Kaiser Permanente Coverage for Residential Treatment

Inpatient or residential addiction treatment facilities offer individuals a highly structured and supportive environment where they can focus solely on their recovery journey. With round-the-clock care and access to various therapeutic modalities, it provides a comprehensive approach to addressing substance abuse disorders using various types of treatment. In most cases, residential treatment is considered the gold standard in addiction treatment. Therefore, finding an inpatient rehab program Kaiser Permanente insurance covers is not difficult.

Kaiser Permanente Coverage for Outpatient Treatment

Several types of outpatient treatment make it possible for people to seek treatment to get help even though they cannot commit to an inpatient plan. Several options exist in terms of outpatient treatment in California. 

Intensive Outpatient Programs (IOP)

Intensive Outpatient Programs (IOPs) provide recovery support for individuals facing substance use or mental health issues. Participants usually attend therapy sessions multiple times per week for a set number of hours each day while residing at home or in a sober living environment. These programs focus on skill development, preventing relapse, and facilitating a smooth transition to less intensive care.

Partial Hospitalization Programs (PHP)

PHPs offer an outpatient treatment alternative that provides significant care comparable to residential settings. Participants usually attend daily sessions for a portion of the day and can return home afterward. This is often an intermediary option for those patients leaving an inpatient treatment facility and who need further mental health support. Kaiser Permanente insurance does cover PHP treatment under certain policies.

Additional Outpatient Treatment Programs 

In addition to IOP and PHP, some treatment providers offer other types of substance abuse support on an outpatient basis. For example, medication-assisted treatment (MAT) paired with individual therapy is commonly sought-out because it is an evidence-based option that can be successful. Some of these programs are also covered by Kaiser Permanente. 

Kaiser Permanente Rehab Coverage FAQs

How can I verify my Kaiser Permanente insurance benefits?

If you are looking for rehabs that take Kaiser Permanente, reach out to Solution Based Treatment at (833) 999-1941 to verify your benefits and determine which programs are covered. Oftentimes, we can het back to you within an hour with your benefit information and which treatment facilities are viable in your preferred area. You can also contact your insurer directly by calling Kaiser Permanente at (800) 488-3590 or by visiting Healthy.KaiserPermanente.org.

How much does Kaiser Permanente insurance cover?

Kaiser Permanente insurance covers different amounts depending on the insured plans. Some plans cover a set amount for so many days of treatment, while others may offer a specific out-of-pocket cost per treatment scenario. For instance, with a Bronze 60 plan through Kaiser, you have no out-of-pocket costs for an outpatient behavioral health visit. 

Do treatment centers need to be In-Network?

Kaiser Permanente offers several different plans, and some do cover some out-of-network providers, while others do not. For example, if you have the Platinum 90 plan, out-of-network providers are not covered at all. In most cases, plans will not cover as much of the fees for an out-of-network treatment center, but some costs will be covered. 

Can you get a single case agreement with Kaiser Permanente?

Kaiser Permanente may offer single-case agreements for substance abuse treatment, which allows individuals to receive coverage for treatment at specific facilities outside the network. These agreements are negotiated on a case-by-case basis between the insurer and the treatment provider, when there is significant need to access care not within Kaiser Permanente’s network.

How is a Kaiser Permanente HMO different from a PPO?

Kaiser Permanente’s HMO (Health Maintenance Organization) necessitates choosing a primary care physician and obtaining referrals for specialized care. On the other hand, its PPO (Preferred Provider Organization) option offers more flexibility, enabling members to access healthcare from in-network or out-of-network providers without referrals.

Does Kaiser Permanente cover drug and alcohol rehab?

Yes. All of Kaiser Permanente’s plans cover mental health and drug rehab to some extent. Therefore, you should have no problems finding a rehab program that takes Kaiser Permanente insurance to help you pay for treatment. 

Does Kaiser Permanente cover outpatient addiction treatment?

Yes, depending on which Kaiser Permanente plan you have, your policy should cover certain types of outpatient treatment. Be sure to consult your policy specifically to determine how much and what types of treatment are covered. 

Does Kaiser Permanente cover inpatient mental health?

All modern insurance companies now take inpatient mental health treatment programs more seriously and provide coverage for most programs. Kaiser Permanente offers good coverage if you determine you need residential treatment. 

How do I pay for costs not covered by Kaiser Permanente insurance?

When you decide to seek treatment for addiction, not finding rehabs that accept Kaiser Permanente can be disheartening. However, there are other options available to cover the costs of your treatment plans, such as securing private funding, government assistance programs, and working with treatment centers to create a payment plan.