Last Updated on November 21, 2021 by Ben Lesser
Most patients and families use Kaiser Permanente health insurance first when paying for drug and alcohol dependence or addiction. According to the Affordable Care Act, addiction recovery programs are among the ten essential services that all health insurance plans would provide to customers. Customers of Kaiser Permanente can choose from various treatment services for drug abuse and addiction.
When a drug use disorder is diagnosed, Kaiser Permanente covers various treatment options. Their health plans will cover anything from outpatient therapy to in-home care. They suggest that the following factors should be considered when deciding which recovery programs or program type would be most effective:
- The seriousness of the addiction
- Symptoms or diseases of Mental health
- Family members are willing to help
- At home, you have Privacy and Security
- To cover the expense, there are payment resources available
What Is Kaiser Permanente?
Kaiser Permanente is a top-tier, not-for-profit health plan service and healthcare provider, with 11.8 million members, approximately 22,000 doctors, 57,000 nurses, 39 hospitals, and 682 medical offices and other facilities in 2017. Individuals who live in a Kaiser Permanente coverage area and have a Kaiser Permanente healthcare plan can choose a Kaiser Permanente healthcare provider and change doctors at any time by going to kp.org. Appointments can be made over the phone or online.
Kaiser provides behavioural health services. Most policies provide participants with direct access to mental and behavioural health care and chemical dependency treatment without the need for a referral from a primary care physician. Members should contact the Mental Health Access Unit to arrange behavioural health care independently, as they can do for other plans. Non-urgent health issues can be communicated with a doctor’s office by email; test reports can be accessed online; medications can be refilled online; and nurses are available for medical advice 24 hours a day, seven days a week.
Kaiser Permanente has a strong reputation for delivering high-quality, professional, and accessible healthcare to as many people as possible. Kaiser provides group health insurance to businesses and private health insurance to families and individuals. The organization also offers Medicare benefits to those that are 65 years old or have a disability that qualifies them for the program. Kaiser Permanente is a primary healthcare provider in the United States, with coverage in eight states (Washington, Oregon, Colorado, California, Hawaii, Georgia, Virginia, and Maryland) and the District of Columbia.
How to Use Kaiser Permanente Coverage for Rehab
Inpatient recovery coverage is prevalent among Kaiser members. Individuals who live in a Kaiser Permanente service area and have a Kaiser Permanente healthcare plan can select a Kaiser Permanente healthcare provider and change doctors at any time by going to kp.org. Appointments may be taken over the phone or online. Non-urgent health issues can be communicated with a doctor’s office by email; test reports can be accessed online; medications can be refilled online; and nurses are available for medical advice 24 hours a day, seven days a week.
An initial meeting and discussion with your primary care provider is always the first step in finding treatment for substance abuse or dependence problem. Individuals can schedule this meeting or appointment with the doctor’s office by calling, going online, or sending an email. A primary care physician may refer or approve individuals for additional treatment based on medical necessity.
After an initial assessment, a primary care physician (PCP) may refer or approve individuals for further treatment in a specialist substance abuse treatment facility, depending on medical necessity. Professionals who understand the nuances of benefits and how to help people use their policies to pay for care are familiar with drug and alcohol treatment centres.
Kaiser Permanente Drug and Alcohol Treatment Center
Since mental health care and substance use disorder (SUD) are among the ten basic health benefits that all Marketplace plans must cover, all Kaiser Permanente health plans sold in the Marketplace provide some addiction treatment coverage. Besides, the Mental Health Parity and Addiction Equity Act (MHPAEA) mandates that any plans and insurance issuers that offer healthcare coverage for substance use disorders or mental health not limit those benefits in any way that makes them less valuable than medical/surgical services. This legislation will affect your Kaiser Permanente medical plan.
Different levels of coverage are available for Kaiser Permanente packages. Medication for substance abuse disorders can take several forms, including inpatient treatment, acute outpatient, and outpatient. Contact Kaiser Permanente to know more about each plan, including what care levels are covered.
Often double-check that the program or provider you’re thinking of using supports your Kaiser Permanente contract.
Outside of the State Coverage by Kaiser Permanente
As of 2019, Kaiser Permanente provides care in eight states and Washington, D.C.:
- Washington, D.C
With a few exceptions, chemical dependency and mental health care must be delivered in the same way they would when you’re in your own Kaiser Permanente service area. There’s a chance you’ll need a recommendation. It’s uncertain if this policy would protect people who travel to a non-local hospital-based care centre on purpose. Call Kaiser Permanente’s “Away from Home Travel Phone” to conduct a search and obtain all relevant information.” Check to see if the policy or insurer you’re considering supports the insurance.
How can you Find out If a Rehab Centre Accepts Kaiser Permanente Insurance?
It can be easy to understand insurance plans, copays, and where a particular plan’s coverage starts and finishes. It’s critical for policyholders who want to know if a rehab centre accepts their Kaiser insurance policy to contact Kaiser insurance to find out which rehab centres are in-network. Policyholders may also inquire directly with the treatment facility they wish to join.
A qualified recovery centre and mental health facility will provide you with the treatment you need if you or a loved one deals with opioid abuse and mental health condition symptoms. Please contact Windward Way today to learn more about their robust opioid and mental health treatment services.
What to Expect from Kaiser Rehab
Kaiser covers Centre-based programs and outpatient chemical dependency treatment, and mental health care. Members can contact their insurance provider to find out when they can get service. Intensive Outpatient Programs (IOP), acute care services, and case management services are some of the substance abuse treatment options available. Many benefits do not have lifetime or annual coverage maximums for mental health or substance abuse care.
Suppose a Kaiser insurance plan member wants to be covered at the In-Network benefit level. In that case, the services must be Clinically Necessary and provided by an In-Network facility or care provider. While a referral from a primary care provider isn’t required in most cases for covered services, preauthorization is required. Also, Kaiser participants can meet their In-Network Out-of-Pocket Minimums using covered in-network mental health and drug use programs. Acute inpatient, residential treatment, and detoxification services are all considered inpatient treatments by Kaiser.
Types of Treatment Services that are Provided
Depending on the patient’s needs and the type of policy they have, Kaiser Permanente can cover any of the following forms of drug recovery programs:
- Care is Given on An Outpatient Basis: Outpatient care for addiction may include various services provided in a clinic, a therapist’s office, or a hospital and is thus protected in part by Kaiser Permanente. Although they are still resolving day-to-day stressors that may or may not be reasons for drug abuse, some patients may struggle to remain safe and sober when they are not actively in a recovery session or get to treatment sessions frequently on time. This type of treatment has several advantages, including scheduling flexibility and cost savings.
- Outpatient Care is Intensive: Intensive outpatient therapy is much more thorough than regular outpatient therapy. Intensive outpatient treatment services typically consist of 10 to 20 hours of rehabilitation treatments spread out over three to five days of the week, while standard outpatient treatment typically consists of just a few sessions per week. Some services require patients to attend six to eight hours per day, seven days a week. Intensive outpatient treatment is an excellent option for people who need a lot of help but don’t think residential care is right for them.
- Care in a Residential Facility: Inpatient drug recovery programs offer round-the-clock services, making them the most extensive choice for those looking to conquer a substance abuse problem. Continuous monitoring reduces the risk of relapse and allows for a greater emphasis on clinical development and rehabilitation. Patients often benefit from a break from the stressors that come with a life characterized by family relationships, employment, and other obligations. Instead, feeling better is the prime goal of inpatient care every day.
The Next Step After Health Insurance
Few health insurance policies cover the total cost of drug addiction treatment, and Kaiser Permanente is no exception. Copays, deductibles, and care preauthorization may be required to provide coverage for a portion of the cost. The remainder will be paid out of the patient’s pocket.
In the Majority of Cases, Families Choose to Raise Funds by Using Services Such As:
- Individual Savings
- Loans from family
- Financing on credit
Contact us today by calling our toll free number 615-490-9376 to learn more about how you and your family can get Kaiser Permanente health insurance.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. He is a freelance medical writer specializing in creating content to improve public awareness of health topics. We are honored to have Ben writing exclusively for Dualdiagnosis.org.