Hearing Aid Benefit
CarePlus will reimburse up to $4,000 toward the purchase of hearing aid(s) for routine hearing loss during a rolling 36-month period beginning on the first date of purchase. This benefit is available only if the following conditions are met:
- You have exhausted your base medical program benefits for hearing aids or benefits for hearing aids under other group health coverage you are enrolled in; or,
- If you have no base medical program benefits or coverage under another group health program to exhaust, then the hearing aid must be determined by an audiologist to be medically necessary.
This benefit is limited to the cost of the hearing aid. This benefit does not cover any of the following:
- Office Visits with an Audiologist
- Diagnostic or Routine Hearing Exams
- Hearing Aid Repairs
- Replacement Batteries
- Hearing Aids Provided for Cosmetic Purposes
Determining Benefit Amounts
As this benefit is only paid as a supplemental reimbursement, the CarePlus participant must first purchase the hearing aid and then request reimbursement from their health coverage providing benefits for basic medical expenses. This requirement applies whether the participant has hearing aid benefits under any other medical coverage or not. The explanation of benefits or its equivalent they receive regarding your base medical coverage must be included in the claim submitted to CarePlus. Prior approval is not required for the hearing aid benefit, but all required documentation must be submitted in order to avoid a delay. If the participant does not have other medical coverage from any source, they may still receive reimbursement under this benefit.