Hearing Aid Coverage

In July 2021, Penn added a hearing aid benefit to all our medical plans. (For retirees, this benefit went into effect in January 2022). The benefit provides up to $4,000 per participant to be covered as medically necessary, but not more than every three years. This benefit applies to enrolled faculty, staff, retirees and their dependents, including children.

How To Access the Benefit

If You Have PennCare/Personal Choice, Keystone HMO, or IBC Medigap Premium and Standard Plans

Faculty and staff enrolled in one of these plans can be reimbursed for hearing aid costs by submitting claims directly to Independence Blue Cross (IBC). IBC will reimburse members directly up to the $4000 maximum once the paid claim is processed. 

Penn Medicine Hearing Aid Program:

Participants enrolled in Penncare, Keystone HMO and IBC Medigap plans who obtain their hearing aid from Penn Medicine’s Hearing Aid Program will only be billed the amount in excess of the $4000 benefit at the time of service.

You will still need to submit a claim form to Independence Blue Cross or Highmark to have your plan accumulators (out of pocket max) updated accordingly. Penn Audiology will not submit these claims on your behalf.

How to submit your claim if you use a Penn Medicine provider:

PennCare/Personal Choice or Keystone HMO

Penncare and Keystone HMO participants should use the IBC claim form. Be sure to attach the receipt you will receive from Penn Audiology to the claim and remit directly to IBC.

IBC Medigap Premium and Standard Plans

IBC Medigap Premium and Standard plan participants should use the Highmark claim form. Be sure to attach the receipt you will receive from Penn Audiology to the claim and remit directly to Highmark.

How to submit your claim if you use a provider other than Penn Medicine:

PennCare/Personal Choice or Keystone HMO

Members enrolled in PennCare and Keystone HMO, use the IBC claim form to request your reimbursement. Full, upfront payments are required to the provider at this time because there are no participating in-network hearing aid providers for these IBC-affiliated plans. You must complete and sign the form and attached an itemized receipt that includes the procedure codes and diagnosis.

IBC Medigap Premium and Standard Plans

Members enrolled in Retiree Medigap coverage, use the Highmark claim form to request your reimbursement. Full, upfront payments are required to the provider at this time because there are no participating in-network hearing aid providers for these IBC-affiliated plans. You must complete and sign the form and attach an itemized receipt that includes the procedure codes and diagnosis. 

If You Have an Aetna Plan

Aetna in-network providers can be found on Aetna Navigator or by contacting the Benefit Solution Center at 866-799-2329.

For Aetna High Deductible Health Plan and POS II Standard(ACA) participants:

The deductible must first be met before hearing aid coverage applies. Aetna High Deductible with HSA participants pay 10% once the deductible is met. POS II Standard participants (part-time and ACA eligible staff) pay 30% after meeting the deductible.

For Penn Aetna Choice POS II participants:

If you use an Aetna participating provider, you will only be responsible for your co-insurance( the amount in excess of $4000) payment and your provider will submit the claim to Aetna.

If you choose a non-participating provider, you will need to pay the full cost of your hearing aid upfront and submit your claims directly to Aetna for reimbursement. Please log into Aetna Navigator or contact Aetna member services to obtain the out of network claim form. 

For question or assistance with accessing the benefit, contact the Benefit Solution Center at 866-799-2329.