Kaiser Permanente Insurance Coverage for Gambling

Last updated on November 4th, 2019

  • Does Kaiser Permanente Insurance Cover Treatment for Gambling Addictions?
  • Inpatient Gambling Treatment vs. Outpatient Therapy
  • What If I Have No Insurance?
  • Using Our Helpline to Determine Kaiser Permanente Rehab Options
  • Questions and Answers

gambling chips(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 gambling addictions which is also called compulsive gambling. Problem gambling is disruptive to the gamblers life and their loved ones, yet they cannot control the compulsion to gamble. This is true whether they are winning or losing, happy or sad. Problem gambling impacts the individual both financially and socially. It can destroy relationships and social networks even if they can afford to lose the money. Triggers for gambling can include anxiety, stress, loneliness, fear and depression. These emotional factors can trigger the illness and make the problem worse. Since gambling is a compulsive disorder it is considered a mental health disorder and is covered under that part of the insurance coverage.

Does Kaiser Permanente Insurance Cover Treatment for Gambling Addictions?

Kaiser Permanente does cover treatment for gambling addictions. The treatment coverage will be dependent on the individual policy and the state they live in. Treatment is available in three principle forms. This includes counseling and psychotherapy, medications such as depression medicine or mood stabilizers and group therapy or self-help groups. One of the biggest challenges with the treatment of a gambling addiction is the individual accepting that they have a problem and that it is impacting those they care about. Blaming others is classical behavior for dependency disorders and this creates a challenge when treating a person who does not feel they should have to change.

Type of Rehabs Kaiser Permanente Will Pay For

Kaiser Permanente supports a variety of treatment options through coverage. Treatments available will depend on the severity of the problem and the individual policy and its coverage. Counseling is the first step to getting treatment. From there, the therapist can refer the client to more intense treatment programs which can include either inpatient or outpatient programs. The root cause of a gambling disorder is inability to handle stress or anxiety. Gaining the tools to deal with everyday stresses will create solutions that the gambler can learn to depend on outside of the gambling environment. Abstinence is also required. It is not possible for a compulsive gambler to gamble, “just a little bit.”

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

Kaiser Permanente covers treatment and rehab costs as determined by the policy. There will almost always be out of pocket expenses that must be covered outside of insurance. These start with co-pays for doctors’ appointments and medications. If an inpatient stay is required then deductibles will need to be met before any coverage kicks in. Coverage will be determined by the mental health coverage within the policy.

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

Each policy will list the specific coverage amount offered. It is expected that the individual or family member will pay the difference between what the policy covers and what the total cost of treatment is. Rarely does insurance cover 100 percent of the treatment. The factors to look at include the policy deductible and the co-pays for medication and doctor visits. Then there is also a maximum paid per occurrence and possibly a maximum covered per day limit. These limits will help determine how much out of pocket expenses will be covered.

Inpatient Gambling Treatment vs. Outpatient Therapy

” Problem gambling impacts the individual both financially and socially. It can destroy relationships and social networks even if they can afford to lose the money.”

Gambling treatments are most often treated on an outpatient level. This will include individual therapy and possible group therapy combined with medication. Outpatient programs allow the individual to continue with the demands of life, while still getting treatment. Outpatient programs can be intense and time consuming with the gambler meeting with therapists either daily or several times a week. Inpatient programs are available for those who have a more severe addiction. These include 24 hour monitoring and live in facilities. The inpatient treatment programs have a completely controlled environment where the gambler is not able to gamble. They are also taught skills needed to deal with the strong cravings and triggers and taught how to recognize and overcome these obstacles.

Should I Choose a Residential Rehab Program?

Residential rehab programs are beneficial for severe cases of addiction. Compulsive disorders cannot be overcome by willpower alone. They require help from professionals. There are cases where gamblers have lost their homes, cars and jobs because of the illness. Getting treatment before these major losses occur is the best route. Those who have not found success with medication and counseling should consider inpatient treatments. Residential programs are also used for those with severe disorders who are in denial that the problem is as bad as it really is. Sometimes it takes a residential program to help the patient see they are destroying their life due to compulsive gambling.

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

Each policy will provide coverage based on the terms of the policy and the state the covered person lives. With every policy there are in service and out of network providers. This classification determines the level of coverage offered. Of those providers and treatment programs that are in-network, the coverage will be at the highest payout level. Out of network (and often out of state) programs will be paid at a much lower level. The program must also be approved by the insurance company. It is possible for regional treatment programs to be out of state and still covered at the highest level of in-network providers. The policy will determine how the facility and program is classified. For programs that are not approved there may be no coverage at all so it is important to check the coverage before entering a treatment program.

Does Kaiser Permanente Pay for Private or Luxury Treatment?

Kaiser Permanente covers inpatient private or luxury treatment in some of its policies. The coverage listed in the policy will determine levels of coverage. Often policies will have a per day limit that will determine the amount they will pay. If this results in a private room or extra amenities then they are included. If not then the additional costs must be paid by the policy holder. Some policies will specify the facility or room type that is covered instead of a dollar amount. Luxury treatments can include activities such as spa treatments or golf. They also generally include upgraded meals and other services not found in standard programs. For patients who are struggling to stay in the program luxury treatment options can encourage them to complete the program and fully recover.

What Does Executive Treatment Offer Over Other Rehabs?

Executive treatments programs are options for executives or business people who need to continue with work obligations while still attending an inpatient treatment program. These facilities offer the use of business equipment like computers and phones on a limited basis. The patients are required to complete all elements of the program but can choose to use free time for completing work needs.

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. Factors that determine the level of coverage include the program and its approval with the insurance company. Inpatient treatment programs also must begin with a doctor’s referral and an initial evaluation by the facility. Program lengths can range from:

  • 10 day program
  • 30 day program
  • 60 day program
  • 90 day program

Extended programs are only available if the shorter programs have produced results, but it has been determined that additional time is needed for a complete recovery.

What If I Have No Insurance?

does-insurance-cover-drug-rehabSupport groups and self-help groups like Gamblers Anonymous 12 step program are available to everyone and are of no cost to the addict. There are also gambling hotlines that can be utilized at no cost to the individual. Speaking with the doctor or therapist to set up a payment plan is another option. Government services generally offer limited counseling services on a sliding scale based on the individual’s income. These can provide affordable care and even help with medication costs for those without insurance.

Verify Your Benefits

The cost of alcohol or drug addiction treatment may appear to be an obstacle, but we are here to help. Insurance may cover all or some of your rehab.

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Using Our Helpline to Determine Kaiser Permanente Rehab Options

Many patients with a gambling addiction have a hard time admitting they have a problem. If you or someone you know gambles to the extent that it is impacting their life in a negative way, call and get help today. Without help the problem will only get worse. Call 1-888-716-9806 to learn about the options available for treatment and what coverage your insurance offers.

Questions and Answers

Will Kaiser Permanente Cover Multiple Rehab Stays?

Coverage will depend on where the person lives and their individual policy.

Does Insurance Pay for Aftercare?

After care is an important part of inpatient care. This care is generally covered by most polices and can include ongoing medication and/or counseling treatment. These services are covered based on the policy.

Could Rehab Make My Insurance Premiums Higher?

Not generally. Insurance rates are created through a complicated algorithm that takes many factors into account. It is not like car insurance where the driver’s actions determines the rate. Health insurance considers the total cost of insuring the average person, meaning the individual expenses have little to do with policy rates.

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

The Affordable Care Act has expanded mental health coverage in many policies providing needed treatment for those who find they need services.

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