Illinois Compiled Statutes 215 ILCS 5/356z.30 – Coverage for hearing aids for individuals under the age of 18
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a) As used in this Section:
“Hearing care professional” means a person who is a licensed hearing instrument dispenser, licensed audiologist, or licensed physician.
“Hearing instrument” or “hearing aid” means any wearable non-disposable, non-experimental instrument or device designed to aid or compensate for impaired human hearing and any parts, attachments, or accessories for the instrument or device, including an ear mold but excluding batteries and cords.
(b) An individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after August 22, 2018 (the effective date of Public Act 100-1026) must provide coverage for medically necessary hearing instruments and related services for all individuals under the age of 18 when a hearing care professional prescribes a hearing instrument to augment communication.
(c) An insurer shall provide coverage, subject to all applicable co-payments, co-insurance, deductibles, and out-of-pocket limits, subject to the following restrictions:
(1) one hearing instrument shall be covered for each
“Hearing care professional” means a person who is a licensed hearing instrument dispenser, licensed audiologist, or licensed physician.
Terms Used In Illinois Compiled Statutes 215 ILCS 5/356z.30
- individual: shall include every infant member of the species homo sapiens who is born alive at any stage of development. See Illinois Compiled Statutes 5 ILCS 70/1.36
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14
- United States: may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14
“Hearing instrument” or “hearing aid” means any wearable non-disposable, non-experimental instrument or device designed to aid or compensate for impaired human hearing and any parts, attachments, or accessories for the instrument or device, including an ear mold but excluding batteries and cords.
(b) An individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after August 22, 2018 (the effective date of Public Act 100-1026) must provide coverage for medically necessary hearing instruments and related services for all individuals under the age of 18 when a hearing care professional prescribes a hearing instrument to augment communication.
(c) An insurer shall provide coverage, subject to all applicable co-payments, co-insurance, deductibles, and out-of-pocket limits, subject to the following restrictions:
(1) one hearing instrument shall be covered for each
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ear every 36 months;
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(2) related services, such as audiological exams and
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selection, fitting, and adjustment of ear molds to maintain optimal fit shall be covered when deemed medically necessary by a hearing care professional; and
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(3) hearing instrument repairs may be covered when
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deemed medically necessary.
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(d) If, at any time before or after August 22, 2018 (the effective date of Public Act 100-1026), the Secretary of the United States Department of Health and Human Services, or its successor agency, promulgates rules or regulations to be published in the Federal Register, publishes a comment in the Federal Register, or issues an opinion, guidance, or other action that would require the State, pursuant to any provision of the Patient Protection and Affordable Care Act (Pub. L. 111?148), including, but not limited to, 42 U.S.C. § 18031(d)(3)(B) or any successor provision, to defray the cost of coverage for medically necessary hearing instruments and related services for individuals under the age of 18, then this Section is inoperative with respect to all such coverage other than that authorized under Section 1902 of the Social Security Act, 42 U.S.C. § 1396a, and the State shall not assume any obligation for the cost of coverage for medically necessary hearing instruments and related services for individuals under the age of 18.