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  Kaiser Permanente

email: reimburse@cochlear.org




Kaiser Permanente is the largest health maintenance organization (HMO) in the nation with over 11, 300 physicians and 8.1 million members, most of whon are enrolled through their employer.

It is made up of separate plans operating in nine States and the District of Columbia. While these plans offer similar coverage policies, each plan does vary somewhat from the other.

Enrollment under each plan is as follows: California 6,132,515; Colorado 371,752; Georgia 272,633; Hawaii 220,261; Mid-Atlantic 545,064; Northwest 449,633 (Group Health Cooperative 584,366); Ohio 170,830.

We are not aware of any Kaiser Permanente plans that do not cover cochlear implants for both adults and children. The Northern California plan reports about 12 cochlear implant claims per year, which is very large annual number for any single health plan.

Kaiser Permanente plans generally reimburse all but 20 percent of what the plans determines is an allowable charge (usually much less than the total cost.) Patients are only responsible for the 20 percent coinsurance, as the providers have agreed to write off the remaining difference as a condition of their contract with Kaiser Permanente.

For an example of the cochlear implant policy under Kaiser Permanente for the Mid-Atlantic region, click here.