Wisconsin is requiring state-regulated major medical policies in the state to cover hearing aids, cochlear implants, and related products and services for infants and children.
The act that created the mandates began to apply to group and individual policies and to self-insured state and municipal health plans starting Jan. 1.
Affected Wisconsin plans must cover the cost of hearing aids and cochlear implants that are prescribed by a physician or by a licensed audiologist for an insured child who is deaf or hearing impaired.
An insurer need not pay for more than one hearing aid per ear every 3 years, and it can apply cost-sharing provisions and limitations that apply to other types of care.
But an insurer cannot use a preexisting condition exclusion to get out of paying for hearing aids and cochlear implants, and it cannot use the benefit limits that apply to other types of durable medical equipment and prosthetics to limit hearing aid and cochlear implant coverage.
An insurer must provide hearing aid and cochlear implant coverage for all hearing impaired children, not simply those who have "severe to profound deafness," officials say.
The rule does not apply to temporary heath insurance policies or limited benefit health insurance policies.
Wisconsin also is exempting any "preferred provider plan that is not a defined network plan."
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.