Section 8Y. Any contract between a subscriber and the corporation under an individual or group hospital service plan that provides hospital expense and surgical expense insurance, delivered, issued or renewed by agreement between the insurer and the policyholder, within or without the commonwealth, shall provide benefits for residents of the commonwealth and all group members having a principal place of employment within the commonwealth for the 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 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 benefits provided by this section shall be subject to the same terms and conditions established for any other medical condition covered by such individual or group hospital service plan.
[(f)] Any contracts, except contracts providing supplemental coverage to Medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed in the commonwealth shall provide as benefits to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for such person's children 21 years of age or younger, who are insured under such contracts or plans, for the cost of 1 hearing aid per hearing impaired ear up to $2,000 for each hearing aid, as defined under 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 any other benefits provided by the insurer. Nothing in this section shall prohibit a corporation 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
Chapter 176a - Non-Profit Hospital Service Corporations
Section 1a - Right to Become Subscriber; Open Enrollment Periods
Section 1b - Medicare Supplemental Group Coverage; Medical Assistance Recipients
Section 1c - Retroactive Premium Rate Increase
Section 1d - Contracts of Reinsurance
Section 2 - Incorporators; Directors; Certificate of Organization; Commissioner's Examination Report
Section 3 - Certificate of Compliance; Examination by Commissioner
Section 3a - Discrimination Against Abuse Victims in Terms of Hospital Service Plans
Section 3b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information
Section 4 - Accounting System; Accountant, Claim Manager, Underwriter and Actuary
Section 5 - Joint Administration With Certain Corporations
Section 6 - Approval of Nongroup Contracts
Section 7 - Information Gathering Authority of Commissioner; Confidentiality and Privilege
Section 8 - Conditions to Issuance or Delivery of Contract
Section 81/2 - Sale of Group Non-Profit Hospital Service Contracts
Section 8a3/4 - Retroactive Claims Denials for Behavioral Health Services
Section 8b - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion in Contracts
Section 8c - Refusal to Contract With Blind or Deaf Persons; Prohibition
Section 8d - Limited Extension of Benefits
Section 8e - Diethylstilbestrol Exposure; Discrimination
Section 8f - Divorced or Separated Spouses; Continuation of Eligibility for Benefits
Section 8g - Cardiac Rehabilitation Expense Benefits
Section 8h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care
Section 8i - Home Care Benefits
Section 8k - Infertility Diagnosis and Treatment Benefits
Section 8l - Nonprescription Enteral Formulas for Home Use
Section 8m - Standardized Claim Form
Section 8n - Off-Label Drug Use; Cancer
Section 8o - Hospital Service Plan Benefits for Bone Marrow Transplants
Section 8p - Items Medically Necessary for Diagnosis and Treatment of Diabetes
Section 8q - HIV/AIDS Treatment; Off-Label Prescription Drug Coverage
Section 8r - Coverage of Hospice Services for Terminally Ill Patients
Section 8s - Nurse Anesthetist and Nurse Practitioner Services
Section 8t - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment
Section 8u - Emergency Services Provided to Insureds for Emergency Medical Conditions
Section 8v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
Section 8x - Coverage for Patient Care Services Under Qualified Clinical Trials
Section 8y - Diagnosis and Treatment of Speech, Hearing and Language Disorders
Section 8aa - Coverage of Prosthetic Devices and Repairs
Section 8bb - Coverage for Eligible Dependents Under 26 Years of Age
Section 8cc - Coverage for Medically Necessary Hypodermic Syringes or Needles
Section 8dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder
Section 8ee - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate
Section 8ff - Coverage for Orally Administered Anticancer Medications
Section 8gg - Coverage for Abuse Deterrent Opioid Drug Products
Section 8hh - Preauthorization for Substance Abuse Treatment Not to Be Required
Section 8ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services
Section 8jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease
Section 8mm - Pain Management Access Plans
Section 8nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products
Section 8pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs
Section 8qq - Coverage for Prescription Eye Drops
Section 10 - Group Hospital Service Plan; Approval or Disapproval of Contracts and Rates; Filing
Section 10a - Preferred Provider Arrangements
Section 12 - Publication of Assets and Liabilities
Section 13 - Hospitalization and Medical Service for Officers and Employees of Corporation
Section 14 - Misrepresentation of Terms of Subscriber's Contract
Section 14b - Disclosure of Information; Mental or Nervous Conditions; Exceptions
Section 15 - Costs of Solicitation of Subscribers and Administration
Section 17 - Submission of Disputes and Controversies
Section 18a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset
Section 20 - Filing of Amendment of By-Laws
Section 21 - Submission of Advertising Matter to Commissioner
Section 22 - Filing of Riders, Endorsements and Applications With Commissioner
Section 24 - Special Contingent Reserve Fund
Section 25 - Licensing of Agents
Section 26 - Salaries, Compensation or Emoluments Paid by Corporation
Section 27 - Payroll Deductions for Governmental Employees
Section 28 - Violations; Penalties
Section 31 - Contracts for Administrative or Other Services; Loans and Investments
Section 32 - Payment of Sums Owed to Subscriber's Estate
Section 33 - Insolvency of Health Maintenance Organization; Replacement Coverage
Section 34 - Report of Individuals Provided With Creditable Coverage
Section 36 - Attribution of Members to a Primary Care Provider