Kaiser Permanente Insurance Coverage for Eating Disorders

Last updated on November 4th, 2019

binge-eating-disorder(Please note: Rehabs.com strives to provide you with the most updated information on each carriers’ addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by Kaiser Permanente.)

Kaiser Permanente covers eating disorders through its mental health treatment options. Eating disorders have a variety of causes and will vary from person to person. This makes the disorder especially difficult to treat. It impacts people of all ages and all sizes and results in unhealthy dieting methods that can become life threatening, if not treated. The most common types of eating disorders include:

Professional treatment is often required in order to help the person learn healthy eating habits and deal with the emotional issues that are causing the illness. Dieting methods can include restricting calories to a dangerously low level, purging after eating meals and other unsafe dieting practices. The consequences can include organ failure and bone weakness in addition to other illnesses caused by poor nutrition and a weakened immune system.

Does Kaiser Permanente Insurance Cover Treatment for Eating Disorders?

Kaiser Permanente does cover treatment for eating disorders. The treatment coverage will depend on the state the individual lives as well as the policy they hold. Treatment begins with an appointment with a medical doctor or a mental health provider. Kaiser also offers a mental health unit that can assist with finding appropriate services. Classes are available in the areas of depression, anxiety, insomnia and more. These services are all provided in order to help individuals gain access to solutions on how to deal with these emotional disorders. As these root disorders often trigger eating disorders. Understanding the other mental health issues can often provide insights that will help the individual with the actual eating disorder.

Type of Rehabs Kaiser Permanente Will Pay For

Kaiser Permanente offers different treatment options for eating disorders depending on the severity of the disorder and the coverage in the individual policy. Eating disorders have both a medical element and a physiological element to them, requiring unique treatment requirements. Working with both a medical or primary care doctor and a psychologist or physiatrist as a team is the most effective form of treatment. The eating disorder can cause many health issues and can become life threatening if the disorder goes untreated for an extended period of time. The root cause of the eating disorder is psychological and therefore counseling is necessary to help the patient deal with the mental issues that are creating the disorder.

How Much of The Cost of Rehab is covered by Kaiser Permanente?

Kaiser Permanente covers rehab and treatment which is determined by the policy of the individual and what treatment programs are being sought. It is necessary to look at both the medical coverage as well as the mental health coverage to determine the treatment options that are covered under the policy. Many patients start with the primary care physician and then get a referral for mental health counseling. When these two forces work together the best results are achieved. For most cases medication and counseling (both group and individual) provide the solution. For extreme cases, either outpatient or inpatient care may be required. Kaiser covers inpatient care similar to the coverage of a hospital stay.

Can I Pay Above What My Insurance Will Provide to Receive Treatment?

Policies offer different coverage amounts. When the patient selects coverage they choose the amount of coverage that will be provided. Rarely will all of the treatment costs be covered by insurance. Expenses that must be paid by the individual can include deductibles and co-pays. These amounts will be similar to those incurred on a standard doctor’s visit or hospital stay. Prescription medications will also be covered as other medical prescriptions are covered. Other costs that may be applicable for inpatient care will include maximum per occurrence and/or maximum per day limits on the insurance policy. For all doctors and counselors choosing a provider that is within the Kaiser network will offer the highest level of coverage. Choosing a service provider outside the network will limit the insurance payment and increase the out of pocket expenses.

Inpatient Eating Disorder Treatment vs. Outpatient Therapy

“Professional treatment is often required in order to help the person learn healthy eating habits and deal with the emotional issues that are causing the illness.”Eating disorders center on control, or the lack of control. This can be a very strong emotion where the patient feels they cannot control things in their lives so they control their food intake. This desire or need to control food can be so powerful that it requires inpatient treatment in order to monitor the nutritional intake of the patient. Outpatient programs provide services that are similar to the inpatient programs without 24 hour monitoring. The patient is able to remain in their home during treatment enabling them to fulfill work and home obligations. The individual can arrange for counseling sessions and doctor appointments that work around their daily obligations.

Should I Choose a Residential Rehab Program?

Residential rehab programs are only needed in extreme cases of eating disorders. Most can be treated with counseling, group therapy and medical intervention. This can result in medications, nutrition education side by side with therapy. For those who are not finding success with these traditional treatments residential program are available. Residential programs will monitor all food intake and provide intense therapy treatments to help the patient learn to cope with the anxiety, depression or other mental disorder in a way that does not include food deprivation.

Will Kaiser Permanente Pay for Local Rehab and Out-of-State treatment?

While each policy is different and coverage is determined by the policy, a few guidelines will help determine what coverage is available. Insurance companies create payment agreements with a certain set of doctors and treatment facilities. These channels will provide the highest level of treatment and payment from the insurance company. They are identified as in-network providers. For those seeking out of network providers (which are often out of state) the coverage may be significantly less than if using in-network providers. Many insurance companies offer coverage regionally or nationally and therefore it is possible to have an in-network provider, that is out of state. Checking the policy details is the only way to determine.

Does Kaiser Permanente Pay for Private or Luxury Treatment?

Kaiser Permanente covers private and luxury treatment for inpatient care in some policies. Each policy and state will determine the coverage that is available to the patient. Some policies will list the types of rooms that are covered at what level. Often if semi-private is covered, the patient can pay the difference for a private room. Some policies have a per day maximum that may or may not provide for the cost of a private room. Luxury treatments are generally in the form of special activities like spa treatments and access to gourmet meals. Such treatments can create a relaxing environment that facilitates faster healing and recovery for the patient.

What Does Executive Treatment Offer Over Other Rehabs?

Executive treatments are available to those who need treatment but have job or life demands that cannot be put on hold. Patients are provided the use of computers, phones and other equipment on a limited basis. They are still required to complete all of the elements of treatment but can choose to use free time for meeting family or work obligations, while still getting the help they need.

What Treatment Lengths Will Kaiser Permanente Pay For?

The length of treatment that is covered by the policy will depend on the specific policy that is held. Other factors that determine coverage include the facility and program being sought and the doctor’s recommendations. For facility treatment to be covered the patient must receive a Doctor’s referral. The facility will then evaluate the patient and make a recommendation for a specific program and program length. This can be anywhere from 10 days and 6 months. Treatment options can include inpatient stays, outpatient treatment, medication, counseling and a combination of the above.

What If I Have No Insurance?

insurance-and-addictionIf no insurance is available there are a number of support groups that can help at no cost to the individual. There are 12 step programs that include overeater’s anonymous, anorexics and bulimics anonymous and eating disorders anonymous. These are offered in most large cities. Other resources include doctors that offer financial assistance, payment plans and or pro bono treatment services. There are counseling services offered by most county and cities that charge on a sliding scale based on the patient’s ability to pay.

Using Our Helpline to Determine Kaiser Permanente Rehab Options

Many patients with eating disorders are embarrassed by the illness and do not want to address the issue. As with many mental illnesses the problem goes undiagnosed too long. If there is someone suffering from an eating disorder getting help right away will help put them on the road to recovery and reduce or end their emotional suffering. Call us at 1-888-716-9806 today to understand your options and learn where to get help.

Questions and Answers

Will Kaiser Permanente Cover Rehab Stays?

Coverage will depend on the individual’s policy and the state of residence.

Does Insurance Pay for Aftercare?

Follow up care after inpatient treatment is treated as a medical need and generally covered by most polices. This might include continued group or individual therapy or medication. These will all be covered based on the terms of the insurance policy.

Could Rehab Make My Insurance Premiums Higher?

Not usually. There are many factors that determine the cost of a policy. While usage is one factor it is usage for a large group or even a regional area, rather than an individual’s usage.

Has The Affordable Care Act (Obamacare) Affected Opiates/Opioids Addiction Coverage?

The Affordable Care Act has impacted mental health treatment and expanded coverage in many policies. It is now treatment at similar levels as medical coverage is treated.

Does your insurance cover addiction treatment?

Use our free and confidential online insurance checker to see if your insurance covers treatment at an American Addiction Center facility.

See if you’re covered