MassHAFCC: September 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

Friday, September 28, 2012

CELEBRATION at the Massachusetts State House!

September 27, 2012 - MassHAFCC and their families, Massachusetts legislators including House Bill 52 sponsor Representative Sean Garballey, representatives from Boston's Children's Hospital, MCDHH Deputy Commissioner Patricia Ford and members of the Deaf/Hard of Hearing community at large were present to witness the ceremonial signing of House Bill 52 (An Act to Provide Hearing Aids to Children) into Law (Chapter 233 of the Acts of 2012) by Massachusetts Governor Deval Patrick.

This bill, after being filed by Representative Garballey, began its journey in the Joint Committee on Children, Families and Persons with Disabilities with Representative Khan and Senator Rodriques as Co-Chairs of the Committee and moved to the Joint Committee on Health Care and Finance chaired by Representative Walsh.

Brief comments were made by Lisa Adams (MassHAFCC President), Michelle Motta Dardeno and Kim LaBrecque (MassHAFCC Board Members) and Dr. Marilyn Neault (Director of Habilitative Audiology at Boston Children's Hospital) following congratulations by Governor Patrick. Many children, families and professionals from across the state were thanked for testifying in person, submitting written testimony and making many phones in support of passing this bill.

Of note, Lisa shared that "...the impact of this law is already being felt across our state in hospitals and audiology offices-- it has instantly changed the initial discussion between practitioners diagnosing hearing loss and families hearing the diagnosis for the first time. This is big news for our children: we can diagnose hearing loss early and ensure access to sound, speech and language early too."

Dr. Neault introduced a mother and her 4 month old daughter who was recently diagnosed with hearing loss through the Newborn Hearing Screening program. Mom explained that she was "completely overwhelmed" when she found out how much hearing aids cost. Everyone in the room echoed her sentiment and tears as she stated "I can't thank you enough" over again. This new law will remove the financial burden for this family and all families across the Commonwealth.

Massachusetts became the 20th state to pass legislation mandating insurance coverage for pediatric hearing aids in the United States when the bill passed unanimously through the House and Senate and officially signed into law on August 7th, 2012.

The full 24 minute recording of the ceremony: http://www.youtube.com/watch?v=oEXq_yJkoNU.

Monday, September 24, 2012

11 Misconceptions Teachers Should Know about Children with Hearing Loss

We recently came across this article ("Eleven misconceptions teachers should know about children with hearing loss") by Janice Schacter Lintz (mom of an 18-year-old with a severe to profound hearing loss who is about to enter her freshman year at Brown University). The author does a nice job explaining each point in a manner easily understood by all. There are many truths worth remembering and sharing with the teachers, specialists and support staff that educate our children.

http://hearinghealthmatters.org/hearingviews/2012/eleven-misconceptions-that-teachers-should-know-about-children-with-hearing-loss/

Here are the 11 misconceptions to entice you to read the full article.

People with hearing loss are older adults.
A child who responds to sound does not have a hearing loss.
Having a late-diagnosed hearing loss is the same as being born with a hearing loss.
Hearing aids and cochlear implants restore hearing to normal.
With hearing aids or CIs, children can usually hear everything that is said in class, and if they can’t hear something they will advise the teacher.
Increasing the sound volume on a hearing aid will enable a child with hearing loss to understand what is said.
Children who wear hearing aids or a CI for their hearing loss do not need an FM unit as well.
A child who can understand what’s said in small group settings won’t have a problem watching a movie or video without captions. If the film or video has captioning, the child does not need it hooked up to his or her FM system.
People with hearing loss are dumb, stupid, mute, have intellectual limitations, and are bound to be unsuccessful.
Children with a hearing loss are born to parents who have a hearing loss and use American Sign Language (ASL).
People with hearing loss cannot learn other languages.

Wednesday, September 12, 2012

New Hearing Aid Law for Children

Hi everyone- You may now read the new hearing aid law for children in Massachusetts online. Click on the following link. The citation is: Chapter 233 of the Acts of 2012.

http://www.malegislature.gov/Laws/SessionLaws/Acts/2012/Chapter233

The law becomes effective on January 1, 2013. There may be regulations drafted prior to that date. We will keep you posted.

MASSHAFCC

Friday, September 7, 2012

1983 vs. 2012

Can you believe that in 1983, the New York Times found that then President Reagan's public hearing aid use was newsworthy? Yes, its true!

http://www.nytimes.com/1983/09/08/us/reagan-begins-to-wear-a-hearing-aid-in-public.html

Of particular interest was this statement:

"Among Presidential advisers, Mr. Reagan's use of a hearing aid revived speculation on whether his age would be an issue if he seeks re-election next year. The general feeling was that it would not."

REALLY??? I, for one, am thankful that the use of hearing aids at ANY age is less of an issue in 2012 than in 1983. People at every age are affected by hearing loss. If hearing aids help, we should wear them without reservation, fear of embarrassment or discrimination.

It never ceases to amaze me when I think of how these powerful devices help our children navigate through life everyday. To all deaf/hard of hearing children who know firsthand the necessity and benefits of wearing hearing aids everyday, we commend your courage, determination and accomplishments!