Kaiser Permanente Drug & Alcohol Rehab

Paying for Alcohol & Drug Rehab With Kaiser Permanente

If you have Kaiser Permanente insurance coverage and need substance abuse treatment, you’re in luck. Kaiser Permanente plans typically cover a portion of drug and alcohol rehab. When you’re searching for an addiction treatment program, make sure you ask if they accept your insurance plan. If you’d like more information about the details of your plan, make sure to call Kaiser Permanente.

(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.)

About 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 Foundation Health Plan.
• Kaiser Foundation Hospitals.
• Permanente Medical Groups.

Kaiser Permanente offers individual and family insurance plans, both of which offer some sort of coverage for substance abuse treatment.

Does Kaiser Permanente Cover Drug & Alcohol Rehab?

All Kaiser Permanente health plans sold in the Marketplace cover addiction treatment in some way because substance use disorder and mental health services are one of ten essential health benefits that any plan sold in the Marketplace must cover.³ Further, the Mental Health Parity and Addiction Equity Act (MHPAEA) compels certain plans and insurance issuers offering benefits for substance use disorders or mental health to not limit those benefits in a more unfavorable way than they do medical/surgical benefits.⁴ This law may apply to your Kaiser Permanente health plan.

Coverage may vary between Kaiser Permanente plans. In general, treatment for substance use disorders may be delivered at a variety of levels, such as outpatient, intensive outpatient, and inpatient.⁹ Contact Kaiser Permanente to find out more about your plan, including what levels of care may be covered.

Always check to make sure the program or provider that you are considering accepts your Kaiser Permanente plan.

Kaiser Permanente Coverage Out of State

In general, Kaiser Permanente offers care in 8 states and Washington, D.C., as of 2019:⁶

• California.
• Colorado.
• Georgia.
• Hawaii.
• Virginia.
• Maryland.
• Oregon.
• Washington.
• Washington, D.C.

If you’re visiting another Kaiser Permanente service area, chemical dependency and mental health services should be covered the same as if you were in your own area, although there are exceptions. You may need a referral. It’s unclear if this coverage would be the same for individuals who intentionally travel to go to a non-local treatment center. Call Kaiser Permanente’s “Away from Home Travel Line” to check and get all the details.⁶

Make sure to verify that the program or provider that you are considering accepts your plan.

Other Areas?

Outside of these areas, emergency care and urgent care should be covered.⁶ Substance use disorder treatment is unlikely to be covered. Call Kaiser Permanente’s “Away from Home Travel Line” for more information.

Addiction Treatment Questions to Ask Kaiser Permanente

When you call Kaiser Permanente, you’ll want to have your member ID card in front of you. This is important because your member ID card number on it.¹⁰ Asking relevant questions can help you clarify the details of your plan and guide your treatment search. Some questions you may want to ask include:

• Where can I go for care?
• Do you cover detox services? To what extent?
• Do you cover outpatient treatment? To what extent?
• Do you cover inpatient treatment? To what extent?
• Do you cover the cost of prescription medications? To what extent?
• What will my out-of-pocket fees be?
• How many days of treatment do you cover?

This information will be useful to you moving forward.

Paying Out-Of-Pocket Costs

It’s up to you to cover the remaining costs after your Kaiser Permanente plan pays its portion of any covered treatment. The total of these out-of-pocket costs can vary based on many factors, but some treatment programs may have one or more options to help you afford recovery help, such as:

• Payment plans: Rehab programs may offer payment plans where you arrange to spread out the total cost over regular payment installments, to make the financial burden more manageable. Be sure to look at interest rates and other details of the plan.
• Sliding fee scale: Programs may offer a sliding fee scale, where the treatment costs will vary based on the individual’s income—if you make less money, you will have lower costs. This may only be an option if you pay entirely out-of-pocket.
• Scholarships: Programs may offer rehab scholarships where you can potentially receive treatment at a discounted cost or no cost at all.

Additional Rehab Financing Options

Health Insurance Providers and Coverage Levels

Sources

1. Kaiser Permanente. (n.d.). Who We Are.
2. Kaiser Permanente. (n.d.). Fast facts.
3. S. Centers for Medicare & Medicaid Services. (n.d.). What Marketplace health insurance plans cover.
4. Centers for Medicare & Medicaid Services. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).
5. gov. (n.d.). Mental health & substance abuse coverage.
6. Kaiser Permanente. (2019). Before you travel.
7. Kaiser Permanente. (n.d.). Shop plans.
8. Kaiser Permanente. (2018). Let us help you find new health care coverage.
9. gov. (2017). Medicaid Innovation Accelerator Program: Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A Resource for States Developing SUD Delivery System Reforms.
10. Kaiser Permanente. (2019). Your member ID card.
11. Consumer Financial Protection Bureau. (2017). How does a medical credit card work?
12. Consumer Financial Protection Bureau. (n.d.). Understanding online marketplace lending.