Does Kaiser Permanente Insurance Cover Drug or Alcohol Rehab?
Kaiser Permanente Insurance Coverage for Drug and Alcohol Rehab
What is Kaiser Permanente Insurance?
Kaiser Permanente insurance offers healthcare plans to over 12 million members in the states of Colorado, California, Hawaii, Washington, and Oregon, as well as Georgia, Virginia, Maryland, and Washington, D.C.1.2 Kaiser Permanente was founded in 1945, and while it is not in a large number of states, Kaiser is the largest nonprofit healthcare provider in the U.S.2
Does Kaiser Permanente Insurance Cover Substance Abuse Treatment?
If you have Kaiser Permanente insurance coverage and are seeking drug rehab treatment, you may wonder if Kaiser insurance can cover your treatment. Many health plans are required by law to offer some form of substance abuse coverage, and although there are some exceptions, your Kaiser Permanente insurance plan may be required to provide drug rehab coverage.3 If you purchased your Kaiser Permanente insurance through the healthcare exchanges in your state under the Affordable Care Act (ACA), then your plan must provide substance abuse treatment benefits.4 If you are interested in a specific hospital or drug rehab program, the program can verify your benefits and coverage. In addition, you can also call the number on the back of your insurance card for more information about your specific plans and ask questions about coverage for substance abuse treatment.
What Will Kaiser Permanente Insurance Cover?
When you have a Kaiser Permanente health insurance plan, you should be able to call your Kaiser plan to confirm whether you have drug rehab insurance coverage. You may also have questions about the types of substance use treatment that would be covered. The Kaiser Permanente website notes that your drug rehab program may consist of:5
- Inpatient treatment, where you stay 24/7 at a facility or hospital.
- Inpatient residential treatment, which is generally longer, and may last for months.
- Outpatient treatment, which allows you to continue living at home while attending group therapy sessions 1–2 times per week.
Kaiser notes that the type of drug treatment you may receive depends on numerous factors, including:5
- The severity of your substance use disorder.
- Your overall mental health status.
- Your level of family support.
- Your living environment.
- What type of treatment you can afford.
Types of outpatient treatment that may be covered by your Kaiser health insurance plan include:6 (conclusions, 2nd paragraph; description of service, last paragraph)
- Intensive outpatient (IOP), where you attend treatment several times a week, for 2 to 3 hours at a time.
- Partial hospitalization programs (PHPs), which may meet up to 20 hours per week.
Regardless of the type of inpatient or outpatient treatment that is best for you, Kaiser notes that your drug rehab program usually involves the 12-step approach, utilizing the principles of Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), as well as a combination of medical oversight and individual, group, and family therapy.5
Does Kaiser Permanente Insurance Cover Mental Health Care?
If your Kaiser Permanente healthcare plan offers substance use coverage, such as those plans purchased under the ACA, mental health treatment is also covered. If you have a mental health disorder along with a substance use disorder, this is called co-occurring disorders, and both need to be treated. The best approach is to treat co-occurring disorders simultaneously in an integrated model.7(points to remember section)
How Long Does Kaiser Permanente Insurance Cover Rehab?
Each person with a substance use disorder has different needs and there is not one single treatment plan that is right for everyone. However, staying in treatment for an adequate length of time is important, with stays of at least 90 days being an ideal length, according to research.8 (n. 5)
Kaiser notes that inpatient treatment may last from 1 to 6 weeks.5 Many factors affect the length of treatment, and you can get more information about your Kaiser insurance plan and coverage for inpatient treatment by calling the number on the back of your card.
What If My Kaiser Permanente Insurance Policy Does Not Cover Rehab?
If your Kaiser insurance plan does not cover your drug treatment program of choice, you may be able to find other ways to pay for treatment. There may be options through the drug rehab program to finance your treatment by making monthly payments. You can also pay for treatment using a credit card or by arranging for a loan. Some programs do offer treatment scholarships. Regardless of how you pay for treatment, getting treatment sooner than later is better. If you are ready to go to treatment, do not put it off until later.
Kaiser Permanente Insurance In-Network vs. Out-of-Network Rehab Centers
You may have heard the terms in-network providers and out-of-network providers and are unsure how this may apply to which drug treatment programs may be available to you. If a drug treatment program is in-network with Kaiser, then the facility has contracted with Kaiser and provides treatment at a set price, which is usually discounted from the standard price. If a drug treatment program is out of network with Kaiser insurance, you will usually have to pay a higher rate to receive care at that facility. You can check with Kaiser by calling the number on the back of your insurance card to see what drug rehab programs are in-network or out of network for your plan.
Kaiser Permanente Rehab Centers
American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Blue Cross Blue Shield insurance plan, the following AAC facility accepts Kaiser Insurance for drug and alcohol addiction rehab.
- Laguna Treatment Hospital: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Kaiser insurance.
How to verify Kaiser Permanente Insurance Coverage for Rehab?
Frequently Asked Questions
Since mental health is one of the essential health benefits, all major health insurance providers, including Kaiser, provide coverage and treatment for mental health issues. To determine the right kind of treatment program for each patient an evaluation must be conducted first. This type of assessment will provide both your primary care physician and addiction specialists with a comprehensive picture of your psychological and emotional state, as well as cognitive functioning.16This type of evaluation can be conducted by a psychiatrist, psychologist, or social worker. The specialist will ask you some questions and examine you so that they can form a full picture of your mood, behavior, thinking, and memory. This type of assessment might even include some lab tests.16
- Kaiser Permanente. (2021). Find doctors and locations.
- Kaiser Permanente. Who we are.
- gov. The mental health parity and addiction equity act (MHPAEA).
- gov. What marketplace health insurance plans cover.
- Kaiser Permanente. (2021). Inpatient and outpatient treatment for substance abuse disorder.
- McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance abuse intensive outpatient programs: assessing the evidence. Psychiatric Services, 65(6), 718-726.
- National Institute on Drug Abuse. (2018). Substance use disorders and other mental illnesses: Drugfacts.
- National Institute on Drug Abuse. (2018). Principles of effective treatment.
- Kaiser Permanente. (2022). 10 Most-Asked Questions.
- Kaiser Permanente. (2022). Glossary.
- Kaiser Permanente. (2022). Find Doctors and Locations.
- Vrecko S. (2015). Everyday Drug Diversions: A Qualitative Study of the Illicit Exchange and Non-Medical Use of Prescription Stimulants on a University Campus. Social science & medicine (1982), 131, 297–304.
- Kaiser Permanente. (2022). Utilization Management Process March 2022.
- U.S. Department of Health & Human Services. (2022). About the Affordable Care Act.
- Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
- Kaiser Permanente. (2022). Mental Health Assessment.
- Insurance Provider Name
- Policy Member's Full Name
- Policy Membership/Subscriber ID