amount of legislative support - 71 bipartisan "official" co-sponsors plus numerous others; 3) there was a diverse array of people who testified at the Hearing in May; and, finally 4) H.52 supporters are well-organized and focused.
Mr. Allan Also indirectly reminds us that the session is ending soon. PLEASE DO YOUR PART TO SEE THAT H.52 PASSES!! Be sure *your* legislators in both the House and Senate are well aware of your position and ask them to support House Bill 52!!
http://www.dpcma.org/News/WeeklyUpdates/tabid/786/articleType/ArticleView/articleId/519/Weekly-Update-July-16-2012.aspx
MAKE YOUR CALL TODAY!!

Thursday, July 19, 2012

Keeping the message going

A group of MassHAFCC families ventured into the State House today to continue efforts to keep attention focused on H.52 during these last few weeks of the session. Postcards summarizing the minimal financial impact were delivered to every Representative and Senator. They were received very well!! Visit the MassHAFCC Facebook page for some smiling faces memorializing the day. Keep your calls coming in to your legislators in support of House Bill 52!!

Wednesday, July 18, 2012

"...the cost of ONE postage stamp per member per YEAR."

The Health Business Blog recently commented on House Bill 52 in a blog entitled "Mandated hearing aids benefit for Massachusetts children: Sounds like a good idea to me" (see link below). The writer provides the more typical cons for *any* mandated coverage yet comes to the conclusion that the pros for this bill are far more persuasive. WE AGREE!
Keep up your telephones, emails and contacts to your legislators in support of the bill - your voice really does matter and does make a difference!!
www.healthbusinessblog.com/2012/07/mandated-hearing-aid-benefit-for-massachusetts-children-sounds-like-a-good-idea-to-me/

Thursday, July 12, 2012

WE NEED YOUR HELP TO PASS BILL!!

FINAL STAGES- WE NEED YOUR HELP!
 
We are very close to seeing House Bill 52, "An Act to Provide Access to Hearing Aids for Children" become a law! With just two weeks left in the legislative session, we still expect this bill to pass. It remains extremely important for everyone to stay involved. Your phone calls, testimony, letters, emails and general support of the bill have made a big difference. Our legislators have heard you and they continue to respond to you as constituents in support of this bill.

PLEASE TAKE 5 MINUTES TO CALL YOUR REPRESENTATIVE AND ASK HIM/HER TO REQUEST THE SPEAKER TO MOVE THIS BILL TO THE HOUSE FLOOR FOR A VOTE!

PLEASE TAKE 5 MINUTES TO CALL YOUR SENATOR AND ASK HIM/HER TO TALK TO THE SENATE PRESIDENT TO PUT THIS BILL ON THE FLOOR FOR A VOTE!

Click here for contact information for all legislators: http://www.malegislature.gov/

We will continue to post information on our blog over the next two weeks: http://masshafcc.blogspot.com/

PLEASE CHECK OUR BLOG TO STAY INFORMED!

Let's make access to hearing aids a reality for all children in the Commonwealth with hearing loss!

Sunday, July 8, 2012

We Are Very Close to Passing Bill!

Nice work everyone!!

Because of your hard work last week making phone calls and contacting your legislators, we received the mandate review report (cost analysis) for HB52 from the Division of Health Care Finance and Policy. The numbers are very favorable and confirm what we have known all along: that the implementation of House Bill 52 will have a minimal financial impact on health insurance premiums in MA.

The report concluded that the enactment of House Bill 52 will cause no more than a 0.015% increase to insurance premiums. This translates to an increase of $0.04 per member per month (using the mid-level scenario in the report, with $0.02 and $0.07 as the low and high-level cost estimates, respectively).

What needs to happen: House Ways and Means must report the bill out favorably. The House must vote on the bill. The Senate must vote. The Governor must sign the bill into law. While we have just 3 weeks left in the legislative session, we are extremely optimistic that this bill will pass this session.

What you can do: Please keep checking this blog frequently. With the end of the session drawing near, things happen daily at the State House that could affect this bill and your support thereof.

We know that we can count on you for your support!

Let's make this happen for all children with hearing loss in the Commonwealth! Your voice represents them.