Hearing Aid Benefits. This benefit will provide reimbursement for hearing aids as follows: The acquisition cost of the hearing aid. The dispensing fees as established by agreement between Green Shield and the participating provider, PROVIDED
Hearing Aid Benefits. The CCBDD shall provide to full time employees a hearing plan subject to the provisions of the Ohio AFSMCE Care plan.
Hearing Aid Benefits. For Covered Dependents age 15 years and younger, Covered Benefits include the cost of a Medically Necessary hearing aid for each ear as prescribed or recommended by a Member’s Participating Physician or Participating audiologist, up to the Hearing Aid Benefit Maximum, subject to any applicable Copayment. Covered Benefits also include Medically Necessary services and supplies related to the hearing aid. Coverage is provided under the same terms and conditions as for any other condition. • Inherited Metabolic Diseases Benefit. Coverage is provided for expenses incurred in the therapeutic treatment of inherited metabolic diseases, including the purchase of medical foods and low protein modified food products, when diagnosed and determined to be Medically Necessary by the Member’s Physician. The benefits shall be provided to the same extent as for any medical condition under the Certificate. • Non-standard formulas. Certain infant formulas are covered when:
Hearing Aid Benefits. Hearing aids and ancillary equipment up to a maximum of $2,000 per Member in any 24-month period. You pay nothing You pay nothing Benefit Member Copayment4 Services by Preferred, Participating, and Other Providers5 Services by Non- Preferred and Non- Participating Providers6 Home Health Care Benefits Home health care agency Services (including home visits by a nurse, home health aide, medical social worker, physical therapist, speech therapist, or occupational therapist) Up to a maximum of 100 visits per Calendar Year per Member by home health care agency providers. If your Plan has a Calendar Year medical Deductible, the number of visits start counting toward the maximum when Services are first provided even if the Calendar Year medical Deductible has not been met. 20% Not covered11 Medical supplies and laboratory Services 20% Not covered11 Home Infusion/Home Injectable Therapy Benefits Hemophilia home infusion Services provided by a hemophilia infu- sion provider and prior authorized by the Plan. 20% Not covered Home infusion/home intravenous injectable therapy provided by a Home Infusion Agency (Home infusion agency visits are not sub- ject to the visit limitation under Home Health Care Benefits.) Note: Home non-intravenous self-administered injectable drugs are covered under the Outpatient Prescription Drug Benefit. 20% Not covered11 Home visits by an infusion nurse Home infusion agency nursing visits are not subject to the Home Health Care Calendar Year visit limitation 20% Not covered11 Hospice Program Benefits Covered Services for Members who have been accepted into an approved Hospice Program. All Hospice Program Benefits must be prior authorized by the Plan and must be received from a Participating Hospice Agency. 24-hour Continuous Home Care 20% Not covered12 General Inpatient care 20% Not covered12 Inpatient Respite Care You pay nothing Not covered12 Pre-hospice consultation You pay nothing Not covered12 Routine home care You pay nothing Not covered12 Benefit Member Copayment4 Services by Preferred, Participating, and Other Providers5 Services by Non- Preferred and Non- Participating Providers6 Hospital Benefits (Facility Services) Inpatient Emergency Facility Services $100 per admission plus 20% $100 per admission plus 20% Inpatient non-Emergency Facility Services Semi-private room and board, and Medically Necessary Services and supplies, including Subacute Care. For bariatric surgery Services for residents of designated counties, see the Baria...
Hearing Aid Benefits. When used in this provision the following words have the following meaning:
Hearing Aid Benefits. Hearing Aid instrument and ancillary equipment (up to a maxi- mum of $2,000 per member every 24 months for the hearing aid and ancillary equipment) You pay nothing You pay nothing Home Health Care Benefits Home health care agency services (Including home visits by a nurse, home health aide, medical so- cial worker, physical therapist, speech therapist or occupational therapist) Up to a maximum of 100 visits per Member, per Calendar Year, by home health care agency providers. If your benefit Plan has a Calendar Year Deductible, the number of visits starts counting toward the maximum when services are first provided even if the Calendar Year Deductible has not been met. 20% Not covered 8 Medical supplies 20% Not covered 8 Home Infusion/Home Injectable Therapy Benefits Hemophilia home infusion services Services provided by hemophilia infusion providers and prior authorized by Blue Shield. Includes blood factor product. 20% Not covered 8
Hearing Aid Benefits. Benefits are provided for a hearing aid instrument, monaural or binaural including ear mold(s), the initial battery, cords and other ancillary equip- ment. The Benefit also includes visits for fitting, counseling and adjustments. The following services and supplies are not cov- ered:
Hearing Aid Benefits. This plan provides for the following benefits to eligible employees, retired employees, surviving spouses (subscribers) and eligible dependents once in any period of 24 calendar months, provided that:
Hearing Aid Benefits. Hearing Aid instrument and ancillary equipment (every 24 months for the hearing aid and ancillary equipment) 50% Home Health Care Benefits4 Home health care agency Services (including home visits by a nurse, home health aide, medical social worker, physical therapist, speech therapist, or occupational therapist) Up to a maximum of 100 visits per Calendar Year per Member by home health care agency providers. $5 per visit Medical supplies and laboratory Services You pay nothing Benefit Member Copayment Home Infusion/Home Injectable Therapy Benefits Hemophilia home infusion Services provided by a Hemophilia Infusion Provider and prior authorized by the Plan. You pay nothing Hemophilia therapy home infusion nursing visit provided by a Hemophilia Infu- sion Provider and prior authorized by the Plan (Nursing visits are not subject to the Home Health Care Calendar Year visit limitation.) $5 per visit
Hearing Aid Benefits. Benefits are available for hearing aids for covered Members age seventeen (17) and under when obtained from a Network Provider or another Provider approved by Us. This Benefit is limited to one hearing aid, per ear, in a thirty-six (36) month period. The hearing aid must be fitted and dispensed by a licensed audiologist, licensed hearing aid specialist or hearing aid dealer following the medical clearance of a Physician and an audiological evaluation medically appropriate to the age of the child. We will pay up to Our Allowable Charge for this Benefit. We may increase Our Allowable Charge if the manufacturer’s cost to the Provider exceeds the Allowable Charge. In no event will We pay more than one thousand four hundred dollars ($1,400.00) per hearing aid, per ear, in a thirty -six (36) month period. If the Member purchases a hearing aid that costs more than one thousand four hundred dollars ($1,400.00), the Member will be responsible for all amounts above one thousand four hundred dollars ($1,400.00). Charges over one thousand four hundred dollars ($1,400.00) are non-Covered charges and do not accrue to the Member's Out-of-Pocket Amount. Eligible implantable bone conduction hearing aids are not subject to the above limitation and provisions. They are covered the same as any other service or supply, subject to any applicable Coinsurance and Deductible Amounts.
