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Mailing or Faxing an Application:

  1. Complete and sign the Policy Holder Information on the application you received. Click here to print a copy.
  2. Bring your hearing instruments to your practitioner for an inspection. Your practitioner will then complete the Hearing Instrument Information section.
  3. Send the completed application and your annual Protection Plus payment to ESCO within thirty days of your practitioner’s inspection.
  4. Once processing is complete, confirmation of coverage will be sent to you within seven business days.

Note: Your practitioners signature is not required if you are submitting this application within 60 days of receiving your replacement hearing instruments.