Since the Affordable Care Act went into effect in 2010, insurance plans must cover addiction treatment as an essential benefit.1 But each plan is different in how much they cover, which treatment programs they approve, and what copayments and deductibles apply.
Substance use treatment involves different levels of care such as outpatient, intensive outpatient, partial hospitalization, inpatient, and aftercare. Some patients move between different levels of care while in recovery.
While the exact answer will depend on the program you’re interested in and your plan details, in general, Kaiser will cover at least some of your treatment. The best way to know what your plan does and doesn’t cover is to contact Kaiser. You can do this a few ways:
You can also call the treatment center you plan to attend and ask if they accept Kaiser Permanente insurance.
A good first step is talking to your doctor. They can help assess your treatment needs and help you choose a treatment center. But before you enroll in a treatment program, make sure it’s approved and covered through Kaiser Permanente mental health coverage. Also, find out how much of the cost you will have to pay (called “out-of-pocket” costs). The program may have financing options if you need them.
Kaiser Permanente does not require a referral to access mental health services, which usually includes addiction treatment.2
Individual health plans are available in various states, and you may be able to get financial help with monthly premiums through the Health Insurance Marketplace.3 You can make choices once a year about the plan you want based on price, coverage, deductibles, and copayments. The insurance company lets you choose your doctor and change any time. It also offers care when you’re away from home.4
You can get Medicare plans from Kaiser Permanente as well.5 These add-on, or supplemental, plans give you extra healthcare benefits beyond basic Medicare. This may include prescription drugs, dental, and vision, and more.
Kaiser Permanente also offers Medicaid benefits plans in 9 states.6 The exact coverage you get for addiction recovery will depend on the plan in your state, but you can expect at least basic coverage.
Deciding to get treatment takes a lot of courage. The good news is that most insurance plans cover both inpatient and outpatient treatment. The specific programs covered will depend on your insurance plan. You may have to pay copays or deductibles. To get the details, be sure to talk to your insurance company.
You can also verify your insurance coverage online to see which programs Kaiser Permanente will cover.
Note: We try to offer the most updated information available about insurance. But insurance health plan information does change quickly. Please check with your insurance company to ensure that you have the most recent and correct information about your coverage.