Does Kaiser Permanente Insurance Cover Rehab?

Table of Contents

Does insurance cover drug rehab? Yes. Although the cost of addiction treatment can be high, healthcare benefits may cover much of the expense. This page will explain more about:

  • Kaiser Permanente health plans.
  • Options for using Kaiser Permanente mental health coverage benefits for addiction treatment.
  • Healthcare coverage for inpatient and outpatient treatment.
  • How to check your benefits.

Kaiser Permanente Health Plans

Founded in 1945, Kaiser Permanente is a non-profit health insurance company that provides coverage to 12.4 million people across the United States.1, 2 Their network includes 39 hospitals, more than 700 medical offices, 23,000 doctors, and 63,000 nurses.2 Plans are divided by the following tiers:3

  • Bronze, which has the highest deductible, higher copayments for office visits, and a 40% coinsurance for inpatient mental health care once the deductible is met.
  • Silver, which has a lower deductible, lower copayments for office visits, and a 20% coinsurance for inpatient mental health care once the deductible is met.
  • Gold, which has no deductible, lower copayments for office visits, and a set copay for inpatient mental health care for the first 5 days of treatment with no charge for additional covered treatment.
  • Platinum, which has no deductible, the lowest copayments for office visits, and the lowest set copay for inpatient mental health care for the first 5 days of treatment with no charge for additional covered treatment.

Medicaid is a federally and state-funded program that provides healthcare coverage to low-income individuals or those with disabilities.4 Kaiser Permanente offers Medicaid coverage plans at low or no cost.4 Medicare is a federal program that provides health insurance to adults aged 65 or older or those with qualifying disabilities.5 Kaiser Permanente offers Part C coverage plans, known as Medicare Advantage plans, which offer various benefits.5

American Addiction Centers has a relationship with Kaiser Permanente and may be able to assist you with admission into one of our facilities. To find out if your plan with Kaiser Permanente covers drug rehab in our facilities, contact us at 1-888-287-0471 or use our online insurance tool to verify your coverage.


Kaiser Permanente Insurance for Drug and Alcohol Rehab

Does Kaiser Permanente cover drug rehab? Yes. Mental health parity laws have been enacted to ensure that insurance plans offer similar levels of coverage for mental health and substance use treatment as they do for physical health care.6 While Kaiser Permanente therapy coverage benefits vary depending on the plan and your specific needs, the following services may be covered:6

  • Detox
  • Inpatient treatment
  • Partial hospitalization programs
  • Intensive outpatient treatment
  • Outpatient treatment
  • Medication-assisted treatment for withdrawal or managing co-occurring disorders

If you aren’t sure if your insurance covers drug rehab at one of our facilities, you can verify your coverage here.


Kaiser Permanente Insurance for Inpatient Rehab

Kaiser Permanente’s plans are mainly health maintenance organization (HMO) plans, which means that you must see providers that are in-network for treatment to be covered.3,7 Inpatient treatment, where you stay at the facility while receiving treatment, may be covered depending on your plan and individual needs, although the length of treatment that is covered can vary. Kaiser Permanente doesn’t require any referrals for mental health treatment, although you may need prior authorization before starting treatment.8


Kaiser Permanente Insurance for Outpatient Rehab

Outpatient treatment is provided in a clinic or office-based setting, so you can receive care while still participating in your usual daily activities, such as attending school, going to work, and handling responsibilities at home. Outpatient services may be covered by your Kaiser Permanente insurance plan, depending on your benefits and individual needs. HMO plans require you to seek care from an in-network provider for treatment to be covered.3,7 You won’t need to obtain a referral for any type of mental health treatment, but you may need to get prior authorization before beginning treatment.8

Checking Your Insurance Benefits

Before starting treatment, you may want to check your insurance benefits or ask about your addiction treatment coverage. You can do this by calling the phone number on the back of your insurance card. Member services representatives can answer any questions you have about your insurance plan. You can also create or access an online account where you can view your benefits or search for a covered provider.

Kaiser Permanente offers 3 types of insurance plans specifically for federal employees.9 These plans may differ based on your geographic location but will include:9

  • A basic option plan, which has the lowest premiums but includes a deductible and higher copayments for office visits, hospital stays, and prescriptions.
  • A standard option plan, which has higher premiums than the basic plan, no deductible, and lower copayments for office visits, hospital stays, and prescriptions than the basic plan.
  • A high option plan, which has the highest premiums, no deductible, and lowest copayments for office visits, hospital stays, and prescriptions.

Paying for addiction treatment can be overwhelming, but insurance can cover a large portion of treatment, making it affordable and accessible. Navigating your insurance benefits can be confusing. Many insurance plans, including Kaiser Permanente, offer some coverage for addiction treatment. This may include various types of treatment, such as inpatient or outpatient services. Checking your benefits before starting treatment is a good way to confirm your coverage and avoid unexpected charges.


Sources

  1. Kaiser Permanente. Who we are.
  2. Kaiser Permanente. Fast facts.
  3. Kaiser Permanente. (2019). Compare 2020 plans.
  4. Kaiser Permanente. (2020). Learn about your Medi-Cal/Medicaid options.
  5. Kaiser Permanente. (2020). Tell me about Medicare.
  6. National Alliance on Mental Illness. What is mental health parity?
  7. Healthcare.gov. Health maintenance organization (HMO).
  8. Kaiser Foundation Health Plan. (2020). How to get care.
  9. Kaiser Permanente. (2019). 2020 benefits and rates.

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