Section V: Hearing Aid Benefit

1. Only services prior authorized by Interplan and provided by Sacramento ENT (Ear Nose and Throat) Medical Group will be covered. Your first visit will be with a Sacramento ENT physician. The Plan pays on the same basis as any other prior authorized Interplan specialist visit.
2. After your initial exam with the Sacramento ENT physician, you will be referred to Sacramento ENT’s audiology department for testing and hearing aids when necessary. In some cases, continued medical treatment from a Sacramento ENT provider may be necessary.
3. As with other types of medical care, coverage is not available under this benefit for hearing loss covered by Worker’s Compensation.
4. For hearing aids pre-authorized by Interplan and prescribed by a Sacramento ENT Medical Group provider, the Plan pays 100% of the contract amount, up to a maximum total payment of $2,000 ($1,000 per ear).
5. For adults, the Plan will cover a maximum of one hearing device per ear every three years, if necessary as determined by the Plan. For children, the frequency is one device per ear annually, if necessary as determined by the Plan.
6. An annual hearing aid maintenance check is required. Maintenance checks are covered at 75% of the contract amount, up to $30 per year. If you fail to obtain this annual maintenance check, the Plan will not pay for replacement of hearing aids.
7. The Plan does not cover replacement of hearing aid batteries and parts.
8. Sacramento ENT Medical Group is located at:
   3810 “J” Street
   Sacramento, California 95816
   (916) 736-3399