*In order to receive hearing benefits, you must be enrolled in an active health plan.

The hearing benefit is a maximum of $1,250 per ear (maximum of $2,500 for 2 ears) every 36 months.

The following hearing aid services are covered when provided by a physician or when prescribed by a physician and provided by an audiologist or hearing aid dealer/fitter. 

Benefit Coverage
Hearing aid evaluation tests (to determine the type and make of hearing aid to best correct a hearing problem). The following hearing aid services are covered at 100% of the plan allowance, whichever is less, up to $1,250 per ear per 36– month period.

Highmark Blue Shield payments are made directly to
Participating Providers. For services of Non- Participating
Providers, Highmark Blue Shield makes payment on the
Same basis, directly to the member. 

Purchase of the following types of hearing aids:

  • In the ear
  • Behind the ear, including air and bone conduction types
  • On the body
  • Eyeglass type hearing aids, which are covered and payable in the same manner as behind the ear hearing aids
Necessary repairs and maintenance when provided after the expiration of the warranty.
Limitations
  • Payment for a hearing aid is limited to one hearing aid in any 36- month period.
  • A maximum amount of $1,250 per ear can be allowed per 36 – month period for hearing aid evaluation tests, hearing aid purchase and necessary repairs for maintenance.
  • The hearing aid evaluation test and/or hearing aid must be provided within six (6) months of an audiometric examination.
  • Doctor office visit, ear examinations, and audiometric examinations are not covered under this plan.
  • Benefits after Termination: Hearing aids ordered when coverage is in effect and delivered within 90 days after termination date.
  • Replacement of lost or stolen hearing aids is not covered.

*This exhibit provides general information. Detailed information about benefits and eligibility are contained in the benefit plan documents.