updates

summary-of-benefits-paragraphs.txt

@@ -84,70 +84,30 @@ For Diagnostic tests and procedures there is a $0 to $100 copay .
 For Outpatient X-rays there is a $0 to $75 copay .
 For Radiation therapy, there is a  $15 copay or 20% of the cost .
 
-Here is information about Hearing benefits.
-Medicare-covered hearing exam: $15 copay 
-Routine hearing: 
-In-Network: 
-HER963 
-• $0 copay for routine hearing exams up to 1 per year. 
-• $0 copay for each Advanced level hearing aid up to 1 per ear every 3 
-years. 
-• $299 copay for each Premium level hearing aid up to 1 per ear every 
-3 years. 
-Hearing aid purchase includes the following.
-• Unlimited follow-up provider visits during first year following 
-TruHearing hearing aid purchase 
-• 60-day trial period 
-• 3-year extended warranty 
-• 80 batteries per aid for non-rechargeable models 
-You must see a TruHearing provider to use this benefit. Call 
-1-844-255-7144 to schedule an appointment (for TTY, dial 711). 
-
-Dental Medicare-covered dental services: $15 copay 
-Routine dental: 
-The cost-share indicated below is what you pay for the covered service. 
-In-Network: 
-DEN046 
-• $0 copay for scaling and root planing (deep cleaning) up to 1 per 
-quadrant every 3 years. 
-• $0 copay for comprehensive oral evaluation or periodontal exam, 
-occlusal adjustment, scaling for moderate inflammation up to 1 
-every 3 years. 
-• $0 copay for bridges, complete dentures, crown recementation, 
-denture recementation, panoramic film or diagnostic x-rays, partial 
-dentures up to 1 every 5 years. 
-• $0 copay for crown, root canal, root canal retreatment up to 1 per 
-tooth per lifetime. 
-• $0 copay for bitewing x-rays, intraoral x-rays up to 1 set(s) per year. 
-You do not need a referral to receive covered services from plan providers. Certain procedures, services and drugs 
-may need advance approval from your plan. This is called a "prior authorization" or "preauthorization." Please 
-contact your PCP or refer to the Evidence of Coverage (EOC) for services that require a prior authorization from the 
-plan . c
-• $0 copay for adjustments to dentures, denture rebase, denture 
-reline, denture repair, emergency diagnostic exam, tissue 
+Here is information about outpatient Hearing benefits.
+Medicare-covered hearing exam there is a $15 copay .
+Routine hearing that is In-Network, called HER963, there is a $0 copay for routine hearing exams up to 1 per year. 
+There is a $0 copay for each Advanced level hearing aid up to 1 per ear every 3 years. 
+There is a $299 copay for each Premium level hearing aid up to 1 per ear every 3 years. 
+A hearing aid purchase includes unlimited follow-up provider visits during first year following a TruHearing hearing aid purchase . The hearing aid purchase has a  60-day trial period and a 3-year extended warranty and  80 batteries per aid for non-rechargeable models .  You must see a TruHearing provider to use this benefit. Call 1-844-255-7144 to schedule an appointment (for TTY, dial 711). 
+
+Medicare-covered dental services have a  $15 copay .
+For a routine dental service, the cost-share indicated below is what you pay for the covered service. 
+For In-Network, DEN046 , there is a $0 copay for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years. 
+There is a $0 copay for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years. 
+There is a $0 copay for bridges, complete dentures, crown recementation, denture recementation, panoramic film or diagnostic x-rays, partial dentures up to 1 every 5 years. 
+There is a $0 copay for crown, root canal, root canal retreatment up to 1 per tooth per lifetime. 
+There is a $0 copay for bitewing x-rays, intraoral x-rays up to 1 set(s) per year. 
+There is a $0 copay for adjustments to dentures, denture rebase, denture reline, denture repair, emergency diagnostic exam, tissue 
 conditioning up to 1 per year. 
-• $0 copay for emergency treatment for pain, fluoride treatment, oral 
-surgery, periodic oral exam, prophylaxis (cleaning) up to 2 per year. 
-• $0 copay for periodontal maintenance up to 4 per year. 
-• $0 copay for amalgam and/or composite filling, necessary 
-anesthesia with covered service, simple or surgical extraction up to 
-unlimited per year. 
-• $3000 maximum benefit coverage amount per year for preventive 
-and comprehensive benefits. 
-Dental services are subject to our standard claims review procedures 
-which could include dental history to approve coverage. Dental benefits 
-under this plan may not cover all American Dental Association 
-procedure codes. Information regarding each plan is available at 
-Humana.com/sb . Network dentists have agreed to provide services at contracted fees 
-(the in-network fee schedules, of INFS). If a member visits a 
-participating network dentist, the member will not receive a bill for 
-charges more than the negotiated fee schedule on covered services 
-(coinsurance payment still applies). 
-Use the HumanaDental Medicare network for the Mandatory 
-Supplemental Dental. The provider locator can be found at 
-Humana.com > Find a Doctor > from the Search Type drop down select 
-Dental > under Coverage Type select All Dental Networks > enter zip 
-code > from the network drop down select HumanaDental Medicare. 
+There is a $0 copay for emergency treatment for pain, fluoride treatment, oral surgery, periodic oral exam, prophylaxis (cleaning) up to 2 per year. 
+There is a $0 copay for periodontal maintenance up to 4 per year. 
+There is a $0 copay for amalgam and/or composite filling, necessary anesthesia with covered service, simple or surgical extraction up to unlimited per year. 
+There is a $3000 maximum benefit coverage amount per year for preventive and comprehensive benefits. 
+Dental services are subject to our standard claims review procedures which could include dental history to approve coverage. Dental benefits under this plan may not cover all American Dental Association procedure codes. Information regarding each plan is available at Humana.com/sb . 
+Network dentists have agreed to provide services at contracted fees (the in-network fee schedules, of INFS). If a member visits a participating network dentist, the member will not receive a bill for charges more than the negotiated fee schedule on covered services (coinsurance payment still applies). 
+Use the HumanaDental Medicare network for the Mandatory Supplemental Dental. The provider locator can be found at 
+Humana.com > Find a Doctor > from the Search Type drop down select Dental > under Coverage Type select All Dental Networks > enter zip code > from the network drop down select HumanaDental Medicare. 
 
 Vision • Medicare-covered vision services: $15 copay 
 • Medicare-covered diabetic eye exam: $0 copay