How Your Hearing Benefit Works

Know What’s Covered and How to Use Your Benefit

Original Medicare covers hearing and balance exams that your doctor orders to check for a medical problem. Elderplan Advantage for Nursing Home Residents (HMO-POS I-SNP) covers these Medicare-covered hearing exams and gives you a way to pay for over-the-counter (OTC) hearing aids through your monthly OTC benefit.

Your Hearing Coverage at a Glance

This plan does not have a separate hearing aid allowance. Instead:

• Over-the-counter (OTC) hearing aids. You can use your $175 monthly OTC benefit to buy eligible OTC hearing aids and hearing amplifiers from the OTC catalog, up to your available balance. Unused OTC dollars do not carry over.
• Medicare-covered hearing exams. Diagnostic hearing and balance exams that your provider orders are covered at 20% coinsurance, whether you go in-network or out-of-network.

How to Use Your Hearing Coverage

1. For OTC hearing aids: Shop the OTC catalog in your benefits portal at MyBenefitsCenter.com, or at a participating retailer and pay with your OTC card.
2. For a Medicare-covered exam: Use the search tool on the Find a Hearing Specialist page, or choose any Medicare-approved hearing provider. You pay 20% of the cost.

Medicare-Covered Hearing Care

These are services your provider orders to find out whether you need medical treatment — for example, to check dizziness, balance problems, or hearing loss caused by a medical condition.

• What’s covered: Diagnostic hearing and balance exams performed by your physician, audiologist, or other qualified provider.
• Your cost: 20% coinsurance, in-network or out-of-network