Page 60 - Appendices for Eric Hartman
P. 60

HEARING





       Hearing exam                           $0 copay                               Limits apply






       Fitting/evaluation                     $0 copay                               Limits apply







       Hearing aids - all types               $450-750 copay                         Limits apply





   PREVENTIVE DENTAL

   Care to prevent or  nd problems with your teeth and gums.





       Oral exam                              $0 copay                               Limits apply







       Cleaning                               $0 copay                               Limits apply





       Fluoride treatment                     Not covered





       Dental x-rays                          $0 copay                               Limits apply
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