How Your Hearing Benefit Works

Know What’s Covered and How to Use Your Benefit

Original Medicare does not cover hearing aids. Your Elderplan Plus Long-Term Care plan includes hearing care as a supplemental benefit through TruHearing, helping you access hearing exams, hearing aids, and other covered hearing services.

Senior Woman being fitted with a hearing aid

Covered: Medicare-covered diagnostic hearing and balance evaluations
Your cost: $0 copay
A diagnostic hearing exam helps determine whether hearing aids or other treatment may benefit you.

Covered: Hearing aids, all types — up to $2,000 for both ears combined, every year
Fitting and evaluation: $0 copay — once every year
Your cost: $0 copay up to the $2,000 limit. Prior authorization is required — your physician or specialist must authorize the hearing aid before it is covered.

Important Reminders About Your Hearing Benefit

Your $400 Flex Benefit can help cover costs above the plan limit. If your hearing aids cost more than $2,000, your annual Flex Benefit allowance can be used toward out-of-pocket costs.
$2,000 combined limit for hearing aids. This covers both ears. If your hearing aids cost more than $2,000, you are responsible for the difference. Your Flex Benefit can help cover these costs.
Annual limit applies. Your hearing aids, fitting and evaluation are each covered once every year (rather than every three years as in some other Elderplan plans).
Prior authorization is required for hearing aids. Always get prior authorization before ordering hearing aids. Authorization must come from a physician or specialist. Hearing aids dispensed without authorization may not be covered.
Always use your Elderplan Member ID card— not your red, white, and blue Medicare card — at all hearing appointments.
Hearing aid batteries may be covered through Medicaid rather than this plan. Contact your local Medicaid office or Member Services for more information.

Prior Authorization for Hearing Aids

Prior authorization is required before your hearing aid will be covered. If you receive a hearing aid without prior authorization, it may not be covered.

Do not order your hearing aid before getting authorization. Prior authorization must be obtained from Elderplan before your hearing aid is dispensed. Ask your physician or hearing specialist to submit the authorization request on your behalf before you proceed with your order.

How the Authorization Process Works

Your provider submits the request. Your physician or hearing specialist contacts Elderplan to request prior authorization for your hearing aid. They will provide clinical information supporting the medical need.
We review and decide. Elderplan reviews the request based on medical necessity criteria and notifies you and your provider of the decision in writing.
Authorization confirmed — proceed with your fitting. Once approved, your provider can proceed with your hearing aid fitting and dispensing. Your fitting and evaluation are covered at a [$0] copay.
If authorization is denied, you have the right to appeal any denial. Your denial notice will include the reason and instructions for filing an appeal. Contact Member Services for help.