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2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 5. Benefits

Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals

Hearing Services (Testing, Treatment, and Supplies)
 
Note: For Standard Option, we state whether or not the calendar year deductible applies for each benefit listed in this Section. There is no calendar year deductible under Basic Option.

Benefit Description

Hearing Services (Testing, Treatment, and Supplies)

 
  • Hearing tests related to illness or injury
     
  • Testing and examinations for prescribing hearing aids

Note: For our coverage of hearing aids and related services, see page 57.


Standard Option - You Pay
Preferred: 15% of the Plan allowance (deductible applies)

Participating: 35% of the Plan allowance (deductible applies)

Non-participating: 35% of the Plan allowance (deductible applies), plus any difference between our allowance and the billed amount

Basic Option - You Pay
Preferred primary care provider or other healthcare professional: $30 copayment per visit

Preferred specialist: $40 copayment per visit

Note: You pay 30% of the Plan allowance for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 152 for more information about “agents.”)

Participating/Non-participating: You pay all charges
 
Benefit Description

Not covered:

 
  • Routine hearing tests (except as indicated on page 45)
     
  • Hearing aids (except as described on page 57)


Standard Option - You Pay
All charges

Basic Option - You Pay
All charges