Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO) Hearing Aid Benefits

H5262-001-0

Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

plan information last updated December 22, 2023

Company: Quartz Medicare Advantage
Plan enrollment: 5,008
Total monthly premium: $119
Max annual payment: No Maximum Payment
Plan link on Medicare.gov: Plan on Medicare.gov
Plan website: quartzbenefits.com/medicareadvantage
Plan member phone number: 800-394-5566
Plan prospect phone number: 800-394-5566

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

Supplemental OTC Benefit Amount Per Period: $25.00
Benefit Amount is Every: Every three months
Can The Benefit Rollover Periods? No
Total Annual OTC Supplmental Benefit: $100.00

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?: Yes
How many hearing aids does the plan allow? 2 per Every year
What is the max coverage amount? $1,500
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 two years
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? No
Is Physician Referral Needed? No

See If Your Hearing Loss Qualifies For No-Cost Hearing Aids

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