Page 83 - Appendices for Eric Hartman
P. 83
HEARING
Hearing exam In-network: $0 copay Limits apply
Out-of-network: 30%
coinsurance
Fitting/evaluation In-network: $0 copay Limits apply
Out-of-network: 30%
coinsurance
Hearing aids - Inner ear Not covered
Hearing aids - Outer ear Not covered
Hearing aids - Over the ear Not covered
PREVENTIVE DENTAL
Care to prevent or nd problems with your teeth and gums.
Oral exam Not covered
Cleaning Not covered
Fluoride treatment Not covered
Dental x-rays Not covered
