Hearing Exam - Community Health Plan of Washington - Medicare Advantage

Hearing Coverage Included on All Plans

Members can see a hearing specialist (audiologist) for exams to diagnose hearing and balance issues. Depending on your plan, you may have a copay or coinsurance, please see specific plan information below.

Hearing aid fittings and hearing aids are not a covered benefit unless Medicare criteria are met.

Hearing Aid Supplement for SNP Members

For MA Dual Plan (HMO SNP) members, we cover one hearing aid at no cost and one routine hearing exam is covered per year. In 2021, SNP members have a maximum benefit of $1,700 every year. Cost sharing is anything over benefit maximum allowed.

To be eligible for hearing aids, SNP members must:

  • Complete a hearing evaluation, including audiogram or appropriate diagnostic exam
  • Receive a recommendation from a licensed audiologist or hearing aid specialist

2021 Hearing Benefits by Plan

MA Plan 1 (HMO)
Routine Hearing Exam: Not covered. Routine hearing exams, hearing aids, and hearing aid fittings are not covered by Medicare.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 20% coinsurance. Must be performed by a physician, audiologist, or other qualified provider in an outpatient setting.

Hearing Services (hearing aid fittings, hearing aids): Not covered

MA Plan 2 (HMO)

Routine Hearing Exam: Not covered. Routine hearing exams, hearing aids, and hearing aid fittings are not covered by Medicare.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 20% coinsurance. Must be performed by a physician, audiologist, or other qualified provider in an outpatient setting.

Hearing Services (hearing aid fittings, hearing aids): Not covered

MA Plan 3 (HMO)

Routine Hearing Exam: Not covered. Routine hearing exams, hearing aids, and hearing aid fittings are not covered by Medicare.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 20% coinsurance. Must be performed by a physician, audiologist, or other qualified provider in an outpatient setting.

Hearing Services (hearing aid fittings, hearing aids): Not covered

MA Plan 4 (HMO)

Routine Hearing Exam: Not covered. Routine hearing exams, hearing aids, and hearing aid fittings are not covered by Medicare.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 20% coinsurance. Must be performed by a physician, audiologist, or other qualified provider in an outpatient setting.

Hearing Services (hearing aid fittings, hearing aids): Not covered

MA No RX Plan (HMO)

Routine Hearing Exam: Not covered. Routine hearing exams, hearing aids, and hearing aid fittings are not covered by Medicare.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 20% coinsurance. Must be performed by a physician, audiologist, or other qualified provider in an outpatient setting.

Hearing Services (hearing aid fittings, hearing aids): Not covered

MA Dual Plan (HMO SNP)
Routine Hearing Exam: 0% of the cost. The hearing exam must be performed by a licensed audiologist, limit one exam per year.

Specialty Hearing Exam to diagnose conditions and diseases such as balance or hearing loss: 0% of the cost.

Hearing Services (hearing aid fittings, hearing aids): 0% of the cost.

Hearing Aids and Hearing Aids Supplies: $1,700 benefit maximum every year. Cost share is anything over benefit maximum

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