Getting to the point where you realize you need help with an addiction is a tough journey in itself. Now that you’ve made it here, you might be wondering if you can afford the treatment or even asking – does Kaiser Permanente cover drug or alcohol rehab? If so, is it outpatient, residential inpatient and what else does the insurance coverage include?
Fortunately, since the Affordable Care Act went into effect in 2010, insurance plans must cover basic addiction treatment as an essential benefit.1 However, each plan is different in how much is covered, which treatment programs are approved, and what copayments and deductibles apply.
If you have a Kaiser Permanente health plan, you may wonder how they, specifically, cover addiction treatment. Here’s what you need to know.
American Addiction Centers has a strong relationship with Kaiser Permanente and may be able to help you get approved for one of our treatment programs. Give us a call at 1-888-509-8965 Who Answers? or use the insurance verification tool to see if there is coverage from your specific plan.
Kaiser Permanente does not require a referral to access mental health services.2 You can give them a call to find out what’s covered in your specific plan. They’ll ask questions and help you get on a care plan that’s right for your needs.
Inpatient services are commonly needed for substance addiction recovery. You may need to be away from your current environment to detox within a residential inpatient setting, address your mental health, and start making new decisions. However, not every inpatient program is covered. Work with your insurance provider before you enroll to choose an approved plan.
Outpatient addiction treatment is another option. Participants live at home and attend classes and appointments regularly. The addiction treatment coverage offered by Kaiser Permanente generally includes outpatient care; the coverage level varies based on your plan and the program you choose.
Before you enroll, make sure the program is approved and covered through Kaiser Permanente Shield mental health coverage. Also, find out how much of the cost you will be responsible for. The program may have financing options if you need them.
While the exact answer will depend whether on the program you’re interested in and the specifics of your insurance plan, in general, there will be some coverage for drug and alcohol rehab. Individual health plans are available in various states and you may qualify for assistance 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 allows you to choose your doctor and change anytime; it also offers care when you’re away from home and a variety of health resources.4
Those with Medicare can get coverage from Kaiser Permanente as well.5 These add-on plans give you extra healthcare benefits beyond basic Medicare, including access to health resources and no co-pay for preventative care.
If you use Medicaid or Medi-Cal, you also have healthcare coverage choices with Kaiser Permanente. The insurer offers Medicaid benefits plans in 9 states.6 The exact coverage you receive for addiction recovery will depend on the plan in your state, but you can expect at least basic coverage.
It’s essential to fully understand your specific plan and how it applies to addiction recovery treatment. You can speak to the insurer directly or contact the treatment program and ask if they accept Kaiser Permanente benefits. However, the insurance company will always make the final decision.
Many times, detox is one of the most challenging part of recovery. Getting the drugs out of your system and dealing with withdrawal can be painful. You may feel physically ill, be in pain, shake, or have other symptoms. Your exact experience will depend on how long and how much you’ve been using and the substance you are detoxing from.
Once Kaiser Permanente determines your specific needs, they’ll work on setting you up with proper care. This may mean working with an addiction medicine provider who helps you through detox. The exact coverage for the treatment process will depend on your insurance plan and which program you choose.
Does insurance cover going into drug or alcohol rehab treatments centers and facilities? Check your insurance benefits to understand what costs you can expect and know what costs will be covered. The easiest way to do this is to call Kaiser Permanente or check your online account for a list of benefits.
You can also use the insurance verification link to see which programs your insurance will cover. Or, you can fill out the form below.
You can also contact specific rehab programs and ask if they accept Kaiser Permanente therapy coverage. However, you also need to check with the insurer directly. If you feel that the out-of-pocket costs are too high for you, ask the program about financing options or assistance that may be available.
Deciding to get treatment takes a lot of courage. The good news is that most insurance plans offer coverage for both inpatient and outpatient treatment. The specific programs covered will depend on your insurance plan. You may have to pay co-payments or deductibles. To get the details, be sure to talk to your insurer.