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Does Kaiser Insurance Cover Therapy for Sex Addiction?
(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.)
What Kind of Coverage Does Kaiser Permanente Insurance Offer for Sex Addictions?
If you suffer from a sex addiction or other intimacy disorder, Kaiser Permanente Insurance offers emotional and behavioral health coverage for children, teens, families and adults. For all behavioral health services, coverage is broken down in detail by region on the Kaiser Permanente website, which also links to online support groups. Some covered options for Kaiser Permanente customers include: visitations to approved behavioral health centers (no referral required in most cases), taking educational courses, joining mental or behavioral health groups, inpatient and outpatient addiction treatment programs, Intensive OutPatient treatment (IOP) programs, and medication management. Preauthorization is required for all coverage. It is important to note that not all programs are covered, even if a treatment is described on the Kaiser Permanente website. Refer to your Summary Plan Description for a list of all covered benefits under your health plan.
How Much of the Cost of Rehab is Covered by Kaiser Permanente Insurance?
Coverage costs vary significantly based on the type of sex addiction treatment that is being sought. The average premium for all behavioral and mental health services covered by Kaiser Permanente is between $80 to $100 (information is based on a healthy 28-year old male and gathered from online quote averages). That said, the costs paid for through Kaiser Permanente Insurance coverage for sex addiction rehab may vary depending on who the coverage is for (Individual, Individual and Spouse and Family, Group, etc) and the Plan Type (PPO, HMO, etc).
Can I Pay Above What My Insurance Will Provide to Receive Treatment?
You are allowed to pay above the standard Kaiser Permanente Insurance coverage for sex addiction rehab. There are limitations on Kaiser Permanente Insurance coverage amounts for sex addiction treatment, and some treatments or treatment centers may not be covered at all. While pre-authorization is required for coverage, non-covered providers are an option for those with the financial resources to pay for them. Inpatient Addiction Treatment vs. Outpatient Therapy Sex addiction treatment and rehabilitation programs can be classified into two broad categories: inpatient and outpatient. Both services offer traditional treatments, including 12-step programs, group therapy or counseling sessions, education, medication prescriptions, family therapy, etc. Inpatient treatment centers are essentially short-term residencies; patients will sleep at the facility and receive 24-hour care and supervision. For sex addiction, inpatient services are offered in the form of special clinics. There are many types of outpatient rehabilitation, but usually involve regular visits to a facility or counseling professional. The patient does not stay on-site full time during outpatient therapy, which can be a challenge if there are problems or temptations at home. Since outpatient services do not charge room and board, they are subsequently less expensive on average.
Should I Choose a Residential Rehab Center?
“If you suffer from a sex addiction or other intimacy disorder, Kaiser Permanente Insurance offers emotional and behavioral health coverage for children, teens, families and adults.”
Residential rehab centers are treatment facilities that combine detoxification services, psychological counseling and after-care services. As the name implies, they are a form of inpatient care. Kaiser Permanente recommends residential rehab centers for those who: have tried outpatient treatment but found it ineffective, have additional physical/mental health disorders, have a difficult or stressful home situation, or don’t live near a convenient outpatient sex addiction treatment clinic. Consider the following factors before entering a residential rehab center:
- cost and coverage of the rehab center
- treatment methodologies of the rehab center
- effectiveness of rehab center (this can be difficult, since not all rehab facility organizations publish success rates)
- professional career/family impact of living in residential rehab center
Compulsive sexual disorders can be difficult to diagnose. Only enter into a rehab facility if you or your loved one has a confirmed, diagnosed sexual addiction. The treatments and the costs associated with these facilities are designed for a specific condition and may not be effective for others.
Will Kaiser Permanente Insurance Pay for Local Rehab and Out-of-State Treatment?
Kaiser Permanente Insurance (along with its subsidiaries) provides health coverage that ranges from California to Washington D.C. In addition, there are Kaiser drug rehab centers in every covered state. To find a local rehab center, call their Treatment Solutions (800-890-1956). Emergency Care and Out-of-Area Urgent Care may be covered through your Kaiser plan, although sexual disorders are unlikely to qualify. In general, Kaiser offers very limited out-of-network coverage. The main exception is for those who have an employer-provided PPO health plan.
Does Kaiser Permanente Insurance Pay for Private or Luxury Treatment?
Private and luxury treatment rehabilitation centers may be covered through your Kaiser Permanente health plan. Participating providers may offer private rooms, recreational activity, or luxury resort addiction treatment services.
High-end treatment services come in both inpatient and outpatient clinics
While Kaiser Permanente is not obligated to accept any negotiated terms, if you find a treatment service that you or your loved one would prefer to use that is not covered by your health plan, you can speak to the clinic staff and request that they negotiate coverage terms with Kaiser Permanente.
What Does Executive Treatment Offer Over Other Rehabs?
Executive treatment programs are designed to provide upscale, high-level services and amenities that you may not find at more traditional facilities. Executive centers often target very specific patient demographics; for instance, you might find a treatment center designed for VIP businesswomen or female executives. Common luxury services include private rooms, gourmet meals, swimming pools and spas, conference rooms, horseback riding, and other accommodations. These centers offer the ability to meet with business associates and maintain a comfortable working lifestyle while receiving help. Note, however, that some luxury treatment programs can cost in excess of $25,000 per month.
What Treatment Lengths Will Kaiser Permanente Insurance Pay For?
Typical inpatient treatment program lengths range between one and six weeks for sex addiction, however Kaiser Permanente Insurance coverage treatment ranges from 28 days to 90-plus days. Many facilities will offer different treatment lengths, but not all facilities are covered through your health plan. Be sure to check with your health plan or a Kaiser representative prior to being admitted. Some forms of treatment, such as forms of outpatient therapy, may not have set daily program lengths. Most Kaiser rehab centers or programs are outpatient, and some have treatment options that can run in excess of a full year.
What if I Have No Insurance?
If you or your loved one do not have sufficient (or any) insurance coverage for a sexual disorder – or if your preferred rehab service not offered through Kaiser Permanente — there are other options available. As always, it is recommended to first check with your insurance provider before deciding on a treatment option. Many treatment facilities understand that rehab programs are expense (especially inpatient centers) and offer flexible payment plans. You can also speak with our specialists to identify your coverage options and potential treatment programs.
Determining Your Kaiser Permanente Insurance Rehab Options
Sometimes the best way to determine the appropriate rehabilitation program is to speak with a professional. A representative from your insurance provider can help you or your loved one identify what your options are and help you understand the right choice given your specific situation. If you are looking to make the transition to a healthy lifestyle, call your insurance company right away.
Question and Answers
Will Kaiser Permanente Cover Multiple Rehab Stays?
Depending on pre-authorization, Kaiser Permanente may cover an additional visit. You are likely to be partially covered based on a percentage of days spent in inpatient rehabilitation, although benefits will vary depending on your history with benefits use.
Does Insurance Pay for Aftercare?
Yes. Kaiser Permanente does offer select coverage for aftercare programs, although preauthorization is required and you’d likely need to find an in network provider. Network options, individual coverage and treatment methodologies can all affect coverage.
Could Rehab Make My Insurance Premiums Higher?
Maybe. This is a significant fear among members of all health insurance plans, not just UnitedHealth plans. After a certain number of treatment days, member co-pays are likely to increase. Whether or not premiums rise depends on your coverage and type of plan and treatment type.
Has the Affordable Care Act (ObamaCare) Affected Substance Abuse and Mental Health Insurance Coverage?
Yes. The Affordable Care Act lists addiction treatment one of its ‘ten essential health benefits’ required of insurance exchange companies. It is illegal under the ACA for companies to deny coverage to those with preexisting conditions, such as addiction and mental illness.