OneCare (HMO D-SNP) Hearing Aid Benefits

H5433-001-0

OneCare (HMO D-SNP)

plan information last updated December 22, 2023

Company: CalOptima Health OneCare
Plan enrollment: 17,720
Total monthly premium: $0
Max annual payment: No Maximum Payment
Plan link on Medicare.gov: Plan on Medicare.gov
Plan website: https://www.caloptima.org/en/ForMembers/OneCare
Plan member phone number: 877-412-2734
Plan prospect phone number: 877-412-2734

OTC Supplemental Benefits (OTC Catalog May Include OTC Hearing Aids)

Supplemental OTC Benefit Amount Per Period: $100.00
Benefit Amount is Every: Every three months
Can The Benefit Rollover Periods? No
Total Annual OTC Supplmental Benefit: $400.00

IMPORTANT NOTE:

Plans may not include hearing aids in their eligible OTC supplemental items. Please call the plan to verify if they include hearing aids in their OTC supplement catalog.

Prescription Hearing Aid Coverage

Does plan cover hearing aids?: Yes
Can benefits be used for OTC Hearing Aids?: No
How many hearing aids does the plan allow? 2 per Every year
What is the max coverage amount? $1,000
Is the benefit per ear or for both ears combined?: Both ears combined
Is the benefit ONLY available in-network? Can be out of network
What time period does the coverage apply to? Every year
Is there a maximum out of pocket cost? No out of pocket maximum
Does the member have to pay Coinsurance? No coinsurance required
Is a CoPay required? No
Is Prior Authorization Needed? Yes
Is Physician Referral Needed? Yes

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