Kaiser Permanente Coverage for Addiction Treatment
Discover Kaiser Permanente’s drug rehab coverage, including inpatient and outpatient options. Learn how to access care today.
Kaiser Permanente Coverage for Addiction Treatment
Discover Kaiser Permanente’s drug rehab coverage, including inpatient and outpatient options. Learn how to access care today.
Kaiser Permanente offers health insurance coverage in several states. They were founded in California in 1945 and have expanded from there. Kaiser is unique among insurers because they run Kaiser Medical Centers, which provide a variety of care to members. I especially like that Kaiser Medical Centers are leaders in LGBTQ+ care.
Does Kaiser Permanente Cover Drug Rehab?
Thanks to the Affordable Care Act (ACA), most long term insurance plans cover at least some of the cost of mental health and substance use treatment. There are exceptions to the law, however, so it pays to double check.
Each plan is different, so it’s important to understand the details of your specific plan. Don’t be afraid to reach out to the insurance company to get the information you need. You can ask what addiction treatment centers are part of your plan, for example. You can also find out what out of pocket costs, like copayments or deductibles, you’ll have to pay.
Does Kaiser Permanente Cover Suboxone & Methadone (MAT)?
Medication assisted treatment (MAT) uses FDA approved medication combined with other therapies to treat opioid and alcohol use disorders.
Suboxone and methadone are two of the most commonly prescribed medications for MAT. Kaiser Permanente offers plans that can help with the cost of these prescriptions. You may need to use in network MAT programs and pharmacies, however, so make sure you verify the details of your plan before you begin treatment.
Does Kaiser Permanente Cover Other Mental Healthcare?
Kaiser Permanente members have access to multiple options for mental and behavioral health care. Options include primary care, emergency care, and specialty care. Self care tools and resources are also available at no cost.
Most Kaiser Permanente plans include coverage for mental and behavioral health treatment. The types of treatment you might get for mental health include inpatient care, crisis support, support groups, therapy, and health classes.
Some people have a mental health diagnosis alongside addiction, which is known as co occurring disorders. Your Kaiser Permanente plan can generally help you pay for the integrated care you need to address both at once, which dramatically improves your chances of long term recovery.
Kaiser Permanente Coverage Areas
Kaiser has both health insurance and medical facilities. Most, if not all, Kaiser health plans have to be used at Kaiser clinics. You wouldn’t, for example, be able to go to the University of Oregon Health Services using your Kaiser insurance.
Kaiser Permanente operates in multiple states across the country, including California, Oregon, Washington state, Colorado, Georgia, and Hawaii. They also have clinics and hospitals in the D.C. area, including parts of Maryland and Virginia.
There are 40 Kaiser hospitals and 616 affiliated medical offices in their service areas. One benefit is that if you have a California Kaiser plan and go to college in, say, Colorado, you can use your California plan at Kaiser clinics in Colorado.
There are many ways to see your Kaiser doctor. You can schedule a video visit, make a phone appointment, or go to the clinic in person. There are also online visits and email advice available.
Types of Kaiser Permanente Plans
Kaiser’s individual and family plans are based on how you pay your costs. There are copay plans that have no deductibles. The premium is a bit higher, but you pay less when you get treatment. There are also deductible plans which are cheaper but you have to cover a deductible before the copay coverage kicks in.
Virtual plans charge you less for telehealth visits while still giving you access to in person care when needed. Finally, there are high deductible plans where you set up a special HSA bank account to save money to cover your health needs.
Kaiser Permanente also offers Medicare plans, Medicaid plans, employer plans that allow companies to offer health benefits to employees, and coverage for federal employees.
What Inpatient Rehab Does Kaiser Permanente Offer?
Kaiser uses their hospitals and clinics to provide addiction treatment. They cover a lot of types of treatment focusing on evidence based care recommended by your doctor. I love that Kaiser is actively involved in substance use treatment research. It helps them deliver state of the art care.
Their facilities offer medical detoxification and inpatient/residential care. A medical detoxification program uses FDA cleared prescriptions to help ease your withdrawal symptoms and reduce the potential serious side effects that are linked to some addictive drugs.
You have several options for inpatient or residential treatment at an approved treatment center. This can include evidence based treatments you receive in an individual or group setting. You can also get a combination of education and medical care along with therapy in a comprehensive treatment program.
At an inpatient or residential facility you live there and can get therapy during the day or evening hours. Inpatient care can be a good choice if you’ve tried outpatient treatment and it just didn’t work or when you have other physical or mental health conditions. It can also be helpful when your home situation makes it more difficult to stay clear of drugs and alcohol.
Insurance plans vary so it’s important to check your policy benefits and limitations. For example you might need to get a referral or preauthorization before you start rehab.
What Outpatient Addiction Treatment Does Kaiser Permanente Offer?
There are different types of outpatient addiction treatment Kaiser Permanente covers. Outpatient programs can be more challenging since you are practicing your new mindsets and habits in the pressure of daily life but the programs help you build the needed skills to handle these triggers.
This most intensive outpatient treatment is a partial hospitalization program (PHP) which is also known as a day program. You attend most of the day but spend the evenings at home or in a sober living environment. The next step down is an intensive outpatient program (IOP) where you receive around 9 hours a week of treatment and are able to work or attend school outside of your sessions. Finally, in a standard outpatient program you may have one or two therapy sessions each week.
You’ll likely get evidence based therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). These are usually delivered through individual and group therapy along with family therapy when appropriate.
If you struggle with opioid or alcohol misuse, medication assisted treatment (MAT) might be a good solution. MAT allows you to use FDA approved medicine to manage cravings during treatment. This keeps you focused on your recovery and helps prevent relapse.
Your outpatient program may also offer peer support and aftercare programs that help prevent relapse and support your long term recovery. Peer support programs connect you with people who have been through the program and understand the challenges you face. Aftercare programs may include therapy and usually include some community support such as 12 step or other community support meetings.
Can I Travel Out of State for Treatment With Kaiser Permanente?
Yes, you can travel out of state for addiction treatment with Kaiser Permanente insurance. However for most Kaiser plans you still need to stay in network and use Kaiser Permanente clinics. That means you can go out of state and use your Kaiser insurance at a Kaiser clinic in the new state but you cannot get coverage at other treatment centers in that state.
If you do have a Kaiser plan that allows out of network coverage you can go to non Kaiser clinics in other states but you’ll pay far more in terms of your deductible and copayments. It’s best if you can find a suitable in network provider.
What to Do if Kaiser Permanente Won’t Cover the Cost of Rehab
Kaiser Permanente clinics offer high quality care for drug and alcohol addiction treatment but you may feel these clinics are not a good fit for you. This means you’ll be going to an out of network treatment center which may will not be covered by your insurance plan. In this case there are other ways to help pay for rehabilitation.
Your friends or family might be able to help or you might find an affordable faith based organization you align with to get treatment at. Some centers have a sliding scale of fees can be more affordable than other options. You might also set up a payment plan that spreads out the cost of treatment or get a scholarship or grant to cover rehab.
Calls to any general helpline will be answered or returned by one of the treatment providers listed, each of which is a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Who Answers?
800-784-1361
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