Kaiser Permanente Insurance For Alcohol and Drug Rehab
- Kaiser Permanente Insurance Coverage
- Using Insurance To Pay For Addiction Treatment
- Do I Have To Stay In-Network?
- Out-Of-Pocket Costs
- Covered Treatment Programs
- Verifying Your Insurance Coverage
Kaiser Permanente is a major health insurance company which offers insurance plans that provide a number of benefits. Many rehab centers accept Kaiser Permanente insurance for drug and alcohol rehab programs, though coverage varies among plans.
Kaiser Permanente insurance does offer health care coverage to Americans using their insurance benefits. Many essential health benefits are covered by the plans, including coverage for drug or alcohol rehabilitation.
How much coverage you’ll have through your Kaiser Permanente plan may vary based on the plan level and your specific inpatient treatment program, outpatient treatment options, medications, and other factors.
Spring Hill Recovery Center is in-network with a number of health insurance plans.
If you are looking into seeking behavioral health support, it will help to know:
- what your Kaiser Permanente plan will cover
- how much you will need to pay for addiction treatment out of pocket
- how to verify that your insurance covers your treatment before you begin
Kaiser Permanente Insurance Coverage For Massachusetts Drug And Alcohol Rehab
The kind of coverage you have will vary based on your plan. Individual plans range between Platinum, Bronze, Silver, and Gold, while group plans may include traditional deductible plans, PPO plans, point-of-service plans, out-of-area plans, and consumer-directed health plans.
Here is an example of Kaiser Permanente insurance coverage for drug and alcohol treatment:
Kaiser Permanente Platinum HMO Plan: Provides coverage for drug and alcohol rehabilitation with a copay of $250 per day up to $1,250 per stay. Outpatient plans come with copays of $15 per visit for private sessions or $5 for group sessions. Residential treatment may be available at $100 per admission, so long as the services are offered at a licensed facility with 24-hour care.
The type of plan you have will dictate if you have a copay or deductible that must be met.
It is also important to note that Kaiser Permanente only provides coverage in certain states, such as:
- The District of Columbia
Using Kaiser Permanente Insurance To Pay For Addiction Treatment
Addiction treatment can be costly, but it is essential for many. Look at your specific plan to identify if it will provide coverage to you at your substance abuse treatment facility of choice.
Kaiser Permanente insurance may cover treatments such as:
- medical detox
- outpatient rehabilitation
- inpatient and residential treatment
- intensive outpatient rehabilitation
- transitional services
Do I Have To Stay In-Network To Use My Kaiser Permanente Insurance For Massachusetts Drug Rehab?
Most Kaiser Permanente plans provide better coverage if you choose to stay within the network. However, preferred provider organization, or PPO, plans are a good choice for members who want to use out-of-network services.
Here is a summary of the plans offered:
- PPO plans generally have less coverage, and patients can expect to pay more with an out-of-network provider. The insurance company will often still cover a portion of the treatments.
- Point-of-service plans also allow individuals who are outside the Kaiser Permanente coverage area to seek out-of-network services or to use network-contracted providers.
- Consumer-directed health plans allow policyholders to pay into a health savings account and then to use that money, tax-free, to pay for their medical services in or out of network.
- Traditional or deductible plans require participants to pay copays and costs until the deductible is met. These sometimes cover a portion of out-of-network treatments.
- Out-of-area plans are ideal for those who are no longer in the Kaiser Permanente coverage area. Preventative services may be covered, but other services may be subject to deductibles or cost-sharing amounts.
Out-Of-Pocket Costs For Rehab
Using the Kaiser Permanente plan, you should be able to find out your copays and deductible ahead of time. How much you’ll pay out of pocket depends on factors such as how much you’ve paid into your deductible this year and if you have an HSA account.
Copays are typical with Kaiser Permanente’s traditional plans. If your copays will be high, you may be able to offset those fees with the use of your HSA account or by applying for grants, scholarships, and payment plans at the rehab facility of your choice.
How Do I Find A Massachusetts Rehab Center That Accepts Kaiser Permanente Insurance?
The easiest way to find a rehab center that accepts Kaiser Permanente insurance is to use the search provided on your insurance company’s website. You can also reach out to us at Spring Hill Recovery, and we would be happy to tell you more about your copayment amount, coverage, and what to expect.
Does Kaiser Permanente Cover Inpatient/Residential Rehab?
Kaiser Permanente does cover inpatient or residential drug rehab, though the amount you need to pay up front will vary. Generally, the insurance provider requires a copay per visit or stay, and you may have a maximum out-of-pocket requirement along with your deductible.
Since inpatient treatment programs vary in length and format, you may want to speak with our team about your specific program options and if your plan will cover more or less of one or the other. Usually, residential programs are the most expensive, while outpatient programs are less so.
Is Medical Detox Covered By Kaiser Permanente Insurance?
Drug and alcohol detoxification is usually the first step in substance abuse treatment. Kaiser Permanente has many different policies, but most provide coverage for medical detox and treatment.
Does Kaiser Permanente Cover Outpatient Treatment?
Outpatient treatment is a less intensive form of treatment, and it’s one option that the insurance company does cover. It offers coverage for both outpatient and intensive outpatient rehabilitation, depending on your plan.
The Affordable Care Act made it a requirement for insurers to offer mental health treatment to the same extent that they cover other medical expenses, so if you have comorbid mental health conditions and substance abuse issues, then you should be able to have at least a portion of your medical care covered.
You may need to have a referral or precertification for outpatient treatment. A clinical assessment may also be required, depending on your plan.
Is Partial Hospitalization Covered Through Kaiser Permanente Insurance?
Partial hospitalization programs (PHP) are covered through Kaiser Permanente insurance based on the MCG Guidelines Behavioral Health Criteria. Once the treatment is determined medically necessary, then patients can expect the policy to cover their care at least in part.
Is Intensive Outpatient Treatment Covered By Kaiser Permanente?
Kaiser Permanente insurance covers intensive outpatient programs for patients who need a higher level of care than they can receive in an outpatient setting. Referrals should be provided to obtain coverage.
Does Kaiser Permanente Provide Insurance Coverage For Sober Living?
Kaiser Permanente insurance makes sure that you can get preventative care and ongoing treatment for substance abuse. Preventative care is provided at no cost, and long-term sober living support may be offered with approval.
Does Kaiser Permanente Cover Medication-Assisted Treatment Programs?
Medication-assisted treatment (MAT) programs may be covered by your Kaiser Permanente policy. Check your benefits form from your insurance carrier to be sure if your treatment will be covered. Your drug benefits should be included with your basic insurance paperwork.
Are Methadone Costs Covered By Kaiser Permanente Insurance?
Methadone costs may be covered by your insurance plan through Kaiser Permanente if you have an opioid use disorder. The type of medication you take, whether it’s a pill or injection, may affect your coverage.
Will Kaiser Permanente Suboxone Therapy?
Your Kaiser Permanente benefits package should discuss if it will cover Suboxone therapy, though many plans do provide coverage for those with opioid use disorders. Check your drug coverage to see if this medication is covered in full or in part.
Verifying Your Kaiser Permanente Insurance Coverage
The very first thing to do once you know you want to get treatment is to check your health insurance coverage. We make it easy to do this at Spring Hill Recovery.
All you have to do is to reach out to us and tell us your policy information, and we can verify that you will have coverage when you go through treatment in our facility. We will give you information on the policy’s restrictions and benefits, so you know what to expect.
Our alcohol and drug treatment services are available throughout New England, including states such as:
To learn more about Spring Hill Recovery, reach out to us. We would love to talk to you about the drug and alcohol programs that we are currently offering to help with any substance use disorder, as well as how we can help you on the path to recovery.
Written by Spring Hill Editorial Team
©2023 Spring Hill Recovery Center | All Rights Reserved
This page does not provide medical advice.
- Kaiser Permanente—Fast facts https://about.kaiserpermanente.org/who-we-are/fast-facts
- Kaiser Permanente—Intensive Outpatient Program https://thrive.kaiserpermanente.org/care-near-you/northern-california/eastbay/departments/psychiatry/adult-psychiatry/intensive-outpatient-program/
- Kaiser Permanente—Why Choose Kaiser Permanente: Find Health Plans Online https://individual-family.kaiserpermanente.org/healthinsurance/page/why_kp
- Substance Abuse and Mental Health Services Administration—Medication-Assisted Treatment (MAT) https://www.samhsa.gov/medication-assisted-treatment