Blue Shield of California Medicare Plan Hearing Aid Benefits

143,394 Total Members

OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? Enrollees
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-015-0 		HMO No $0 Yes No No Yes No No 25,619
Blue Shield of California Blue Shield Inspire (HMO)
H0504-043-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 17,922
Blue Shield of California Blue Shield TotalDual Plan (HMO D-SNP)
H5928-005-0 		HMO $210 per Quarter No $840 Yes $2,000 No No No No No 17,714
Blue Shield of California Blue Shield Medicare (PPO)
H4937-801-0 		Local PPO No $0 No 16,040
Blue Shield of California Blue Shield AdvantageOptimum Plan (HMO)
H5928-004-0 		HMO $90 per Quarter No $360 No 9,544
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-039-0 		HMO $70 per Quarter No $280 Yes No No Yes No No 8,133
Blue Shield of California Blue Shield 65 Plus Plan 2 (HMO)
H0504-021-0 		HMO No $0 No 6,084
Blue Shield of California Blue Shield Inspire (HMO)
H0504-047-0 		HMO $65 per Quarter No $260 No 5,567
Blue Shield of California Blue Shield AdvantageOptimum Plan 1 (HMO)
H5928-010-0 		HMO $65 per Quarter No $260 No 5,508
Blue Shield of California Blue Shield 65 Plus Choice Plan (HMO)
H0504-040-0 		HMO $90 per Quarter No $360 Yes No No Yes No No 5,020
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-028-0 		HMO $80 per Quarter No $320 Yes No No Yes No No 4,622
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-029-0 		HMO $100 per Quarter No $400 No 2,709
Blue Shield of California Blue Shield Enhanced (HMO)
H0504-049-0 		HMO No $0 Yes No No Yes No No 2,665
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-038-0 		HMO $85 per Quarter No $340 No 2,658
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-017-0 		HMO No $0 No 2,208
Blue Shield of California Blue Shield Inspire (HMO)
H0504-037-0 		HMO No $0 No 2,129
Blue Shield of California CCPOA Medical Plan Medicare (PPO)
H4937-805-0 		Local PPO No $0 No 2,026
Blue Shield of California Blue Shield Inspire (HMO)
H0504-041-0 		HMO $70 per Quarter No $280 Yes No No Yes No No 1,707
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-026-0 		HMO No $0 No 1,304
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-803-0 		HMO No $0 No 1,279
Blue Shield of California Blue Shield Inspire (HMO D-SNP)
H5928-054-0 		HMO $200 per Quarter No $800 Yes $2,000 No No No No No 966
Blue Shield of California Blue Shield Select (PPO)
H4937-002-0 		Local PPO $40 per Quarter No $160 Yes $1,000 No No No No No 764
Blue Shield of California Blue Shield Medicare (PPO)
H4937-802-0 		Local PPO No $0 No 308
Blue Shield of California Blue Shield 65 Plus (HMO)
H0504-804-0 		HMO No $0 No 292
Blue Shield of California Blue Shield Select (PPO)
H4937-001-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No No No No 262
Blue Shield of California Blue Shield TotalDual Plan (HMO D-SNP)
H5928-055-0 		HMO $200 per Quarter No $800 Yes $2,000 No No No No No 237
Blue Shield of California Blue Shield Balance (HMO)
H0504-048-0 		HMO $45 per Month No $540 No 107

Plan Claims Contact Information

Organization Name: Blue Shield Of California
Contact Name: Derek Halley
Title: Senior Manager, Medicare Operations
Phone: 1-818-228-6374
Email: Derek.Halley@blueshieldca.com
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