Friday, February 25, 2011

NC Hearing Aid Mandate Effective January 1, 2011

This past fall, the North Carolina legislature passed an act requiring health benefit plans and the State Health Plan to cover hearing aids and replacement hearing aids for covered individuals under the age of 22. The act was effective for plans with January 1, 2011 and beyond effective dates.

All group medical plans are impacted. Hearing aid coverage will be standard for all fully-insured plans, including MEWAs and the State Health Plan, as well as for self insured groups.

BCBSNC Benefit Design Changes
BCBSNC modified their benefit plans to include the following hearing aid coverage:
• One hearing aid per hearing-impaired ear up to $2,500 per hearing aid every 36 months for covered members under the age of 22 years.
• Benefits include initial hearing aid evaluation, fitting and adjustments and supplies including ear molds.
• This is a 36-month benefit, not a three-year benefit, meaning hearing aids for the left and right ears could have a different 36-month coverage period.
• These benefits will display in the member guide but not in the benefit highlight.

Benefit changes made to comply with state mandates will not impact your group's grandfathered status.

No comments:

Post a Comment