Hearing Benefit
Braven Health understands that hearing services are important to your overall health and well-being. Below is important information to help you get the most out of your hearing benefits.
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Routine Hearing Exam
- During a routine hearing exam, your audiologist will assess your hearing by playing a series of tones or sounds to identify the softest level you can hear. Your audiologist will also measure your ability to recognize familiar words and repeat them.
- All Braven Health members are eligible for one (1) routine hearing exam per calendar year with $0 copayment when using an in-network audiologist. HearUSA is the exclusive in-network provider for annual routine hearing exams
- You can receive a routine hearing exam from an out-of-network audiologist with a cost share, but you'll get the most out of your benefit by using HearUSA provider. See your Evidence of Coverage for details on how much you'll pay when you see an out-of-network audiologist.
- Members should call HearUSA at 1-855-825-4706, (Monday - Friday: 8 a.m. to 8 p.m., ET) to schedule a visit with an in-network audiologist. You can also download the HearUSA Provider Directory to view in-network providers.
- Your audiologist must submit claims for the annual routine hearing exam (CPT 92557) directly to HearUSA*. Claims for all other hearing exams must be submitted to Braven Health for processing. Your provider can visit the following link for instructions on submitting a claim for the annual routine hearing exam: Audiology/Hearing Aid Benefits for Braven Health℠ Members - Horizon Blue Cross Blue Shield of New Jersey.
- If you receive a routine hearing exam from a provider other than an audiologist (for example, an Ear, Nose and Throat doctor), your provider must submit the claim to Braven Health for processing.
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Fitting/Evaluation for a Hearing Aid
- All Braven Health members are eligible for one (1) fitting/evaluation for a hearing aid per year with a $0 copayment when using an in-network audiologist or licensed hearing aid provider. HearUSA is the exclusive in-network provider for a fitting/evaluation for a hearing aid.
- Members should call HearUSA at 1-855-825-4706 (Monday - Friday 8 a.m. to 8 p.m., ET) to schedule a visit with an in-network audiologist or licensed hearing aid provider. You can also download the HearUSA Provider Directory to view in-network providers.
- Your provider must submit claims for the hearing aid fitting/evaluation (CPT V5010) directly to HearUSA*. Instructions for submitting claims can be found at the following link: Audiology/Hearing Aid Benefits for Braven Health℠ Members - Horizon Blue Cross Blue Shield of New Jersey.
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Hearing Aid Coverage
Value Advanced Premium Hearing Aid Copay
(each ear)$299 $599 $1,199 Lifestyle Ideal for inviduals that lead a quiet lifestyle Well suited for moderately active individuals The best choice for more active and busy individuals - Braven Medicare Choice (PPO) and Braven Medicare Freedom (PPO) members pay a flat copay for hearing aids obtained from a HearUSA Center, a HearUSA network audiologist, or a HearUSA hearing aid specialist/dispenser. The amount you will pay depends on the hearing aid you choose and/or what your audiologist recommends. HearUSA is the exclusive in-network provider for hearing aids. Hearing aids obtained outside of HearUSA network are not covered.
- Members should call HearUSA at 1-855-825-4706 (Monday - Friday 8 a.m. to 8 p.m., ET) to schedule a visit with an in-network provider to obtain hearing aids. You can also download the HearUSA Provider Directory to view in-network providers.
- Braven Health group members have a $1,250 allowance towards the purchase of hearing aids from either an in-network HearUSA provider OR an out-of-network provider. However, you will get the most out of your benefit by using a HearUSA network provider.
- Please note: hearing aids that you purchase without a prescription from an audiologist or a hearing aid specialist – also called “over-the-counter”, or OTC, hearing aids – are not covered under your hearing aid benefit. If your plan includes a quarterly over-the-counter (OTC) allowance benefit, you may use this allowance towards the purchase of OTC hearing aids at participating retailers using your Braven Health Smart Card.