Kaiser's Hearing Aid Coverage Varies by Plan and State

Kaiser Permanente covers hearing aids, but the amount and the way they cover them depends on which Kaiser plan you have and which state you live in. Some Kaiser plans include hearing aid coverage as part of their standard benefits. Others offer it as an add-on you can purchase. A few Kaiser plans cover hearing tests but not the devices themselves. You need to check your specific plan documents or call Kaiser directly to know what you have.

Kaiser does not use a single national hearing aid benefit. Regional Kaiser organizations (Northern California, Southern California, Colorado, Georgia, Hawaii, and others) set their own coverage rules. Even within the same state, different plan types — HMO, PPO, Medicare Advantage — may cover hearing aids differently. The only way to know for certain is to look at your plan's summary of benefits or call the member services number on your Kaiser card.

Key Takeaways

  • Kaiser hearing aid coverage depends on your specific plan and region, so you must check your plan documents or call member services to learn what you have.
  • Some Kaiser plans cover hearing aids as a standard benefit, others offer it as a paid add-on, and some cover only the hearing test, not the device.
  • If your Kaiser plan does cover hearing aids, you typically work with Kaiser's audiology department or an in-network provider they direct you to.
  • Medicare Advantage plans through Kaiser may have different hearing aid benefits than commercial Kaiser plans, and coverage amounts often include a dollar limit per ear or per year.

How to Find Out What Your Plan Covers

Start by looking at your Kaiser plan's summary of benefits and coverage document. This is usually available on your Kaiser member portal or you can request it by phone. Search for the words "hearing" or "audiology" in the document. You are looking for whether hearing aids are listed as a covered service, whether there is a copay or coinsurance amount, and whether there is a dollar limit on what Kaiser will pay.

If you cannot find the answer in your plan documents, call the member services number on your Kaiser card. Tell them you want to know whether your plan covers hearing aids, whether you need a referral to see an audiologist, and whether there are any out-of-pocket costs. Write down the name of the person you spoke with and the date, in case you need to reference the conversation later.

Coverage Limits and Out-of-Pocket Costs

Kaiser plans that do cover hearing aids often place a dollar limit on the benefit. This might be stated as a set amount per ear (for example, $1,500 per ear every two or three years) or as a total annual amount. If the hearing aids you need cost more than the limit, you pay the difference out of pocket. Some plans also require you to pay a copay at the time of the visit or a percentage of the cost (coinsurance).

A few Kaiser plans cover hearing aids with no dollar limit, but this is less common. Plans that do not cover hearing aids at all may still cover the hearing test itself, so you can find out whether you need them before deciding whether to purchase them elsewhere. Ask Kaiser specifically whether your plan covers the audiologist visit, the hearing test, the hearing aids themselves, or some combination of these.

Working with Kaiser's Audiology Department

If your Kaiser plan covers hearing aids, you usually start by requesting a referral to Kaiser's audiology department or an audiologist Kaiser has contracted with. In some regions, you can schedule directly with audiology without a referral. Call your Kaiser member services line or use your member portal to find out how to book an appointment in your area.

At your first visit, the audiologist will perform a hearing test to determine whether you have hearing loss and what type. If hearing aids are recommended, the audiologist will discuss which models Kaiser covers under your plan and what your out-of-pocket cost will be. Kaiser typically stocks a range of hearing aid styles and brands, though the selection may be smaller than what you would find at an independent hearing aid retailer.

Medicare Advantage Plans Through Kaiser

If you are on a Kaiser Medicare Advantage plan, hearing aid coverage is often included, but the benefit structure differs from commercial plans. Many Kaiser Medicare Advantage plans cover hearing aids with a specific dollar amount per ear per year or per benefit period. Some plans cover one pair of hearing aids every two or three years. Others cover bilateral hearing aids (one for each ear) as a single benefit.

Medicare Advantage plans are required to cover routine hearing tests, but hearing aid coverage is optional and varies by plan. Check your Kaiser Medicare Advantage plan's annual notice of coverage or call 1-800-464-4000 (Kaiser's national Medicare line) to confirm what your plan covers. If you are turning 65 and considering a Kaiser Medicare Advantage plan partly for hearing aid coverage, compare the hearing aid benefit across the plans available to you before you enroll.

What to Do If Your Plan Does Not Cover Hearing Aids

If your Kaiser plan does not cover hearing aids, you have several options. You can purchase hearing aids directly from an independent hearing aid retailer, an online hearing aid company, or through a big-box retailer that offers them. Some of these retailers offer payment plans or discounts for cash purchases. You can also ask Kaiser to cover just the hearing test so you have a prescription and audiogram to take to an outside provider.

Some people in this situation look into whether they may have access to for hearing aid programs through their state or local health department, or through nonprofit organizations that distribute hearing aids to people who cannot afford them. These programs have income limits and waiting lists, but they exist in most states. Your Kaiser audiologist or primary care doctor can point you toward these resources if they are available in your area.

Frequently Asked Questions

Do I need a referral from my Kaiser doctor to see an audiologist?

It depends on your Kaiser plan and region. Some plans require a referral, others do not. Call your Kaiser member services number or check your plan documents to find out. If a referral is required, your primary care doctor can provide one, or you can request one through your member portal.

Will Kaiser cover hearing aids if I have tinnitus but normal hearing?

Hearing aids are typically covered only if you have measurable hearing loss. Tinnitus alone, without hearing loss, is usually not a reason Kaiser will cover hearing aids. However, some hearing aids are designed to help with tinnitus symptoms. Discuss this with the Kaiser audiologist during your hearing test.

Can I use my Kaiser hearing aid coverage at a non-Kaiser audiologist?

Most Kaiser plans require you to use Kaiser's audiology department or an in-network provider Kaiser has contracted with. Out-of-network audiologists are usually not covered. Check your plan documents or call member services to confirm whether out-of-network hearing aid services are covered at all, and if so, what percentage Kaiser will pay.

How often does Kaiser cover new hearing aids?

This varies by plan. Some plans cover a new pair every two years, others every three years, and some have no set replacement schedule. Your plan documents or member services can tell you the replacement schedule for your specific coverage. If you need new hearing aids before the covered replacement date, you would pay out of pocket.

Does Kaiser cover hearing aid batteries or repairs?

Most Kaiser plans that cover hearing aids also cover batteries and repairs while the hearing aids are under warranty. After the warranty expires, you may have to pay for repairs and batteries out of pocket, though some plans offer extended coverage for a fee. Ask the Kaiser audiologist about what is covered after the initial warranty period ends.