Legislative Changes
- Hearing Instrument Coverage - 2020 Changes
- Starting January 1, 2020 insurers in Illinois are required to provide patients with OPTIONAL hearing coverage.
Illinois residents have seen several changes over the last few years to improve their hearing health coverage in Illinois. A law passed in 2018 requires coverage for replacement hearing aids every three years for children with hearing loss 18 and younger (IL Public Act 100-1026). In August of 2019, Governor Pritzker signed House Bill 3508 which requires insurers to offer optional coverage or reimbursement for hearing instruments & related services for all individuals. Insurance companies will handle this in a number of different ways, from providing an elective coverage option, providing their own hearing care program, or simply rolling hearing health services into their standard coverage.
What this means for our instrument dispensers is that there is likely to be an increase in covered individuals, although not a guarantee that EVERY individual is covered. There is going to be a lot of confusion in these early days regarding this new law, and what is important that we do not make assumptions about coverage and verify benefits. Health care in the United States can be confusing for patients, to say the least. Make sure that patients understand that you may be attempting to help, but as a provider, you are not involved in the arrangement between them and their health insurers.
OTC Hearing Aid Rules Released
On Tuesday, August 16, 2022, the U.S. Food and Drug Administration (FDA) released its [final rule] regarding over-the-counter (OTC) hearing aids. The move will allow those with mild to moderate hearing loss to directly purchase hearing aids from retailers. After considering over 1,000 responses during the public comment period, the FDA decided to make changes to the original October 20, 2021, proposed rule, some of which aligned with Illinois & International's recommendations. See Illinois' Jan 16th Letter to the FDA [here].
The final rule also includes performance specifications and device design requirements specific to OTC hearing aids. The effective date for the final rule is 60 days after the publication in the Federal Register, with FDA reporting it expects OTC hearing aids to be available as soon as mid-October. You may find more information on this topic on the International Hearing Society's Advocacy Page [here].