Mailing or Faxing an Application:
- Complete and sign the Policy Holder Information on the application you received. Click here to print a copy.
- Bring your hearing instruments to your practitioner for an inspection. Your practitioner will then complete the Hearing Instrument Information section.
- Send the completed application and your annual Protection Plus payment to ESCO within thirty days of your practitioner’s inspection.
Note: Your practitioners signature is not required if you are submitting this application within 60 days of receiving your replacement hearing instruments.
- Once processing is complete, confirmation of coverage will be sent to you within seven business days.