PacificSource Medicare MyCare Choice 30 (HMO-POS)
plan information last updated December 22, 2023
Company: PacificSource Medicare
Plan enrollment: 105
Total monthly premium: $0
Max annual payment: $8,950
Plan link on Medicare.gov: Plan on Medicare.gov
Plan website: www.Medicare.PacificSource.com
Plan member phone number: 888-863-3637
Plan prospect phone number: 888-863-3637
OTC Supplemental Benefits (OTC Catalog May Include OTC Hearing Aids)
Supplemental OTC Benefit Amount Per Period: $200.00
Benefit Amount is Every: Every three months
Can The Benefit Rollover Periods? No
Total Annual OTC Supplmental Benefit: $800.00
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?
No maximum
Is the benefit ONLY available in-network? Can be out of network
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? Yes
Minimum CoPay: $599
Maximum CoPay: $999
Is Prior Authorization Needed? No
Is Physician Referral Needed? No
See If Your Hearing Loss Qualifies For No-Cost Hearing Aids
We recommend taking MDHearing's free online hearing test. The test takes 5 minutes, and includes a no-cost telemedicine consultation with a licensed hearing professional from MDHearing
Take Free Online Hearing Screening Test