General Coverage for Hearing Testing:
Hearing testing coverage with Blue Cross NC depends on the specific plan you’re enrolled in.
- Routine Hearing Exams:
- For Medicare Advantage plans (e.g., Blue Medicare HMO or PPO), Blue Cross NC typically covers an annual routine hearing exam at no additional cost when performed by an in-network provider. This is an added benefit beyond Original Medicare, which does not cover routine hearing tests unless they’re medically necessary (e.g., tied to a specific illness or injury).
- For commercial plans (non-Medicare), routine hearing tests are not always covered unless specified in your plan. Many standard HMO and PPO plans exclude preventive hearing screenings unless they’re part of a wellness visit or tied to a diagnosed condition. You’d need to check your plan’s Summary of Benefits and Coverage (SBC) for details.
- Medicare Supplement plans (e.g., Blue Medicare Supplement Plan G or N) follow Original Medicare rules, meaning routine hearing exams aren’t covered unless medically necessary. However, Blue Cross NC offers an optional Dental Vision Hearing Package for some supplement plans, which may include a hearing exam with a coinsurance payment (typically 50%) through the TruHearing network.
- Diagnostic Hearing Tests:
- Across all plan types, Blue Cross NC generally covers diagnostic hearing tests (e.g., audiometry to diagnose hearing loss) if ordered by a doctor and deemed medically necessary. This applies to both commercial and Medicare plans, though copays, coinsurance, or deductibles may apply depending on your plan and whether you use an in-network provider.
Partnerships and Programs:
- TruHearing Partnership: Blue Cross NC collaborates with TruHearing, a hearing care provider network, to offer hearing-related services at reduced costs. For members of qualifying plans (especially Medicare Advantage or those with the Dental Vision Hearing Package):
- You can schedule a comprehensive hearing exam through TruHearing at one of their 4,800+ locations nationwide, including in North Carolina.
- The exam is often free or low-cost (e.g., $0 copay for Medicare Advantage members with hearing benefits), including a year of follow-up visits with a TruHearing provider.
- To book, call TruHearing at 1-866-201-9212 (TTY: 711), Monday–Friday, 8 a.m.–8 p.m. ET. You’ll need your Blue Cross NC ID card to confirm eligibility.
Beltone Option: Blue Cross NC also partners with Beltone, another hearing aid provider, offering free hearing screenings for members at local Beltone offices. This is typically part of a discount program (e.g., via Blue365) and is not a covered benefit, so it’s free but doesn’t include follow-up care unless you purchase a hearing aid.
Process for Hearing Testing:
1. Check Your Plan: Log into Blue Connect, review your plan documents to confirm if routine or diagnostic hearing tests are covered and what your out-of-pocket costs might be.
2. Find a Provider: Use the Blue Connect portal or call Blue Cross NC customer service (e.g., 1-888-351-8283 for commercial plans or 1-888-310-4110 for Medicare Advantage) to locate an in-network audiologist or hearing specialist. For TruHearing or Beltone, contact them directly with your member ID.
3. Schedule the Test: Call the number above for TruHearing, and call 1-888-418-6763 for Beltone. Bring your Blue Cross NC ID card to the appointment.
4. What to Expect: A typical hearing exam includes:
- An audiogram to measure hearing thresholds.
- Speech recognition tests to assess clarity.
- A consultation to discuss results and potential hearing aid options if needed.
Costs and Limitations:
- In-Network vs. Out-of-Network: Coverage is the fullest with in-network providers. Out-of-network tests may not be covered or may incur higher costs, especially for commercial plans.
Frequency: Medicare Advantage plans often limit routine exams to once per year. Commercial plans may not cover them at all unless they are diagnostic.
- Age Considerations: Some plans (e.g., Blue Cross NC’s Federal Employee Program) offer specific hearing benefits for children under 22, including testing, but adult coverage varies widely.
Additional Context:
- Blue FlexCard Tie-In: If you’re on a Medicare Advantage plan with a Blue FlexCard, you might use the card’s allowance to offset costs for hearing-related services (like copays for testing or hearing aids), depending on your plan’s rules.
- Blue365 Discounts: Even if your plan doesn’t cover testing, Blue Cross NC’s Blue365 program offers free screenings through Beltone and discounted exams via TruHearing as a member perk.
How to Confirm:
Since coverage specifics depend on your plan (e.g., Blue Value, Blue Advantage, or a Medicare option), the best step is to:
- Log into Blue Connect and search “hearing testing” under your benefits.
- Call Blue Cross NC customer service with your member ID handy.
- Ask about TruHearing or Beltone eligibility if you’re interested in their services.