Maximum $1,700 Benefit For Each Ear
Beginning this July, the GIC’s Medicare and non-Medicare/active plans, with the exception of Tufts Medicare Preferred (Medicare Advantage or MA) plan, have simplified their hearing aid benefit design. Also, all GIC plans are now offering a maximum $1,700 benefit for each ear every 2 years.
Before July 1, the “traditional” benefit design was relatively more complicated. Every 2 years, it paid the first $500 and then 80% of the next $1,500 for both ears. For example, if you spent a total of $2,000 for the replacement and/or repair of your hearing aids ($1,250 for one and another $750 for the other), then you would be entitled to $1,700 – the first $500 plus 80% of the next $1,500 or $1,200. After the maximum benefit was paid, you would be responsible for the balance, in the case of our example, $300.
Now it’s been simplified to a flat maximum benefit of $1,700 per ear without the need to calculate any percentage that will be covered by insurance. This simplified benefit design has been adopted across-the-board, again except for Tuft’s Medicare Preferred that still provides its coverage, using the traditional benefit design (first $500 plus 80% of the next $1,500).
And more importantly, while some plans had been providing a benefit for each ear, all GIC plans, including the GIC’s 4 Medicare Supplement and Medicare Advantage plans, are offering a maximum benefit of $1,700 for each ear, not just both ears, every 2 years. As Association Insurance Coordinator Cheryl Stillman sees it, “The new benefit design among all the plans, except one, provides a high degree of consistency that is more user friendly. Members won’t have to shop around among the GIC plans to find the best insurance deal for their hearing aids.”
Applying the new benefit to the example above, the $1,250 for one ear would be paid in full, as well as the $750 for the other. You would not be responsible for any balance.
Stillman continues, “This is a very substantial benefit for our members enrolled in the GIC. Instead of being capped at $1,700 for both ears, you are now covered up to $3,400 – $1,700 on each. Those with hearing loss in both ears will realize a significant drop in their out-of-pocket costs.”