Section 23. The commission shall provide to any active or retired employee of the commonwealth who is insured under the commission coverage for expenses incurred in the medically necessary diagnosis and treatment of speech, hearing and language disorders by individuals licensed as speech-language pathologists or audiologists under chapter 112, if such services are rendered within the lawful scope of practice for such speech-language pathologists or audiologists regardless of whether the services are provided in a hospital, clinic or private office; provided, however, that such coverage shall not extend to the diagnosis or treatment of speech, hearing and language disorders in a school-based setting. The coverage provided by this section shall be subject to the same terms and conditions established for any other medical condition covered by the commission.
The commission shall provide to any child, who is 21 years of age or younger, of an active or retired employee of the commonwealth and who is insured under the group insurance commission coverage for the cost of 1 hearing aid per hearing-impaired ear up to $2,000 for each hearing aid, as defined in section 196 of chapter 112, every 36 months upon a written statement from the child's treating physician that the hearing aids are necessary regardless of etiology. Coverage under this section shall include all related services prescribed by a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid evaluation, fitting and adjustments and supplies, including ear molds. The insured may choose a higher priced hearing aid and may pay the difference in cost above the $2,000 limit in this section without any financial or contractual penalty to the insured or to the provider of the hearing aid. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than other benefits provided by the insurer. Nothing in this section shall prohibit the commission from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for such hearing aids under any non-group policy.
Structure Massachusetts General Laws
Part I - Administration of the Government
Title IV - Civil Service, Retirements and Pensions
Section 1 - Purpose of Chapter
Section 3 - Group Insurance Commission
Section 3a - Employees' Advisory Committee
Section 3b - Applicability of Chapter to Commonwealth Charter Schools and Education Collaboratives
Section 4 - Purchase of Insurance Policies by Commission
Section 4a - Administrative Services Contracts
Section 4b - Retroactive Claims Denials for Behavioral Health Services
Section 5 - Insurance and Medicare Benefits of State Employees
Section 7 - Information Furnished Commission by Employees
Section 9 - Dividends, Refunds, Rate Credits; Deposit in Special Funds; Transfer of Reserves
Section 9a - Investment Committee; Investment and Deposit of Funds by State Treasurer
Section 10 - Retirement or Termination of Employment; Effect on Policy; Conversion of Insurance
Section 10a - Additional Insurance
Section 10b - Insurance for Elderly Government Retirees and Their Dependents
Section 10c - Optional Medicare Extension
Section 10d - Disability Insurance; Withholding Payment of Premiums
Section 10e - Insurance for Commonwealth Employee Granted Leave to Care for Dependent Child
Section 11 - Death of Employee or Retired Employee; Continuation of Insurance by Spouse or Dependent
Section 11a - Divorced or Separated Spouses; Continuation of Insurance Coverage
Section 14 - Optional Insurance for Services of Health Care Organizations
Section 16 - Election to Continue Insurance Coverages; Notice
Section 17 - Dental and Vision Expenses; Reimbursement of Employees
Section 17a - Coverage for Nonprescription Enteral Formulas for Home Use
Section 17b - Hospice Services for Commonwealth Employees Insured Under Group Insurance Commission
Section 17c - Required Coverage for Prenatal Care, Childbirth, and Postpartum Care
Section 17d - Coverage for Bone Marrow Transplants
Section 17e - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment
Section 17f - Newborn Hearing Screening Test; Group Insurance Commission Coverage
Section 17h - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
Section 17i - Prosthetic Devices and Repairs; Group Insurance Commission Coverage
Section 17j - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate
Section 17k - Coverage for Orally Administered Anticancer Medications
Section 17l - Coverage for Abuse Deterrent Opioid Drug Products
Section 17m - Preauthorization for Substance Abuse Treatment Not to Be Required
Section 17q - Pain Management Access Plan
Section 18 - Medicare Health Benefits Supplement Plan, Mandatory Transfer; Payment of Penalty
Section 19 - Release From Insurance Coverage; Payment; Reinstatement of Coverage
Section 20 - Charges or Collections of Excess Compensation
Section 21 - Health Care Services Evaluation; Vendor Quality Improvement Program; Annual Report
Section 23 - Coverage for Speech, Hearing and Language Disorders
Section 24 - State Retiree Benefits Trust Fund
Section 24a - State Retiree Benefits Trust Fund Board of Trustees; Membership; Powers and Duties
Section 25 - Insurance Coverage for Diagnosis and Treatment of Autism Spectrum Disorder
Section 28 - Coverage for Certain Services and Contraceptive Methods