Voters should care about this bill because it addresses a significant gap in many private health insurance plans: consistent coverage for advanced hearing devices and the comprehensive care they require. Hearing loss affects millions of Americans, and technologies like cochlear implants can dramatically improve quality of life, communication, and educational/employment opportunities. However, these devices and the associated surgeries, therapy, and ongoing maintenance are incredibly expensive, often costing tens of thousands of dollars, making them inaccessible for many.
If this bill becomes law, it would alleviate a substantial financial burden for individuals and families facing hearing loss, making essential care more affordable and accessible. It would ensure that coverage for these items is treated similarly to other medical benefits, preventing insurance companies from imposing unique, higher cost-sharing or restrictive limits. If it does not pass, many individuals will continue to struggle with out-of-pocket costs, or forgo necessary devices and services, potentially limiting their ability to fully participate in society due to untreated hearing impairment.
KEY PROVISIONS
5AI-extracted
PROVISION 01
Requires group and individual private health insurance plans to cover auditory implant devices (like cochlear implants and bone conduction implants) and external sound processors.
This ensures direct coverage for the core hearing technologies that are often very expensive.
PROVISION 02
Mandates coverage for maintenance, repair, and regular upgrades (every 5 years) of these auditory implant devices and processors.
This ensures the devices remain functional and up-to-date over time, addressing ongoing costs beyond the initial purchase.
PROVISION 03
Requires coverage for related services including comprehensive hearing assessments, pre-operative medical assessments, surgery, post-operative visits, and aural rehabilitation.
This provides a holistic approach to care, recognizing that the devices are only one part of effective hearing loss treatment.
PROVISION 04
Ensures that financial requirements (like co-pays) and treatment limitations for these hearing services are no more restrictive than those applied to most other medical and surgical benefits.
This prevents insurance plans from singling out hearing care with higher costs or stricter limits, making it more affordable.
PROVISION 05
Prohibits plans from denying or limiting coverage for any covered item or service if a physician or qualified audiologist determines it is medically necessary.
This empowers medical professionals to determine appropriate care and prevents insurers from arbitrarily refusing coverage.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Voters should care about this bill because it addresses a significant gap in many private health insurance plans: consistent coverage for advanced hearing devices and the comprehensive care they require. Hearing loss affects millions of Americans, and technologies like cochlear implants can dramatically improve quality of life, communication, and educational/employment opportunities. However, these devices and the associated surgeries, therapy, and ongoing maintenance are incredibly expensive, often costing tens of thousands of dollars, making them inaccessible for many.
If this bill becomes law, it would alleviate a substantial financial burden for individuals and families facing hearing loss, making essential care more affordable and accessible. It would ensure that coverage for these items is treated similarly to other medical benefits, preventing insurance companies from imposing unique, higher cost-sharing or restrictive limits. If it does not pass, many individuals will continue to struggle with out-of-pocket costs, or forgo necessary devices and services, potentially limiting their ability to fully participate in society due to untreated hearing impairment.
KEY PROVISIONS
AI-extracted
high
Requires group and individual private health insurance plans to cover auditory implant devices (like cochlear implants and bone conduction implants) and external sound processors.
This ensures direct coverage for the core hearing technologies that are often very expensive.
high
Mandates coverage for maintenance, repair, and regular upgrades (every 5 years) of these auditory implant devices and processors.
This ensures the devices remain functional and up-to-date over time, addressing ongoing costs beyond the initial purchase.
med
Requires coverage for related services including comprehensive hearing assessments, pre-operative medical assessments, surgery, post-operative visits, and aural rehabilitation.
This provides a holistic approach to care, recognizing that the devices are only one part of effective hearing loss treatment.
high
Ensures that financial requirements (like co-pays) and treatment limitations for these hearing services are no more restrictive than those applied to most other medical and surgical benefits.
This prevents insurance plans from singling out hearing care with higher costs or stricter limits, making it more affordable.
med
Prohibits plans from denying or limiting coverage for any covered item or service if a physician or qualified audiologist determines it is medically necessary.
This empowers medical professionals to determine appropriate care and prevents insurers from arbitrarily refusing coverage.
GLOSSARY
AI-written
Group health plan
A health plan provided by an employer or employee organization to employees and their families.
Health insurance issuer
An insurance company that offers health insurance policies, either to groups or individuals.
Auditory implant devices
Medical devices surgically implanted to help people with severe hearing loss, such as cochlear implants or bone conduction implants, which process sound.
Cochlear implants
An electronic device that partially restores hearing for people with severe hearing loss, by directly stimulating the auditory nerve.
External sound processors
The external part of an auditory implant system that captures sound and sends it to the implanted device.
Qualifying individual
An individual whose hearing loss is severe enough that a doctor or audiologist determines they would benefit from an auditory implant device.
Financial requirements
The costs an individual must pay out-of-pocket for healthcare services, such as deductibles, co-payments, and co-insurance.
ACTION TIMELINE
2 EVENTS
JUL 22, 25
Introduced in House
INTROREFERRAL
JUL 22, 25
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Restrictions on the amount or duration of care a health insurance plan will cover, such as limits on the number of therapy sessions or days in the hospital.
Medical necessity
Healthcare services or supplies that are considered appropriate and necessary to diagnose or treat a medical condition, as determined by a healthcare professional.
