Guide to Kaiser Permanente Insurance Coverage for Addiction Treatment

Last Edited: December 29, 2023

Bianka Fisk

Clinically Reviewed
Jim Brown, CDCA

All of the information on this page has been reviewed and certified by an addiction professional.

Kaiser Permanente Health Insurance can help patients gain recovery from addiction

Click Here for a confidential benefits check or call (866) 578-7471 to speak to a addiction specialist.

Having to deal with a substance abuse problem is devastating. Fortunately, help is out there, but you may be worried about how you will pay for that treatment. Because of the implementation of the Affordable Care Act and the Mental Health Parity Addiction Equity Act millions have been able to get access to health insurance because insurance companies are obliged by law to cover addiction treatment in the same way as they would cover mental health treatment.

Coverage will still vary greatly on who you are insured with, and which plan you have. One popular insurance company is Kaiser Permanente, which is a consortium of managed care facilities. Founded in 1945, Kaiser does not operate all over the country. At the same time, however, they are the largest nonprofit managed care company. It is made up of three individual elements, which are: Permanente Medical Groups, Kaiser Foundation Hospitals, and Kaiser Foundation Health Plan.

Kaiser Permanente health plans exist for families and for individuals. All of their plans cover substance abuse treatment. However, to know exactly what they will cover and what your own out of pocket costs will be, it is better to contact Kaiser and ask them. You can also ask a rehab facility to perform an insurance check for you. Those conversations are 100 percent discreet and confidential and they will not affect your premiums either.

If you are ready to see if your insurance plan covers substance abuse treatment then call (866) 578-7471.

Kaiser Permanente Insurance Coverage for Alcohol and Drug Rehab

Every health insurance plan offered by Kaiser Permanente covers rehab to some degree. This is the law under the Affordable Care Act, which has made sure that private insurance companies offer their members coverage for the treatment of substance abuse, in the exact same way as what they cover other medical problems. This means that you can expect very good coverage by going to Kaiser Permanente. They may, for instance, cover 80 percent of your medical costs under your policy, which includes 80 percent of your rehab costs if you go to rehab. Your out of pocket expenses, therefore, will only be 20 percent.

Whether they actually offer you 80 percent, depends on the particulars of your individual policy. Generally speaking, they offer coverage for abuse screening, the costs of assessments and the cost of your treatment as well. The treatment includes residential inpatient services, intensive outpatient services, and outpatient services.

However, you have to check not just whether your Kaiser Permanente policy covers the cost of addiction treatment; you also have to make sure that the rehab facility that you are considering going to will accept Kaiser Permanente. If not, you will find it very difficult to get the most out of your insurance policy.

Kaiser Permanente and Specialty Alcohol and Drug Treatment

Some people prefer to attend luxurious rehab facilities that have private rooms, comfortable bed linen, gourmet chefs and various non-medical activities as well. These facilities are more expensive, which is why they are usually reserved for busy executives and those in the public eye. Luckily, Kaiser prides itself on covering luxury rehab as well, even if those amenities are not a medical necessity. The rules according to Kaiser Permanente is that they will cover a specific percentage of the cost of your treatment. Hence, if you have 80 percent coverage, they will cover 80 percent of the cost, regardless of what the total is. The more expensive the treatment facility is, the higher the amount that makes up your 20 percent will be as well. For instance, if you find a program that costs $10,000 for 30 days, you will pay just $2,000. If you find another program that costs $50,000 for 30 days, however, you will have to pay $10,000. But this does mean that, so long as you can afford it, you can have access luxury and executive facilities.

This is an important factor to take into consideration when you’re looking for a treatment facility: you need to know that you can afford your treatment, after all. That said, you should not allow finances from stopping you from receiving treatment either. Rather, it means you will have to come up with other methods of paying for your treatment.

Kaiser Permanente Insurance Coverage for Out of Network Provision

[/vc_column_text][vc_column_text]In 2015, Kaiser Permanente was available in the District of Colombia, Washington, Oregon, Maryland, Virginia, Hawaii, Georgia, Colorado and California. The company does put restrictions on where you can go for treatment, however, so it is likely that you will have to a resident in those geographical areas and receive treatment there as well. If not, you will be classed as being out of network.

You must choose only from the in network providers if you want to receive Kaiser Permanente coverage. If you choose to go out of network anyway, then you will have to pay 100 percent of the costs yourself.

Paying for Out of Pocket Costs

Regardless of which treatment program you decide to go to, you will have some out of pocket costs. Luckily, these can be covered in a variety of different ways. For instance:

  • Most rehab facilities have payment plans. This means that you pay back the cost of your treatment over time, usually through monthly installments. Generally, this is linked to your income as rehab facilities understand that a financial burden could send you back to abusive behaviors.
  • Some rehab facilities offer sliding scale payments. This means that the cost of your treatment is linked directly to your income. The less you earn, the less you will have to pay.
  • You can pay for the services using a credit card
  • You can take out a private loan, including home equity or personal loan
  • You can apply for medical financial aid
  • You can apply for a scholarship with the treatment facility if they have one
  • You can apply for grants through organizations, such as the Substance Abuse and Mental Health Services Administration
  • You can sell some of your assets
  • You can ask your friends and family for a loan