HearUSA manages the annual routine hearing exam and hearing aid benefits provided to patients.
For Braven Health Medicare Advantage PPO plans, HearUSA:
- Is the exclusive INN provider for annual routine hearing exams (CPT® code 92257), fitting/evaluation for a hearing aid (HCPCS code V5010), and hearing aids.
- Is the exclusive provider for hearing aids.
- Processes claims on our behalf for Braven Health Medicare Advantage PPO plans.
Members and providers may call HearUSA at 1-855-825-4706 to verify benefits, find a convenient HearUSA network provider location, and/or schedule services to be provided at a HearUSA network location.
HearUSA is not responsible for managing diagnostic hearing and balance evaluations to determine if a patient needs medical treatment. Braven Health consumer and group members can visit Braven Health network providers (e.g., physician, audiologist or other qualified provider) for these diagnostic exams. Braven Health members can visit OON providers for this service, but will incur higher out-of-pocket costs.
Coverage Details and Claim Submission Details
Members obtain INN services from a HearUSA Center or a network HearUSA provider.
Braven Health Consumer Members
See AlsoContact Us - Horizon NJ HealthThe annual routine hearing exam (CPT code 92257) should be performed by a HearUSA network audiologist.
Consumer members may see audiologists outside of the HearUSA network for the annual routine hearing exam ONLY, but they will incur higher out-of-pocket costs.
Hearing aids and fittings/evaluations for hearing aids are only covered when obtained from a HearUSA network provider (audiologist or hearing aid specialist/dispenser).
Braven Health Group Members
The annual routine hearing exam (CPT code 92257) should be performed by a HearUSA network audiologist.
Group members may see audiologists outside of the HearUSA network for the annual routine hearing exam, a fitting/evaluation for a hearing aid, and hearing aids.
Braven Health group members have a $1,250 allowance toward the purchase of hearing aids from either an INN HearUSA provider OR an OON provider. However, members will get the most out of their benefit by using a HearUSA network provider.
HearUSA Claim Submissions
Submit claims for the annual routine hearing exams (CPT 92257), or fitting/evaluation for a hearing aid (HCPCS V5010), by secure email to HearUSA at networkclaims@hearusa.com or mail to:
- HearUSA Network Claims
PO Box 31927
West Palm Beach, FL 33420
Claims for diagnostic hearing and balance evaluations to determine if a patient needs medical treatment should be submitted to Braven Health.
Braven Health Claim Submissions
Submit claims electronically to Braven Health using Payer ID 84367 or mail to:
- Braven Health
PO Box 820
Newark NJ, 07101-0820
Hearing Aid Benefit Summary For Consumer Members
No reimbursem*nt will be provided for hearing aids obtained outside of the HearUSA network.
Members must have a valid prescription for the hearing aid(s).
Braven Health consumer members pay a flat copay for hearing aids from HearUSA network hearing providers only:
- $299 copay per ear for a Value Technology hearing aid. Ideal for people who lead a quiet lifestyle.
- $599 copay per ear for an Advance Technology hearing aid. Well-suited for moderately active individuals.
- $1199 copay per ear for a Premium technology hearing aid. The best choice for more active and busy individuals.
Hearing aid purchase includes:
- 60-day trial period
- Three-year extended warranty
- First year of follow-up provider visits
- First year supply of batteries for non-rechargeable models
Hearing Aid Benefit Summary for Group Members
Members must be encouraged to call HearUSA to find an INN provider to purchase and repair hearing aids. Although group members are able to obtain hearing aids from INN or OON providers, they get the most out of their benefit by using HearUSA network providers.
Members must have a valid prescription for the hearing aid(s).
Services Never Covered Under the Hearing Benefit
The following services are never covered:
- Hearing aids obtained from OON providers (applies to Braven Health consumer members only.)
- Over-the-counter hearing aids, which are hearing aids obtained without a valid prescription and that do not require an audiologist or hearing aid specialist to fit them to the member's ear(s). This applies to both Braven Health consumer and group members.
The information provided here is not intended to replace or modify the terms, conditions, limitations, and exclusions contained within health, dental or vision benefit plans issued or administered by Horizon BCBSNJ. In the event of a conflict between the information contained in this document and the member's plan documents, the member's plan documents shall control.
Audiology Distribution, LLC, doing business as HearUSA and HearUSA centers are independent from and not affiliated with Braven Health or Horizon Blue Cross Blue Shield of New Jersey. HearUSA administers hearing benefits and provides related products and services through their network of independently practicing audiologists, hearing care professionals and company-owned hearing centers for eligible Braven Health members.
