HB4924 Summary

• Creates new Section 356z.19 of the Illinois Insurance Code requiring group and individual health insurance policies and managed care plans to cover cochlear implant surgery (monaural or binaural) and all internal/external components for children identified by age 18 with hearing impairment.

• Mandates coverage for post-treatment services including programming, troubleshooting, repairs, replacement components (processors, microphones, coils, headsets, cables, batteries), FM systems, auditory training, aural rehabilitation, and speech therapy for eligible children.

• Requires coverage of audiological services and hearing aids for children up to age 18 when prescribed and dispensed by a licensed audiologist, with insurers able to limit benefits to every 38 months per hearing-impaired ear and allow up to 4 additional ear molds per year for children under age 2.

• Mandates all required services be provided by speech-language pathologists, audiologists, or physicians licensed to practice in Illinois.

• Applies to Health Maintenance Organizations and Voluntary Health Services Plans by making Section 356z.19 subject to provisions governing these entities.