Kaiser Permanente Insurance Coverage for Addiction Treatment

Using Kaiser Permanente Insurance Coverage to pay for addiction treatment: There are many drug and alcohol treatment centers that accept Kaiser insurance. Depending on your plan and the treatment provider that you choose will determine what Kaiser Permanente will cover. With so many addiction rehab centers that accept Kaiser Permanente insurance, it is best to know exactly what your coverage will pay before deciding which program to choose for your recovery. Some rehabs we work with are in-network with many providers including Kaiser, which means that your treatment may be fully covered or partially covered depending on your insurance plan. You can also call us to find out if there are any drug rehab centers nearby that take Kaiser Permanente Insurance. Most insurance plans will cover drug and alcohol rehab treatment programs. If you would like to find out more about drug rehab programs near you, give us a call and we can get your insurance verified today. 

1-800-513-5423

What you will learn:

• About Kaiser Permanente insurance
• Does Kaiser Permanente insurance pay for substance abuse and mental health treatment?
• Types of mental health and substance abuse treatment Kaiser Permanente will cover
• Addition types that Kaiser Permanente will cover
• How to use your Kaiser Permanente insurance to pay for rehab
• Does Kaiser Permanente cover out-of-network treatment programs?
• How much will you have to pay in out-of-pocket expenses?
• How to get started

About Kaiser Permanente insurance

Kaiser Permanente Insurance is one of the most recognized healthcare providers in the USA. Their insurance group offers nonprofit health care plans to over 12.7 million people serving California, Colorado, DC, Georgia Hawaii, Maryland, Oregon Virginia, and Washington State, with a network of providers that consists of 23,982 physicians, 68,218 nurses, 75,000 allied health professionals, 39 hospitals, and 622 medical facilities.

Does Kaiser Permanente insurance pay for substance abuse and mental health treatment?

Kaiser Permanente does cover mental health and substance abuse treatment programs, although coverage may vary depending on the plan you have chosen and the area in which you reside. If you have Kaiser Permanente insurance your rehab stay may be partially covered or fully covered depending on your plan. To find out more about your specific coverage you can either call the number on the back of your insurance card or log into your insurance portal and check for yourself.

Kaiser has partnered with many treatment centers all over the nation to help give their policyholders a choice as to where they can receive treatment for substance abuse. If you would like to see if your insurance plan is in network with any of these treatment centers, you can call us 24 hours a day, 7 days a week. Navigating the insurance game can be difficult, let us help you. Our addiction specialists can verify your insurance and help you get immediate enrollment into the rehab of your choice. We abide by the HIPAA laws to ensure that your information is kept private. Your insurance company will never be contacted unless you have decided to enter a rehab center program and use your insurance coverage.

Types of mental health and substance abuse treatment Kaiser Permanente will cover

Kaiser Permanente covers many different types of programs for substance abuse and mental health including residential inpatient treatment programs, outpatient treatment, detox, MAT services, and more.

DETOX: Kaiser Permanente will cover part, or all your detox needs if it is medically necessary. You may need to get a doctor’s approval before being covered just to make sure that it is necessary and medically warranted to ensure your safety. Depending on the level of addiction and physical dependency will determine if they cover the costs of detox.

MEDICATION ASSISTED TREATMENT (MAT):  Suboxone is one of the medications that is used in the treatment of opioid addictions and has been approved by the FDA. Suboxone treatment is covered by Kaiser Permanente insurance as well as other medications like Buprenorphine and Naltrexone. Medication-assisted treatment programs are coupled with therapy and counseling to help deliver a complete program that treats both the mind on body. Insurance companies must cover some or all the costs associated with receiving MAT treatment as part of the opioid epidemic protocols laid out by the federal government. Individual coverage may vary depending on the plan you have chosen, location, and availability of services.

INPATIENT: Kaiser Permanente insurance generally covers inpatient rehab. There are many types of inpatient treatment programs available. Levels of care offered include dual-diagnosis treatment programs, long-term rehab stays, and short-term drug rehab. All of which may be covered by your Kaiser plan. The length of stay you are allowed for drug or alcohol rehabs may vary depending on a few select variables. Your coverage may vary depending on your primary care provider’s recommendation, the type of insurance plan you have, and the substance that is being misused. Often people go to an inpatient treatment program and then follow it up with outpatient counseling and recovery meetings that your insurance plan may also cover.

OUTPATIENT: Outpatient treatment is often one of the first steps that people take to help overcome drug and alcohol misuse. Kaiser, as with most insurance companies will pay for outpatient treatment. Outpatient therapy can be limited to a set number of days in a year you can receive counseling, a set dollar amount for covering substance abuse, and or the insurance plan you have chosen.

Addition types that Kaiser Permanente will cover

Kaiser Permanente will cover other addictive substances including opioids and other prescription medication in misuse. Many treatment centers are in-network with Kaiser Insurance Group and choosing the best program for your specific needs is the most important first step in the recovery process. No two people who enter treatment are the same, which is why there are different approaches used in the treatment of addictions.

Addictions covered by Kaiser Permanente include most types of drugs and alcohol that can be habit-forming including:

• Alcohol
• Heroin
• Fentanyl
• Methamphetamine
• Cocaine
• Marijuana
• Benzodiazepines (Xanax, Valium)

How to use your Kaiser Permanente insurance to pay for rehab

Kaiser Permanente Insurance is a very well-known insurance provider. They have made contracts with facilities that offer drug and alcohol treatment programs to their members to help lower the costs of treatment. When you stay in-network you will have fewer out-of-pocket expenses to come up with. You may need to go see your primary provider for an initial consultation to make sure that you do need an inpatient treatment program for substance or alcohol misuse. You can usually set up a meeting with your primary care provider through a phone call, or via e-mail to get started. Your doctor will then assess your medical needs and may refer you for further treatment or assessment at a facility that specializes in treating addictions. Most drug and alcohol treatment programs will have professionals who specialize in helping you understand the complexities of insurance and what they will and will not cover. If your insurance does not cover the full cost of treatment these professionals will be able to give you suggestions for alternate funding.

Does Kaiser Permanente cover out-of-network treatment programs?

Kaiser insurance may cover the program that you have chosen but there will usually be a larger co-insurance payment, deductible, and or co-payments. Staying in-network is usually the best option for someone to save money on their inpatient rehab program. Out-of-network programs do not have a contract with Kaiser Insurance like in-network programs. In-network providers have negotiated a set price and number of days that insurance through Kaiser will cover. This lowers the out-of-pocket costs and in turn, saves you money.

How much will you have to pay in out-of-pocket expenses?

Coverage amounts for drug and alcohol addictions are dependent on your policy, co-insurance, deductible, and co-payments. Many people have a set deductible for both medical and mental health services. This is a set amount you must pay before your insurance plan will start covering your rehab stay. Once the deductible has been met, insurance will typically cover a set amount, depending on your plan. You might need to pay the remaining amount if you have reached your coverage limits.

• Co-insurance is a percentage of a covered service or procedure that you are responsible for. Example: If you have a "30% co-insurance" policy, it means that, when you have a medical bill, you are responsible for 30% of it. You may have to meet a deductible before you make the co-insurance payment depending on your policy.

• Deductible is the amount of money you must pay before Kaiser will cover any expenses. Example: if you have a $5000 deductible you will have to pay that before they will cover the rest of your rehab stay.

• Copay is a set amount that you will pay for a service or procedure before you have met your deductible. You may have to make copayments even after you have met your deductible depending on your policy.

How to get started

You already have taken the first step which is admitting there is a problem that needs to be addressed. The next step is to verify and confirm your benefits which will help you determine the best place for you to receive treatment based on your coverage and needs. You can contact one of our insurance navigators and see if one of the programs we work with is right for you. 

1-800-513-5423

Sources

About Kaiser Permanente insurance

Mental Health Substance Abuse Coverage

Erik Epp – Content Author