MassHAFCC: August 2012

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, August 27, 2012

How can I protect my child from hearing damage from iPods?

In March 2006 Apple released a software update for iPods that allows parents to use a combination lock to set the maximum decibel level for children. Apple posted information online at www.apple.com/sound on how to use this new feature and other strategies to limit long-term hearing damage.

Topics covered on this page:

The Science of Sound
Sound and Your Ears
Listen Responsibly
Think about the Volume
Keep Track of Time

Check it out!!

Sunday, August 19, 2012

Join "Team MassHAFCC"

Team MassHAFCC will be participating again this year in the New England Walk4Hearing on October 28th. It has always been a great time to meet and reconnect with other adults and children with hearing loss in our area. The children have always enjoyed the kid's activities before/after!

If you are interested in raising awareness in our local area about hearing loss, we would LOVE for you to join us! You can join Team MassHAFCC 2 ways:

1. Walk4Hearing website (www.walk4hearing.org)
2. Click on Walk4Hearing in our "links" section of this blog

- Location: Brighton, MA (Artesani Park - 1234 Soldiers Field Rd)
- Date: Sunday, October 28, 2012 (10am check-in/11am walk begins)
- Team name: "Team MassHAFCC"
- Register to join the team

This will be our 3rd year participating as a team. In 2009, we wore light blue and in 2011 we wore navy blue. We've enjoyed walking with MassHAFCC children, parents, grandparents, aunts/uncles and friends. If you join, please contact us if you are interested in purchasing a Team MassHAFCC T-shirt.

Thursday, August 16, 2012

Thank Your Legislators!

Hi everyone- as we are still basking in the rays of our new law, Chapter 233 of the Acts of 2012, we ask that you take a few minutes to thank your legislators for supporting and passing House Bill 52. We contact them when we ask them to do something for us, but I fear they don't hear back from enough of us to thank them for a job well done. This is surely that time. House Bill 52 passed unanimously in the House and Senate and we owe a big thanks to those that made the bill a reality for our children.

Please take 5 minutes to call or write your Representative and Senator to thank them for passing this law.

Then, go back to celebrating!!

-MassHAFCC

Tuesday, August 7, 2012

H.52 has been signed into LAW!!!

It is with the utmost joy that we share that Governor Deval Patrick just signed House Bill 52 into LAW!!

As with any great endeavor, success is never built on the shoulders of a few but on a community of dedicated contributors. We thank Rep. Sean Garballey, H52 sponsor and Dave Koffman in his office for their leadership and ability to garner bi-partisan support across the MA House and Senate. There were many, many legislative supporters including the 71 original co-sponsors that worked tirelessly on behalf of all D/HOH children in Massachusetts. To all the professional, family-based and school-based groups that were ready at every "call to action", we thank you and hope you share in this happy news! Feel free to spread the word!

Details about coverage, etc. will be flushed out as the regulations are drafted/finalized prior to the effective date 1/1/13. The MassHAFCC blog will continue to provide information as it is made available to us.

It is a very happy day!!!

Sunday, August 5, 2012

CALL TO ACTION: Call Governor Deval Patrick and ask him to sign House Bill 52!

We ask all supporters of House Bill 52 across the state for help! Last week's tremendous success for the deaf/ hard of hearing children in Massachusetts has one additional step before the bill can become law: signature by the Governor. The bill was unanimously voted and passed by the Massachusetts House and Senate representing wide spread support and understanding across the state.

Please call Governor Patrick on Monday to make your voice heard loud & clear in support of House Bill 52. Ask him to sign House Bill 52 to allow children across the Commonwealth equal access to sound through hearing aids.

Office of the Governor, Boston: 617-725-4005 or 617-727-3666 (TTY)

THANK YOU!!!

Saturday, August 4, 2012

Press On Hearing Aid Bill

Perhaps you have read a few not-so-favorable articles and editorials in the Boston Herald over the past few days. There is going to be bad press, along with the articles that we'll enjoy reading about the hearing aid bill. Here are a few things to remember about House Bill 52 as you read these articles:

While House Bill 52 is a health insurance mandate, it is not a typical mandate because it is farther reaching than simply covering an insurance cost. Passing House Bill 52 will save on medical expenses associated with untreated hearing loss; speech and language services, which insurance covers (thus insurance itself will realize cost savings); educational costs for special education services associated with servicing children who lag behind in speech, langauge, reading, math, etc. because of late access to hearing aids; and 4) services associated with the social and emotional well-being of the child. Few mandates affect the WHOLE CHILD as significantly as does House Bill 52.

Moreover, House Bill 52 has a $2,000 cap and a 36-month cycle for benefits-- it has cost-containment built into the bill! This squares nicely with Gov. Patrick's policy.

If you decide to leave a comment for any of these articles on-line, please remember these points and feel free to use them.

And, please keep checking back to find out how you can continue to support the bill as it moves to the Governor's desk!

Friday, August 3, 2012

All of us at MassHAFCC would like to thank all of you who helped to pass House Bill 52! We could not have done it without you. Your emails, phone calls, testimonies, letters and hard work paid off and you should feel proud. THANK YOU!!

Thursday, August 2, 2012

It was a truly exciting day at the State House! Rep. Garballey (Arlington) and Rep. Scibeck (South Hadley), Dave Koffman of Rep. Garballey's office and Michele Lisio of Rep. Haddad's office were present. Both the House and the Senate voted unanimously. House Bill 52 is on its way to the Governor's desk! Here we are outside the House Chamber this morning.

Breaking News!!!

House Bill 52 has just been enacted by both the House and the Senate today and is on its way to the Governor's office next. This has truly been a great week!!

Keep checking this blog for more information and breaking news.

Wednesday, August 1, 2012

Success!!

We are very happy to report that House Bill 52 has PASSED in both the Massachusetts House and Senate on 31 July 2012!

MassHAFCC families were able to witness this amazing event first hand both House and Senate chambers gallery as well as via online streaming. The first and second reading of the bill in the House happened rather early in the day. After a period of hours, the bill underwent its third reading and was engrossed by the House by a voice vote. The bill was then passed to the Senate to be engrossed also. The Senate engrossed it with an amendment which was minor in nature.

Procedurally, the bill returned to the House which needed to first concur with the Senate amendment and then be enacted upon. Unfortunately due to the advanced time, the House was only able to concur before midnight stuck.

We have been informed that full enactment by both the House and Senate in informal sessions is scheduled for Thursday. Then it's off to the Governor to sign into law!

This is truly GREAT day for all D/HOH children in Massachusetts!!!