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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>76455</law_id><section_number>38.2-3418.21</section_number><catch_line>Coverage for hearing aids and related services</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-4319</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="2">Mandated Benefits</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> As used in this section:
			&#x201C;<span class="dictionary">Hearing aid</span>&#x201D; means any wearable, nondisposable instrument or device designed or offered to aid or compensate for impaired human hearing and any parts, <span class="dictionary">attachments</span>, or accessories, including earmolds, but excluding batteries and cords. <span class="dictionary">Hearing aids</span> are not to be considered durable medical equipment.
			&#x201C;<span class="dictionary">Related services</span>&#x201D; includes earmolds, initial batteries, and other necessary equipment, maintenance, and adaptation training. <a id="paragraph-274434" class="section-permalink" href="https://vacode.org/38.2-3418.21/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> Notwithstanding the provisions of &#xA7; <a class="law" title="Additional mandated coverage made optional to group policy or contract holder" href="/38.2-3419/">38.2-3419</a>, subdivision A 1 of &#xA7; <a class="law" title="Certification of health benefit plans as qualified health plans" href="/38.2-6506/">38.2-6506</a>, or any other provision of <span class="dictionary">law</span>, each <span class="dictionary">insurer</span> proposing to <span class="dictionary">issue</span> individual or group accident and sickness <span class="dictionary">insurance policies</span> providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription <span class="dictionary">contracts</span>; and each health maintenance organization providing a health care plan for health care services shall provide coverage for <span class="dictionary">hearing aids</span> and <span class="dictionary">related services</span> for children 18 years of age or younger under any policy, <span class="dictionary">contract</span>, or plan delivered, issued for delivery, or renewed in the Commonwealth. The coverage shall include payment of the cost of one <span class="dictionary">hearing aid</span> per hearing-impaired ear every 24 months, up to $1,500 per <span class="dictionary">hearing aid</span>. The insured may choose a higher-priced <span class="dictionary">hearing aid</span> and may pay the difference in cost above $1,500, with no financial or contractual <span class="dictionary">penalty</span> to the insured or to the provider of the <span class="dictionary">hearing aid</span>. <a id="paragraph-274435" class="section-permalink" href="https://vacode.org/38.2-3418.21/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> No <span class="dictionary">insurer</span>, corporation, or health maintenance organization shall impose upon any <span class="dictionary">person</span> receiving benefits pursuant to this section any copayment or fee, and no condition may be applied to the <span class="dictionary">person</span> that is not equally imposed upon all individuals in the same benefit category. <a id="paragraph-274436" class="section-permalink" href="https://vacode.org/38.2-3418.21/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> Coverage shall be available under this section only for services and equipment recommended by an otolaryngologist. Such recommended services and equipment may be provided or dispensed by an otolaryngologist, licensed audiologist, or licensed <span class="dictionary">hearing aid</span> specialist. <a id="paragraph-274437" class="section-permalink" href="https://vacode.org/38.2-3418.21/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> The provisions of this section shall apply to any policy, <span class="dictionary">contract</span>, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2024. <a id="paragraph-274438" class="section-permalink" href="https://vacode.org/38.2-3418.21/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> The provisions of this section shall not apply to short-term travel, accident-only, limited or specified disease policies, or <span class="dictionary">contracts</span> designed for issuance to <span class="dictionary">persons</span> eligible for coverage under Title XVIII of the Social Security Act, known as <span class="dictionary">Medicare</span>, or any other similar coverage under <span class="dictionary">state</span> or federal governmental plans or to short-term nonrenewable policies of not more than six months&#x2019; duration. <a id="paragraph-274439" class="section-permalink" href="https://vacode.org/38.2-3418.21/#F"><i class="fa fa-link"/></a></p></section>
						<section id="G"><p><span class="prefix-number">G.</span> The <span class="dictionary">Commission</span> shall not use any special fund revenues dedicated to its other functions and duties, including revenues from utility consumer taxes or fees from licensees regulated by the <span class="dictionary">Commission</span> or fees paid to the office of the clerk of the <span class="dictionary">Commission</span>, to fund the defrayal of costs for the coverage provided pursuant to subsection B as required by 42 U.S.C. &#xA7; 18031 or any successor provision. The <span class="dictionary">Commission</span> shall not pay any funds beyond the moneys appropriated for the defrayal of costs related to such coverage. Appropriated funds remaining at year end shall not revert to the general fund but shall remain with the <span class="dictionary">Commission</span> for defrayal of costs related to this coverage. <a id="paragraph-274440" class="section-permalink" href="https://vacode.org/38.2-3418.21/#G"><i class="fa fa-link"/></a></p></section></text><history>2023, c. 473.</history><metadata></metadata></law>
