Kaiser Permanente Insurance Coverage For Drug Rehab

Medically Reviewed by Johnelle Smith, M.D. on November 30, 2023

Kaiser Permanente health insurance plans offer coverage for addiction treatment. The cost and level of coverage will vary based on several factors.

Drug And Alcohol Rehab Centers That Accept Kaiser Permanente Insurance

Kaiser Permanente is one of the nation’s most prominent insurance providers, currently covering over 12.7 million Americans.

People facing addiction can use Kaiser Permanente health plans to cover the cost of a substance abuse treatment program.

Each insurance plan will cover at least some of the costs associated with behavioral health care, but the out-of-pocket costs will vary depending on the details of the plan.

Does Kaiser Permanente Insurance Cover Rehab?

Yes, Kaiser Permanente will cover drug and alcohol rehab programs as mandated by the Affordable Care Act (ACA) law enacted in 2010.

Coverage for substance use disorders may include evidence-based treatment services and multiple levels of care, including long-term inpatient programs.

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Substance Abuse Treatment Services Covered By Kaiser Permanente Insurance

Kaiser Permanente covers a vast array of treatment services, some of which are outlined below. For a more comprehensive list of services covered, contact a customer support representative or visit the Kaiser Permanente website.

Treatment Type Covered Not Covered
Long-Term Residential ✔️
Residential ✔️
Inpatient ✔️
Inpatient Detox ✔️
PHP ✔️
IOP ✔️
Outpatient MAT ✔️
Dual Diagnosis Treatment ✔️

Kaiser Permanente Insurance Coverage By Treatment Type

Below are some of the most common addiction recovery services covered by Kaiser Permanente.

Kaiser Permanente Insurance Plan Types

Kaiser Permanente insurance plans are currently available in nine areas including California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington, D.C.

There are a number of plans that may work for you or your loved ones.

Types of plans include:

  • co-pay plans — Co-pay plans have no deductible and you pay for care using an easy-to-follow co-pay or coinsurance schedule. The monthly premium may be higher but the cost of care will be much lower.
  • deductible plans — Deductible plans require you to pay full charges for services until you reach the deductible amount, then you’ll pay much less.
  • catastrophic plans — These types of plans are available in some markets for people under the age of 30. They feature very high deductibles and low monthly premiums.

Individual and family plans are organized into four coverage levels, also called metal tiers. The lower premium, higher deductible plans are Bronze and Silver.

People who know that they’ll be using healthcare services throughout the year may be better off with a high premium, low deductible option such as a Gold or Platinum-tier plan.

How To Use Kaiser Permanente Insurance Coverage For Substance Abuse Treatment

To use Kaiser Permanente insurance for drug and alcohol treatment, you may need to seek a referral from a primary care provider first depending on the details of your plan.

If no referral or pre-authorization is required, you can start by checking the Kaiser Permanente website or calling customer support for help selecting an in-network treatment provider.

Once a provider has been selected, you can contact the rehab center directly and set up an intake appointment.

During the intake appointment, rehab facility staff will use your insurance information to verify coverage and break down the costs of your stay before you begin treatment.

Kaiser Permanente Co-Pays And Deductibles For Addiction Treatment

Co-pay and deductible costs will vary based on the plan and the state in which you live.

For example, if your deductible is $4,000, you would have to pay up to that amount before insurance kicks in. There may also be a fee you have to pay before you reach your deductible.

Fees may range in cost from $100 to $400 depending on the service. Co-pays and coinsurance costs are typically between 20% and 40% of this fee.

For more specifics about the co-pays, deductibles, and coinsurance rates, you can log in to your member portal on the Kaiser Permanente website.

What Addictions Does Kaiser Permanente Insurance Cover?

If you or a loved one are interested in using Kaiser Permanente for substance abuse treatment, you may be wondering what types of addictions are covered.

Addiction to substances such as cocaine, meth, opioids, illicit drugs, alcohol, and prescription medications are all covered by insurance plans through Kaiser Permanente.

Many people are battling mental health disorders such as depression or an anxiety disorder alongside addiction. Treatment for co-occurring disorders is also covered by insurance.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

If your insurance plan does not provide adequate coverage for you or a loved one to receive addiction care, there are an array of other payment options available.

There are grants, such as the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG) that can be used to cover the cost of care for people who couldn’t otherwise afford it.

Faith-based or non-profit rehab programs may provide free treatment for their services, as many of these facilities are entirely funded through donations.

Other ways to pay for addiction care include:

  • sliding fee scales that adjust based on income and family size
  • payment assistance plans
  • free rehab centers funded by the state government
  • government-funded insurance programs such as Medicare or Medicaid for addiction treatment
  • self-pay using cash or credit cards

Finding A Rehab Center That Accepts Kaiser Permanente Insurance

Kaiser Permanente understands the importance of getting prompt treatment for addiction. If you or a loved one needs help, contact the customer service line for assistance.

The Kaiser Permanente website also provides a range of resources for people seeking treatment, including a list of facilities within your network.

You can also call your doctor for a referral to a rehab center, or use the Substance Abuse and Mental Health Services Administration (SAMHSA) search tool.

If you think you’re having a substance use-related or psychiatric emergency, it’s best to call 911 or immediately go to the nearest emergency room.

Find Substance Abuse Treatment Today

Reach out to AddictionResource.net today. Our team can provide more information about drug rehab facilities that may work for you.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on November 30, 2023

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Plymouth, Massachusetts

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