This is why it is important to always look at the patient's benefit manual to see what benefits the patient is allowed.

I looked at mine with my new employer and it limits cerumen removal to one procedure every 90 days as well. This is a BCBS HMO plan.

Some plans exclude it entirely.

Times are a changin with HMOs and PPOs offering less and less benefits, making patients and employers pay more for premiums and out of pocket expenses and paying doctors as little as possible.

I will be talking about the patient benefit manual at this year's National.