Network
20% coinsurance after deductible
Non-Network
40% coinsurance after deductible
Network
20% coinsurance after deductible
Non-Network
40% coinsurance after deductible
Network
Primary Care:
$25 copayment
Specialist:
$40 copayment
Medicare: 20% coinsurance after deductiblwe
Non-Network
40% coinsurance after deductible
One hearing test per year. Additional hearing tests are covered if recommended by provider.
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