KelseyCare Advantage Medicare Plan Hearing Aid Benefits
50,275 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 |
| KelseyCare Advantage |
KelseyCare Advantage Platinum (HMO) H0332-009-0 |
HMO | $125 per Quarter | No | $500 | Yes | $1,500 | Yes | No | No | No | No | 18,894 |
| KelseyCare Advantage |
KelseyCare Advantage Gold (HMO) H0332-002-0 |
HMO | $40 per Quarter | No | $160 | Yes | $1,500 | Yes | No | No | No | No | 14,561 |
| KelseyCare Advantage |
KelseyCare Advantage Gold Freedom (HMO-POS) H0332-004-0 |
HMOPOS | $95 per Quarter | No | $380 | Yes | $1,500 | Yes | No | No | No | No | 8,374 |
| KelseyCare Advantage |
KelseyCare Advantage Rx Retiree (HMO) H0332-811-0 |
HMO | No | $0 | No | 5,531 | |||||||
| KelseyCare Advantage |
KelseyCare Advantage Silver (HMO) H0332-001-0 |
HMO | $50 per Quarter | No | $200 | Yes | $1,500 | Yes | No | No | No | No | 1,035 |
| KelseyCare Advantage |
KelseyCare Advantage Silver Freedom (HMO-POS) H0332-003-0 |
HMOPOS | $50 per Quarter | No | $200 | Yes | $1,500 | No | No | No | Yes | No | 642 |
| KelseyCare Advantage |
KelseyCare Advantage Rx Retiree (HMO) H0332-812-0 |
HMO | No | $0 | No | 538 | |||||||
| KelseyCare Advantage |
KelseyCare Advantage Gold Community (HMO-POS) H0332-008-0 |
HMOPOS | $40 per Quarter | No | $160 | Yes | $1,500 | No | No | No | Yes | No | 486 |
| KelseyCare Advantage |
KelseyCare Advantage Rx Retiree (HMO) H0332-810-0 |
HMO | No | $0 | No | 196 | |||||||
| KelseyCare Advantage |
KelseyCare Advantage Silver Community (HMO-POS) H0332-007-0 |
HMOPOS | $25 per Quarter | No | $100 | Yes | $1,500 | No | No | No | Yes | No | 18 |
