2011 Oregon Revised Statutes
ORS Volume 16, Chapters 705 - 752
ORS Chapter 743a
743A.141 Hearing aids.

(1) As used in this section, hearing aid means any nondisposable, wearable instrument or device designed to aid or compensate for impaired human hearing and any necessary ear mold, part, attachments or accessory for the instrument or device, except batteries and cords.

(2) A health benefit plan, as defined in ORS 743.730, shall provide payment, coverage or reimbursement for one hearing aid per hearing impaired ear if:

(a) Prescribed, fitted and dispensed by a licensed audiologist with the approval of a licensed physician; and

(b) Necessary for the treatment of hearing loss in an enrollee in the plan who is:

(A) 18 years of age or younger; or

(B) 19 to 25 years of age and enrolled in a secondary school or an accredited educational institution.

(3)(a) The maximum benefit amount required by this section is $4,000 every 48 months, but a health benefit plan may offer a benefit that is more favorable to the enrollee. The benefit amount shall be adjusted on January 1 of each year to reflect the increase since January 1, 2010, in the U.S. City Average Consumer Price Index for All Urban Consumers for medical care as published by the Bureau of Labor Statistics of the United States Department of Labor.

(b) A health benefit plan may not impose any financial or contractual penalty upon an audiologist if an enrollee elects to purchase a hearing aid priced higher than the benefit amount by paying the difference between the benefit amount and the price of the hearing aid.

(4) A health benefit plan may subject the payment, coverage or reimbursement required under this section to provisions of the plan that apply to other durable medical equipment benefits covered by the plan, including but not limited to provisions relating to deductibles, coinsurance and prior authorization.

(5) This section is exempt from ORS 743A.001. [2009 c.553 2; 2011 c.500 42a]