(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.)
Kaiser Permanente
Kaiser Permanente is a managed care consortium that was founded in 1945. It does not operate in all of the states, but it is the largest not-for-profit managed care organization in the U.S. It consists of three organizations:
Kaiser Permanente offers individual and family insurance plans, both of which offer some sort of coverage for substance abuse treatment.
All Kaiser Permanente health insurance plans cover some portion of rehab. The Affordable Care Act (ACA) lists drug or alcohol addiction as one of ten "essential health benefits," which means that any insurance sold on the Health Insurance Marketplace must cover addiction treatment.1 Further, the Mental Health Parity and Addiction Equity Act (MHPAEA) ensures that all private insurance plans cover substance abuse treatment to the same degree that they cover other medical issues, so you can expect equal levels of coverage for both.2
This means that if your insurance plan covers 80% of your medical costs, it will pay 80% of your rehab costs. You will be expected to pay the remaining 20% out-of-pocket.
Kaiser Permanente insurance coverage will vary by each policy’s particular offerings. In general, they will cover all substance abuse screening and assessment costs and part of the formal treatment program costs—outpatient, intensive outpatient, and inpatient services.
Always check to make sure the program that you are considering accepts your Kaiser Permanente insurance plan to reap the full insurance benefit.
Treatment facilities with a focus on comfort and amenities tend to cost more than basic rehab services, since upscale locations and services, such as spa treatment, massage therapy, and gourmet meals are not considered "essential." These facilities, known as luxury or executive rehab programs, come with a higher price due to the facility maintenance costs and amenities offered.
Kaiser Covers Luxury
Because your Kaiser Permanente insurance plan will cover a certain percentage of rehab costs regardless of program, selecting a higher-cost facility will mainly impact your out-of-pocket costs.
For example, if your policy requires that you cover 20% of treatment costs, 20% of a $5,000 program will end up costing you far less than 20% of a $40,000 program.
This cost differential is an important factor to consider when looking at treatment programs. Finances can be a significant stressor and trigger that can lead to drug relapse—you want to ensure that your portion of treatment costs works with your financial needs.
Kaiser Permanente operates in 9 states as of 2015:3
These are the Kaiser Permanente areas. Your insurance plan may cover treatment within these area networks, but as always, make sure to call your insurance plan to get all the details.
If You're Out of Network
Outside of these areas, however, substance abuse treatment is not covered.
With a Kaiser Permanente insurance plan, you must stick within the Kaiser Permanente service network. Out-of-region treatment will incur full out-of-pocket costs for you.
Make sure to verify that the program that you are considering accepts your insurance plan.
When you call Kaiser Permanente, you'll want to have your insurance card in front of you. If you're calling for someone else, make sure that you have their insurance card accessible. This is important, because your card has your policy number and name on it. Asking relevant questions can help you clarify the details of your plan and guide your treatment search. Some questions include:
This information will be useful to you moving forward.
It’s up to you to cover the leftover costs after your Kaiser Permanente insurance policy covers their portion of treatment. The total of these out-of-pocket costs will vary by program, but there is always a way to afford recovery help!
Other Financing Options
Other financing options to help you cover your portion of treatment costs include:
Recovery is your number one concern, and if you need help figuring out how to afford rehab, call your insurance company to learn more about the details of your individual plan.
1. Office of National Drug Control Policy. (n.d.). Substance Abuse and the Affordable Care Act.
2. Centers for Medicare & Medicaid Services. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).
3. Kaiser Permanente. (2018). Find doctors and locations.
For those seeking addiction treatment for themselves or a loved one, the Rehabs.com helpline is a private and convenient solution.
Calls to any general helpline (non-facility specific 1-8XX numbers) for your visit will be answered by American Addiction Centers (AAC).
We are standing by 24/7 to discuss your treatment options. Our representatives work solely for AAC and will discuss whether an AAC facility may be an option for you.
Our helpline is offered at no cost to you and with no obligation to enter into treatment. Neither Rehabs.com nor AAC receives any commission or other fee that is dependent upon which treatment provider a visitor may ultimately choose.
For more information on AAC’s commitment to ethical marketing and treatment practices, or to learn more about how to select a treatment provider, visit our About AAC page.
If you wish to explore additional treatment options or connect with a specific rehab center, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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