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Code · New Jersey · Title 26 — Minors · Chapter 2J

26:2J-4.32 Health maintenance organization to provide coverage for hearing aids, cochlear implant for enrollee.

235 words·~1 min read·/nj/title-26/chapter-2j/26-2j-4-32·

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9. a. A health maintenance organization contract for health care services that is delivered, issued, executed or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide health care services for medically necessary expenses incurred in the purchase of a hearing aid or cochlear implant for an enrollee, as provided in this section.
b. The health care services shall include the purchase of a hearing aid for each ear, when medically necessary and as prescribed or recommended by a licensed physician or audiologist. A health maintenance organization may limit the health care services provided in this section to one hearing aid for each hearing-impaired ear every 24 months.
c. A health maintenance organization contract shall provide coverage of the cost of treatment related to cochlear implants, including procedures for the implantation of cochlear devices and costs for any parts, attachments, or accessories of the device, including replacement of obsolete external cochlear implant processors.
d. The health care services shall be provided to the same extent as for any other condition under the contract.
e. This section shall apply to those contracts for health care services under which the right to change the schedule of charges for enrollee coverage is reserved.
L.2008, c.126, s.9; amended 2023, c.275, s.8.
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