Hearing Aids For Children
In 2006, NMCDHH called for a House Memorial 16, which coordinated a study to explore the feasibility of mandating insurance coverage for children's hearing aids. The House Memorial 16 Study Group included representatives from the deaf and hard of hearing community, parents, audiologist, private and non-profit organizations, advocacy groups and state agency representatives.
The experience of eight other states that have mandated insurance coverage was explored and used as a baseline to develop recommendations for New Mexico. The Study Group identified financial barriers that limit timely and affordable access to appropriate hearing aids and related professional services for infants and children with hearing loss.
During the 2007 legislative session, HB 85 & SB 529 both supporting insurance coverage of Hearing Aids for Children, was passed. This legislation helps many parents obtain hearing aids for their children and coverage includes self-insured families in New Mexico. However, the Employee Retirement Income Security Act (ERISA) of 1974, a Federal statute, excludes self-insured plans, including Federal employees, from following any state mandates for health coverage. The majority of the parents of deaf, hard-of-hearing and deaf-blind children are self-insured. As a result, many self-insured parents have received denial letters when requesting payment for their child's hearing aids.
The purpose of the Hearing Aid Children Appeal packet is to provide guidance for Federal, State Employees and self-insured parents of deaf, hard of hearing or deaf-blind children to appeal insurances who declined coverage for hearing-aids. The majority of the parents who are faced with insurance barriers are either covered by employers or national insurance carriers that are affected by the ERISA Act.
The following letters and information provide choices for parents to address their circumstances with their insurance carrier or employer. Appealing does not guarantee that insurance carriers or employers will pay for the hearing aids or add hearing aids to their plans, but at least parents know they've tried to make a change that will benefit not only their child, but perhaps a co-worker's child, neighbor or other New Mexicans faced with the same challenges. The following facts can be used in your letters.
To download the Hearing Aid Children's Appeal packet, please click here