Tennessee § 56-7-2368 - Health insurance coverage for hearing aids for children.

§ 56-7-2368. Health insurance coverage for hearing aids for children.

As used in this section, unless the context otherwise requires: “Child” or “children” means any person under eighteen (18) years of age; and “Hearing aid” means any wearable, nonexperimental, nondisposable instrument or device designed for the ear and used to aid or compensate for impaired human hearing, including earmolds and services necessary to select, fit, and adjust the hearing aid, but excluding batteries, cords, and other assistive listening devices such as FM systems. Every individual or group health insurance policy providing coverage on an expense-incurred basis, every policy or contract issued by a hospital or medical service corporation, every individual or group service contract issued by a health maintenance organization, and every self-insured group arrangement to the extent not preempted by federal law, which is delivered, issued for delivery, or renewed in this state on or after January 1, 2012, shall provide coverage of up to one thousand dollars ($1,000) per individual hearing aid per ear, every three (3) years, for every child covered by such policy whether as a dependent of the policy holder or otherwise. The insured may choose a hearing aid exceeding one thousand dollars ($1,000) 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 by a licensed audiologist or physician or show proof through other suitable documentation of the need for a hearing aid, and this section shall not 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. This section shall not apply to insurance coverage providing benefits for the following: Hospital confinement indemnity; Disability income; Accident only; Long-term care; Medicare supplement; Limited benefit health; Specified disease indemnity; Sickness or bodily injury or death by accident, or both; and Other limited benefit policies. This section shall not apply to TennCare or any successor program provided for in title 71, chapter 5. Acts 2011, ch. 199, § 1. Compiler's Notes. Acts 2011, ch. 199, § 2 provided that the act, which enacted this section, shall apply to policies or contracts issued on or after January 1, 2012.