Delaware General Assembly


CHAPTER 244

FORMERLY

HOUSE BILL NO. 355

AS AMENDED BY

HOUSE AMENDMENT NO. 2

AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO HEALTH INSURANCE CONTRACTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE :

Section 1. Amend Chapter 33, Title 18 of the Delaware Code by adding a new “§3357” thereto as follows:

Ҥ3357. Hearing Aid Coverage.

(a) For purposes of this section, the term “hearing aid" means any nonexperimental, wearable instrument or device designed for the ear and offered for the purpose of aiding or compensating for impaired human hearing, but excluding batteries, cords, and other assistive listening devices such as FM systems.

(b) Every individual health insurance contract, including each policy or contract issued by a health service corporation, which is delivered, issued for delivery, or renewed in this state on or after January 1, 2009, shall provide coverage of up to one thousand dollars ($1000.00) per individual hearing aid, per ear, every three (3) years, for children less than twenty-four (24) years of age, covered as a dependent by the policy holder.

(c) The insured may choose a hearing aid exceeding one thousand dollars ($1,000.00) and pay the difference in cost above the amount of coverage required by this section. Reimbursement shall be provided according to the respective principles and policies of the insurer. The insurer may require the policyholder to provide a prescription or show proof through other suitable documentation of the need for a hearing aid and nothing contained in this section shall preclude the insurer from conducting managed care, medical necessity, or utilization review or prevent the operation of such policy provisions as deductibles, coinsurance, allowable charge limitations, coordination of benefits or provisions restricting coverage to services by licensed, certified or carrier-approved providers or facilities.

(d) This section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare supplement; (6) limited benefit health; (7) specified diseased indemnity; (8) sickness or bodily injury or death by accident, or both; and (9) other limited benefit policies.”

Section 2. Amend Chapter 35, Title 18 of the Delaware Code by adding a new “§3571B” thereto as follows:

Ҥ3571B. Hearing Aid Coverage.

(a) For purposes of this section, the term “hearing aid" means any nonexperimental, wearable instrument or device designed for the ear and offered for the purpose of aiding or compensating for impaired human hearing, but excluding batteries, cords, and other assistive listening devices such as FM systems.

(b) Every group and blanket health insurance contract, including each policy or contract issued by a health service corporation, which is delivered, issued for delivery, or renewed in this state on or after January 1, 2009, shall provide coverage of up to one thousand dollars ($1000.00) per individual hearing aid, per ear, every three (3) years, for children less than twenty-four (24) years of age, covered as a dependent by the policy holder.

(c) The insured may choose a hearing aid exceeding one thousand dollars ($1,000.00) and pay the difference in cost above the amount of coverage required by this section. Reimbursement shall be provided according to the respective principles and policies of the insurer. The insurer may require the policyholder to provide a prescription or show proof through other suitable documentation of the need for a hearing aid and nothing contained in this section shall preclude the insurer from conducting managed care, medical necessity, or utilization review or prevent the operation of such policy provisions as deductibles, coinsurance, allowable charge limitations, coordination of benefits or provisions restricting coverage to services by licensed, certified or carrier-approved providers or facilities.

(d) This section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare supplement; (6) limited benefit health; (7) specified diseased indemnity; (8) sickness or bodily injury or death by accident or both; and (9) other limited benefit policies.”

Approved June 18, 2008