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Kaiser Permanente Coverage for Alcohol Rehab

Kaiser Permanente, one of the leading healthcare providers and nonprofit health plans in the United States, provides an array of solutions aimed at improving physical and behavioral health.1 Kaiser Permanente members receive healthcare guided by a team of Permanente Medical Group physicians, specialists, and caregivers. 1 These healthcare workers are supported by technological advances and tools for health solutions, disease prevention, state-of-the-art care delivery, and chronic disease management. 1
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Where Takes Kaiser Permanente Insurance?

Founded in 1945, Kaiser currently serves 12.4 million members in 8 states plus the District of Columbia.1 Coverage areas are separated into regions as follows: 2

  • Northern California.
  • Southern California.
  • Washington (central Washington, Eastern Washington, Coastal and Olympic Region, and Puget Sound).
  • Colorado (Denver, Boulder, Colorado Springs, Fort Collins, Greeley, Loveland, and Pueblo.
  • Georgia (Atlanta and Athens).
  • Hawaii (Kauai, Hawaii, Maui, Oahu).
  • Mid-Atlantic States (Washington, D.C. and Baltimore, northern Virginia, and suburban Maryland).
  • Northwest (Portland, Eugene, and Salem, Oregon; Vancouver and Longview/Kelso, Washington).

Kaiser Permanente Insurance Plans and Coverage Levels

Kaiser Permanente offers a wide variety of group, individual, family, and Medicaid and Medicare plans.3

Kaiser Permanente Group Insurance Plans

Group plans are typically offered through your employer and may include:3,10,11

  • Traditional or deductible plans: Often referred to as HMO plans, you pay certain service fees, such as co-pays, until you meet your deductible, and you typically have an out-of-pocket annual maximum amount.
  • Preferred provider organization (PPO) plans: PPOs let you use out-of-network providers without referrals, though in-network coverage costs less.
  • Point-of-service (POS) plans: A combination of HMO and PPO plans, this type of plan lets you use in-network providers and network-contracted providers for lower costs, or you can pay more for out-of-network providers.
  • Out-of-area plans: If you live outside a Kaiser area, this plan lets you get treatment with out-of-network providers without a referral. Preventative services are typically fully covered, and other services may be subject to cost-sharing or a deductible amount.
  • Consumer-directed health plans: Several options are available, including a health reimbursement account (HRA), health savings account (HSA), and a flexible savings account (FSA).

Individual and Family Insurance Plans

These are plans you can sign up for on your own. These plans are offered in bronze, silver, gold, and platinum levels, depending on where you live. In general, Kaiser offers the following types of individual and family plans:3

  • Deductible plans: The same type of HMO plans that are offered at the group level, where you pay certain fees until you meet your deductible. It usually completely covers preventive services.
  • Co-pay plans: Covers preventative services, and there is no deductible amount for these services, though they are subject to a co-pay for office visits and other services.
  • Health savings account (HSA) plans: These plans have a combined pharmacy and medical cost deductible, and all costs are out of pocket until you reach your deductible.
  • Deductible catastrophic: This plan covers up to 3 doctor visits per year for those with financial hardship or who are younger than 30.

Medicaid and Medicare Plans

  • Medicaid/Medi-Cal Plans: Kaiser works with Medicaid, a federal and state health program, to provide insurance to people with low income and limited resources. 4
  • Medicare Plans: Kaiser’s Medicare plan offers Parts A, B, and D.5

Will Insurance Pay for Treatment?

Yes, Kaiser Permanente covers alcohol addiction treatment within all their healthcare plans sold in the Marketplace.6 As a member, you will have access to preventative resources, treatment for alcoholism, and aftercare services. Kaiser ensures individuals will have the tools necessary to transition back to their everyday lives once treatment is complete.6

Types of Alcohol Rehab Programs Kaiser Permanente May Cover

Treatment for substance use disorders involves various levels of care such as:

Sometimes individuals will move in between levels of care (step up or down to different levels) depending on their current needs.

Since coverage, plans, and conditions may change, it’s best to check with an insurance advisor for the full details. For example, one plan requires an out-of-pocket cost of $600/day up to 5 days, and then after that, there is no charge for inpatient treatment.7 For outpatient treatment, one plan requires the individual to pay $30 for each visit or $30 each day for services.7 Most plans also have a maximum out-of-pocket limit per year and often vary greatly, some with max limits of $5,000, $10,000 or greater.

Does Kaiser Permanente Cover Mental Health?

Additionally, mental health disorders such as PTSD, anxiety and depression often co-occur with substance use disorders.8 Effective treatment suggests that addressing both the mental health and substance abuse issues together offers improved outcomes.

When seeking treatment for co-occurring conditions, check the specifics of your plan to see exactly how the charges will apply or speak with your insurance provider.

How to Check My Kaiser Permanente Health Insurance Coverage

If you want to check your Kaiser Permanente coverage, you’ll have to register for an online account first. To do so, follow these steps: 9

  • Go to the Kaiser Permanente Registration website here.
  • Select Create my Account.
  • Fill out the information about yourself and select Continue.
  • Be sure you have your medical record number available.
  • Once you’ve finished and selected a user ID and password, you can return to the main website to sign in.

To find out the details about your coverage after you’ve signed in, follow these steps: 9

  • Select Coverage & Costs from the options listed.
  • Under the Plan Ahead option, select Eligibility and Benefits.
  • Now, you can review your eligibility information and see your coverage effectiveness and termination dates.

Additionally, you can call the Kaiser authorization phone number on your card. Alcohol.org is a subsidiary of American Addiction Centers (AAC), a nationwide provider of addiction treatment centers.

Kaiser Permanente Out-of-Pocket Costs

In the instance that not all costs are covered, you may be required to pay a portion of treatment costs out-of-pocket. These costs can vary but some alcohol rehab centers may offer assistance in the following ways to cover payment:

  • Payment plans: Some centers may offer payment plans in which the total cost is spread across a designated number of months and paid in regular payment installments. Be sure to ask about interest rates and the additional fine print of these plans.
  • Sliding fee scale: Some programs may base costs off of an individual’s income by offering a sliding scale. That means, if you make less money, you will have lower costs.
  • Scholarships: Some scholarships may be available to cover some or all of the cost of treatment.

You can discuss payment options with a rehab intake coordinator for further assistance or call AAC’s admissions counselors to discuss ways to pay for alcohol treatment.

Verify Your Kaiser Permanente Coverage for Alcohol Rehab

If you’re ready to seek treatment or want to discuss your options, you can easily verify your insurance below or call our admissions navigators at to learn more. We are available 24/7 to speak with you about treatment and all calls are 100% confidential. There is no obligation to make any decisions today; we’re here to provide support and guidance so that you have all the resources necessary to make the decision when you’re ready.

Sources

  1. Kaiser Permanente. (N.D.). Who We Are.
  2. Kaiser Permanente. (2020). Fast Facts.
  3. Kaiser Permanente. (2021). Shop Kaiser Permanente Healthcare Plans.
  4. Kaiser Permanente. (2021). Learn about Your Medi-Cal/Medicaid Options.
  5. Kaiser Permanente. (2020). Medicare health plans.
  6. Kaiser Permanente. (2021). Addiction and Recovery.
  7. Kaiser Permanente. (2020). Summary of Benefits and Coverage.
  8. National Institute on Drug Abuse. (2020). Common Comorbidities with Substance Use Disorders Research Report.
  9. Kaiser Permanente. (2021). Understanding my coverage.
  10. Kaiser Permanente. (n.d.). PPO, point-of-service, and out-of-area plans.
  11. Kaiser Permanente. (n.d.). Consumer-directed health care.
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