Does Kaiser Permanente Insurance Cover for Drug and Alcohol Rehab?

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If you are considering addiction treatment and have Kaiser Permanente Insurance, this page is designed to help answer some common questions about insurance coverage and drug and alcohol rehab addiction treatment.

Kaiser Permanente is one of the country’s largest non-profit healthcare providers and insures more than 12 million people.1 Kaiser Permanente offers healthcare coverage in specific regions of the country including Hawaii, California, Georgia, Washington, Maryland, Virginia, Washington, D.C., Colorado, and Oregon. Three different types of insurance plans are available to employers/groups, individuals, families, and Medicare recipients.

Does Kaiser Permanente cover drug rehab? Addiction treatment coverage is available under the Kaiser Permanente Health Plan; however, covered services vary based on your insurance plan. It is important to note that the first step in receiving addiction services is to speak to your doctor. Your doctor can verify your symptoms and refer you to a Kaiser Permanente substance abuse facility or another specialized treatment facility.


Kaiser Permanent Coverage Levels and Coverage Plans

Kaiser Permanente mental health coverage is available through a variety of insurance plans, categorized as Gold, Silver, and Bronze plans. Gold plans have the highest monthly costs and the lowest deductible and out-of-pocket costs. Plans are determined by monthly premiums, co-pays, deductibles, and out-of-pocket costs. Kaiser Permanente offers health savings accounts with many of their plans.

Kaiser Permanente offers Medicare coverage for individuals 65 and older that can help supplement basic Medicare plans. Kaiser Permanente offers 2 Medicare plans including the Kaiser Permanente Senior Advantage Basic HMO and the Senior Advantage Enhanced HMO.2 If you have Medicare and require substance abuse services, talk to a Kaiser Permanente insurance representative or your primary care physician for information and a referral to a specialized treatment program suitable to your needs.

Medicaid is a federal- and state-funded health insurance program for individuals and families suffering from financial hardship. Medicaid reimburses the most for mental health care in the United States.3 Medicaid benefits are comprised of mandatory benefits and optional benefits. Mandatory benefits are determined by the federal government and optional benefits are determined by the state you live in. There is a good chance that substance abuse treatment services will be covered, as Medicaid is reimbursing more and more for these services.3 However, the state in which you live can determine if and how much of these services are covered by Medicaid.

Kaiser Permanente offers comprehensive medical facilities that often have doctors, pharmacies, labs, and x-ray services in one location. It is important to choose a plan provider or a provider in the Kaiser Permanente network to reduce out-of-pocket costs as much as possible. You can choose an in-network plan provider and you can change your provider at any time.Kaiser Permanente offers coverage in certain areas only, as noted above. Coverage and services are not available nationwide.

Does Kaiser Permanente Insurance Cover Inpatient Treatment?

Kaiser Permanente therapy coverage is available in 8 states and the District of Columbia. Co-pays, deductibles, and coverage options vary by state. Generally speaking, Kaiser Permanente covers addiction and substance abuse treatment, although it can vary by state and by plan. Substance abuse treatment can include:

  • Medical detoxification.
  • Inpatient residential treatment.
  • Intensive outpatient treatment.
  • Outpatient individual therapy.

Under the Silver HMO Plan in Georgia, medical detoxification and inpatient substance abuse treatment services are covered.5

Does Kaiser Permanente Insurance Cover Outpatient Treatment?

Under the same Silver HMO Plan in Georgia, intensive outpatient therapy, individual and group therapy, and aftercare support visits are covered. 5 It is important to remember that these services are covered when the patient is under the care of a plan provider and when they are prescribed by a plan provider as an essential component of substance abuse treatment.


How to Check My Insurance Benefits?

It has never been easier to verify your coverage. You can call the number on the back of your insurance card and speak to an insurance agent, or you can access your healthcare benefits online through member services. Kaiser Permanente offers specific coverage for federal employees and retirees of the federal government. Some of the benefits of this specific program include cash rewards for making healthy choices as well as free drugs and resources for tobacco cessation.


Does My Health Insurance Plan Cover Drug and Alcohol Addiction Treatment?

Does Kaiser Permanente cover drug treatment? The short answer is yes. The long answer is that your coverage options depend largely on the type of plan you have and where you live. It is important to verify your coverage to see if your addiction treatment is covered under your insurance plan. You can verify your insurance coverage easily here or below.

A common question for people struggling with a substance abuse disorder is does insurance cover drug rehab? Although that may seem like a loaded question, it is easier than you may think to verify your insurance benefits and to see if your insurance provider covers addiction treatment. A first step in the process of receiving substance abuse services is to speak to your primary care doctor. Also, contacting your insurance provider to get clear information on covered services is essential to making healthy and effective decisions in your recovery journey.


Sources

  1. Kaiser Permanente. (2019). Fast facts.
  2. Kaiser Permanente. (2020). Medicare health plans.
  3. Centers for Medicare and Medicaid Services. (n.d.). Behavioral health services.
  4. Kaiser Permanente. (n.d.). Doctors, locations and services.
  5. Kaiser Permanente. (2020). Your 2020 Kaiser Permanente individual and families evidence of coverage.

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