This tool provides research information only and does not guarantee eligibility, coverage, or reimbursement. Benefit details vary by plan year, member status, and administrator rules. Always verify current benefits directly with your insurer or plan administrator before making purchasing decisions.
Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs)
2026 ACA Marketplace plan · OH
According to 2026 Centers for Medicare & Medicaid Services (CMS) public filings, this Silver HMO plan from Anthem Blue Cross and Blue Shield includes hearing aid coverage with 30% after deductible / Tier 2: Not Applicable. This plan is available in Ohio.
This information is derived from publicly available CMS data and may not reflect individual plan variations, rider modifications, or mid-year changes. Always verify benefits directly with the plan or its administrator.
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Hearing Aids
Covered
Metal Level
Silver
In-Network Cost
30% after deductible / Tier 2: Not Applicable
Out-of-Network Cost
100.00%
Quantity Limit
No limit reported
Source
CMS public filing
What this likely means
Based on the 2026 CMS public filing, this HMO plan from Anthem Blue Cross and Blue Shield includes hearing aid coverage as part of its Silver tier benefits. In-network hearing aid costs are subject to 30% after deductible / Tier 2: Not Applicable. Out-of-network costs are subject to 100.00%. The filing notes: "Cochlear implants are covered as durable medical equipment (DME). The benefit is Hearing Aids are limited to Members age 21 or younger."
- •Confirm whether hearing aids require a referral or prior authorization
- •Ask whether your hearing aid provider is in-network for this plan
- •Ask about any quantity or frequency limits on hearing aids
- •Request an estimate of your out-of-pocket cost after deductible
- •Verify whether hearing aid costs count toward your annual deductible and out-of-pocket maximum
This interpretation is based on publicly available CMS filing data and may not reflect individual eligibility, rider modifications, or mid-year changes. Always verify benefits directly with the plan administrator.
See the full plan report
Includes plan administrator details, network requirements, prior authorization rules, cost worked examples, and direct contact numbers.
Questions to ask before ordering hearing aids
For audiologists and clinics
See which plans route hearing benefits through a third-party payer — before the appointment.
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