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Hearing Aid Benefit

Through Amplifon®, Martin's Point offers hearing aid coverage to keep you connected.

All Generations Advantage plan members have a hearing aid benefit through Amplifon.

This extra benefit provides coverage for hearing aids and batteries, which are not covered by Original Medicare.


Purchase hearing aid(s) through the Martin's Point-Amplifon program and get the following:
  • Annual allowance toward hearing aid devices from leading manufacturers with average savings of 60% off MSRP (see chart below for allowance amounts by plan)
  • Two years of free hearing aid batteries
  • One year of free follow-up care for hearing aid fittings and evaluations
  • A 3-year warranty on hearing devices with a 60-day, risk-free trial period

Plan-specific benefit information and common FAQs about your hearing aid benefit can
be found below. For other questions or information regarding hearing aid benefits or devices, members should contact Amplifon directly at 1-888-669-2167.


NOTE: Hearings aids must be purchased through an Amplifon provider, otherwise there is no coverage.



Benefit Maximums by Plan

The following chart details the maximum hearing aid allowance amounts for each Generations Advantage plan.

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Talk to a health plan specialist 8 am–8 pm, Monday - Friday.

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1-877-547-7053 
(TTY: 711)

Current Members:
1-866-544-7504

Explore More Benefits

2024

PRIME PLAN

VALUE PLUS PLAN

SELECT PLAN

ACCESS PLAN

ALLIANCE PLAN

Hearing Aids

$500 per ear/per year

2 years of free batteries

$500 per ear/per year

2 years of free batteries

$500 per ear/per year

2 years of free batteries

$500 per ear/per year

2 years of free batteries

$700 per ear/per year

2 years of free batteries
Hearing Aid Fittings
(w/ hearing aid)		 $0 copay for 1 year   $0 copay for 1 year   $0 copay for 1 year  $0 copay for 1 year   $0 copay for 1 year  
Hearing Services
(Medicare diagnostic)		 $40/$45 copay* $45 copay $40 copay $35/$40 copay** $5 copay

*PRIME PLAN COPAYS BY COUNTY

  • $40 copay—MAINE: Androscoggin, Cumberland, Kennebec, Sagadahoc, and York Counties;
    NEW HAMPSHIRE: Cheshire, Hillsborough, Merrimack, Rockingham, and Strafford Counties
  • $45 copay—MAINE: Aroostook, Franklin, Hancock, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Somerset, Waldo, and Washington Counties; NEW HAMPSHIRE: Belknap, Carroll, Coos, and Grafton Counties

**ACCESS PLAN COPAYS BY COUNTY

  • $35 copay—NEW HAMPSHIRE: Cheshire, Hillsborough, Merrimack, Rockingham, and Strafford Counties
  • $40 copay—NEW HAMPSHIRE: Belknap, Carroll, Coos, and Grafton Counties

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USING THE HEARING-AID BENEFIT A STEP BY STEP GUIDE

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Step One: Audiology Exam

The member must have an audiology exam within 6 months prior to purchasing hearing aids. The hearing aid benefit and the audiology benefit are two completely separate benefits.

Audiology exams are covered under the standard Medicare benefit. Please see Medicare-covered hearing services for more information.

 

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Step Two: Call Amplifon

Once the member has had their exam and determines that they need hearing aids, they should call Amplifon at 1-888-669-2167.

Amplifon will work with you to find an Amplifon network provider in your area.

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Step Three: Hearing Aid Fitting

Amplifon will help the member schedule an appointment to shop for hearing aids. They will send a referral to the provider that carefully demonstrates what their coverage is. This way, when the member arrives for their appointment, the provider will already know the allowance amount and covered models.

It's important to note that the providers in Amplifon's network for selling hearing aids are not the same as the Martin's Point medical network for providing audiology exams.


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Step Four: Claim Submitted by Amplifon

Claims for hearing aids will be submitted directly by Amplifon to Martin’s Point Generations Advantage. Members will be responsible for balances after their benefit allowance has been credited. Hearing aid costs do not contribute to the members out-of-pocket maximum.


PLEASE NOTE: Hearings aids must be purchased through an Amplifon provider, otherwise there is no coverage.

Hearing Aid Benefit FAQs

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The hearing aids must be purchased through an Amplifon provider, otherwise there is no coverage or reimbursement.
Hearing and audiology exams are a medical benefit that is separate from hearing aids (copays apply). Hearing aid providers typically require an exam within the past 6 months before buying a hearing aid.
You will still need to use an Amplifon provider. After your other health insurance has paid their portion, the provider will bill Martin's Point with the Explanations of Benefits from the primary payer. We will still contribute the same amount as we would have had we been the primary and only payer.

For more information, please see this mission critical statement regarding state legislation for hearing aid coverage.

You can also find information about this legislation here on Maine.gov.