Kaiser Permanente Insurance for Drug and Alcohol Rehab Treatment

Table of Contents

If you are concerned that you or your loved one needs drug or alcohol rehab treatment, the first place to start is with your primary care doctor, who can help assess your addiction treatment needs and coordinate a referral to a treatment program. However, when you are thinking about getting addiction treatment, one of your most pressing concerns usually is: Does insurance cover drug rehab? Yes, Kaiser Permanente offers addiction treatment benefits. Although your plan may not cover all of these types of treatment, most plans cover some.

As of 2019, 12 million people have healthcare coverage through Kaiser Permanente, a top-rated non-profit healthcare insurance company that offers health insurance in numerous states through standard health insurance plans and Medicare and Medicaid managed care plans. Kaiser Permanente operates 39 hospitals and over 700 medical clinics and offices.1

American Addiction Centers (AAC) has a relationship with Kaiser Permanente Health Plan and may be able to help you get into one of our facilities. Call 1-888-744-0069Who Answers? or use our online insurance checker to verify your treatment coverage.


Kaiser Permanente Insurance Coverage Levels and Plans

Kaiser Permanente offers several levels of healthcare insurance coverage.2 Kaiser Permanente allows you to choose your primary care physician; preventive care, such as lab work and routine screenings, are free.3 Many employers contract with Kaiser Permanente to provide group coverage for employees.4 Kaiser Permanente offers healthcare coverage in several states, including:5

  • California
  • Colorado
  • Georgia
  • Hawaii
  • Maryland
  • Oregon
  • Virginia
  • Washington (southwest part of the state)
  • Washington, D.C.

The health insurance benefits and coverage offered by plans depends on numerous factors, including which state plan you are covered by. The coverage offered in Colorado by Kaiser Permanente is an example of the typical health insurance benefits that are available. They cover:6

  • Preventative care, such as mammograms and wellness checkups.
  • Prescription drug coverage.
  • Doctor office visits, to both primary care and specialty physicians.
  • Hospital stays.
  • Surgery.
  • Outpatient treatment for mental health and substance abuse.
  • Inpatient treatment for substance abuse and mental health.

Most plans offer a deductible plan that requires you to pay a certain amount of money out of pocket before the health insurance plan starts to pay. In addition, healthcare plans have co-pays for most outpatient services, such as $20 for a doctor visit, with the health insurance plan covering the rest of the cost of the visit. For other services, such as inpatient treatment, health insurance plans cover 80% of the total cost of the stay, and you are responsible for the remaining 20% of the cost.

Most plans also have a maximum out-of-pocket limit per year. Plans vary a great deal, with some plans offering maximum out-of-pocket limits of $5,000, $10,000, or higher.

If you have Medicare coverage, in some states you can purchase plans through Kaiser Permanente to provide managed care and supplemental coverage, which varies somewhat from one state to another. Medicare provides some forms of addiction treatment coverage, and with Kaiser Permanente, your primary care doctor can coordinate your care through a team of doctors and treatment facilities.7

In some states, Kaiser Permanente also provides Medicaid managed care plans. Though the healthcare coverage may differ somewhat from state to state, Medicaid in general offers coverage for mental health and substance abuse treatment at select facilities. Kaiser Permanente offers Medicaid coverage in several states.8

If you have Kaiser Permanente through your state, you may be able to get addiction treatment in another state at a treatment program that has an agreement with Kaiser Permanente. The best way to learn whether your Kaiser Permanente plan will cover your stay for addiction treatment at a particular program is to check your healthcare benefits.9


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Checking Your Insurance Benefits

The easiest way to check your healthcare benefits and coverage is to call the number on the back of your insurance card. Kaiser Permanente also has links on their website to speak to substance abuse specialists who can help you determine what coverage you have and what type of treatment is best for your needs.

If you have Tricare insurance coverage, you can use the treatment locator to find a provider.


Does a Kaiser Permanente Insurance Plan Cover Addiction Treatment?

Does Kaiser Permanente cover drug rehab? Yes, Kaiser Permanente offers addiction treatment benefits. Although your plan may not cover all of these types of treatment, most plans will cover:

  • Detox.
  • Outpatient treatment, where you see a provider a few times a week and go home at night.
  • Inpatient treatment, where you stay 24/7 for a few days or longer.
  • Aftercare services, to provide follow-up once you leave inpatient or outpatient treatment.

For example, one plan offered by Kaiser Permanente for California members provides coverage that pays $600 per day for up to 5 days and then pay nothing after that. Outpatient substance abuse treatment requires that a member pay $30 per visit or per day.10

How do I check my coverage plan to see if my addiction treatment is covered drug or alcohol addiction treatment? You can call the Kaiser authorization phone number on your card, or check your coverage by clicking here or filling out the form below.

If you need addiction treatment and you are covered under a Kaiser Permanente health plan, your plan likely offers some form of coverage for substance abuse treatment. Your exact benefits and coverage may vary depending on which plan you are covered by in your state. If you are looking for support and treatment for your substance use disorder, call us today at 1-888-744-0069Who Answers? to help you determine your healthcare coverage.


Check if your insurance covers addiction treatment

You can use our verify insurance form to check online if your insurance coverage includes rehab treatments for drug or alcohol addiction.

Alternative, we explain insurance coverage levels of some household health insurance brand names via the links below:


Sources

  1. Kaiser Foundation Health Plan. (2020). Kaiser Foundation and Health Plans report 2019 annual report.
  2. Kaiser Foundation Health Plan. (2020). Shop plans.
  3. Kaiser Permanente. Individual and family plans.
  4. Kaiser Permanente. Experience the Kaiser Permanente difference.
  5. Kaiser Permanente. Fast facts.
  6. Kaiser Foundation Health Plan. (2020). Colorado individual and family plan.
  7. Kaiser Foundation Health Plan. (2020). Kaiser Permanente medical health care plans, 2019.
  8. Kaiser Permanente. (2020). Learn about your Medi-Cal/Medicaid options.
  9. Kaiser Foundation Health Plan. (2020). How to get care.
  10. Kaiser Permanente. (2020). Covered CA Gold 80 HMO: Summary of benefits and coverage.
Last updated on August 26, 2020
2020-08-26T13:54:26-07:00
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