¹The Blue Advantage Choice Medical Deductible does not apply to the following in-network and out-of-network services: Primary Care Physician, Physician Specialist, Inpatient Hospital, Inpatient Psychiatric Hospital, Outpatient Mental Health Specialty and Psychiatric Services, Chronic Pain Management Services, Preventive Dental Allowance, Medicare-covered Preventive Services, Nursing Hotline, Hearing Aids, Annual Routine Hearing Exam, Home Infusion Therapy, Medicare Part B Drugs, Telehealth Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Urgently Needed Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Annual Routine Vision Exam and Eyewear Allowance. For additional information concerning the medical deductible, please refer to the Blue Advantage Choice Evidence of Coverage.

²The Blue Advantage Complete Medical Deductible does not apply to the following in-network services: Primary Care Physician, Physician Specialist, Inpatient Psychiatric Hospital, Outpatient Mental Health Specialty and Psychiatric Services, Chronic Pain Management Services, Preventive and Comprehensive Dental Allowance, Medicare-covered Preventive Services, Nursing Hotline, Hearing Aids, Annual Routine Hearing Exam, Home Infusion Therapy, Medicare Part B Drugs, Telehealth Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Urgently Needed Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Annual Routine Vision Exam and Eyewear Allowance. For additional information concerning the medical deductible, please refer to the Blue Advantage Complete Evidence of Coverage.

³The Blue Advantage Core Medical Deductible does not apply to the following in-network and out-of-network services: Primary Care Physician, Physician Specialist, Inpatient Hospital, Inpatient Psychiatric Hospital, Outpatient Mental Health Specialty and Psychiatric Services, Chronic Pain Management Services, Preventive and Comprehensive Dental Allowance, Medicare-covered Preventive Services, Nursing Hotline, Hearing Aids, Annual Routine Hearing Exam, Home Infusion Therapy, Medicare Part B Drugs, Telehealth Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Urgently Needed Services (Primary Care Physician, Physician Specialist, Outpatient Mental Health and Psychiatric Services), Annual Routine Vision Exam and Eyewear Allowance. For additional information concerning the medical deductible, please refer to the Blue Advantage Core Evidence of Coverage.

**Worldwide Emergency/Urgent Coverage refers to coverage of services outside the United States and its territories. Under this benefit, enrollees may obtain only services that would be classified as emergency and urgently needed services had they been covered in the United States. Members utilizing this benefit may remain enrolled in this plan while temporarily outside the United States or its territories for up to six months. This coverage also includes ambulance services worldwide. The medical deductible and copays will apply for each covered worldwide emergency/urgent service received.

***All content ©2026 TruHearing, Inc. All Rights Reserved. TruHearing® is a registered trademark of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. Savings and retail pricing based on a survey of national average hearing aid prices of equivalent aids compared to TruHearing pricing. Actual savings may vary. Follow-up provider visits included for one year following hearing aid purchase. Free battery offer is not applicable to the purchase of rechargeable hearing aid models. Three-year warranty includes repairs and one-time loss and damage replacement. Hearing aid repairs and replacements are subject to provider and manufacturer fees. For questions regarding fees, contact a TruHearing Hearing Consultant.

****Only Ascensia (Contour) and LifeScan (One-Touch) products are preferred with a $0 copay for up to 204 diabetic test strips for 30 days and glucometers at the pharmacy and through mail-order home delivery.