Many people suffering from addiction also experience financial difficulties. They may find it hard to perform well at work and prioritize spending on drugs or alcohol. If they decide to enter treatment, it may be difficult to find the money to pay for it.
Many health insurance plans offer coverage for substance abuse treatment. Kaiser Permanente can help make recovery possible by covering a significant portion of addiction treatment costs.
Kaiser Permanente Drug And Alcohol Rehab Coverage
All Kaiser Permanente health plans offer mental health and substance abuse coverage. This may include medically-assisted detoxification, outpatient care for chemical dependency, and inpatient drug and alcohol rehabilitation programs.
The 2008 Mental Health Parity and Addiction Equity Act ensures that mental health and substance abuse services are now covered to the same extent as medical services. For example, if an individual plan covers a certain percentage of a hospital stay, it will cover the same percentage of an inpatient rehab program. The rule also applies to the number of visits covered and requirements for treatment authorization.
Someone without insurance can get a Kaiser Permanente plan even if they already suffer from a substance use disorder. The Affordable Care Act protects people with pre-existing conditions from being denied insurance or overcharged.
How Much Will Addiction Treatment Cost With Kaiser Permanente?
The percentage of healthcare a person pays for out-of-pocket depends on their insurance plan. Some plans offer lower monthly premiums with higher deductibles and higher out-of-pocket costs, while others cost more per month but require lower payments for covered services.
Kaiser Permanente plans can be purchased through the Health Insurance Marketplace. All healthcare exchange plans charge premiums based on income and family size. They also offer federal financial assistance for out-of-pocket costs.
While the percentage of coverage is determined by health insurance, the actual cost of drug or alcohol rehab programs depends on the rehab center. A luxury rehab facility is more expensive, due to amenities and variety of treatment types offered, and will require a person to pay more out-of-pocket.
If a drug rehab program costs $10,000 and 60 percent of it is covered by a Kaiser Permanente plan, the patient will owe $4,000. If a program costs $40,000, the same percentage will be covered, but the remaining cost will be much higher, at $16,000. This is an important factor to consider when searching for quality and affordable care.
Will My Insurance Pay For
Drug And Alcohol Rehab Services Covered With Kaiser Permanente
Medically-assisted detox programs in an approved hospital setting are covered by Kaiser Permanente. This includes room and board, education, counseling, and other recovery services. With some plans, the copayment for this service is $250 per day with a maximum of $1250 per stay.
Outpatient substance abuse services, such as day-treatment, individual and group counseling, and medical treatment for withdrawal symptoms, are also covered. The copayment for individual treatment may be as low as $20 per visit and $5 per visit for group treatment.
Coverage may include residential rehab treatment in an approved non-medical environment. Some plans require a $100 copay per admission. This applies to transitional recovery services. Long-term residential stays may not be covered.
Each individual plan is different. Contacting Kaiser Permanente will provide the best understanding of personal drug and alcohol rehab coverage.
Does The Rehab Center Have To Be In-Network For Kaiser Permanente Coverage?
Kaiser Permanente offers in-network coverage in nine states: California, Colorado, Georgia, Hawaii, Oregon, Washington, Maryland, Ohio, and Virginia. It also covers Washington, D.C.
Only certain regions are considered in-network, and these offer the best coverage. An employer may provide group plan options for discounted care out-of-network, though these require more out-of-pocket payment for services. Group plan options include:
- Preferred Provider Organization (PPO): This plan offers out-of-network coverage through Private Healthcare Systems (PHCS). It allows people outside of a Kaiser Permanente region to still find care at a reduced cost.
- Out-of-Area: This plan also allows a person to choose from a PHCS network.
- Point-of-Service (POS): This plan combines a health maintenance organization (HMO) plan with a PPO plan to offer flexibility. With this option, a person can choose from three tiers of coverage to stay in-network, choose a PHCS provider, or go out-of-network for care.
- Customer-Directed Health Plan: This allows employees to choose a tax-free health savings account (HSA) or flexible savings account (FSA) to pay for healthcare costs. An employer may also provide funds to employees in a Health Reimbursement Arrangement (HRA).
Many individual plans are HMOs, which require a member to choose from a list of approved doctors or facilities in order to receive coverage. Other plans will still cover part of the cost of treatment when a person goes out-of-network.
How To Find Kaiser Permanente Coverage
Many drug and alcohol rehab centers accept Kaiser Permanente. When a person begins seeking addiction treatment options, it may be helpful for them to talk to a medical professional to determine the best course of treatment before deciding on a facility.
Kaiser Permanente offers individual assessments that can help people determine what services they need. Treatment options can range from early intervention (determining a person’s level of dependency on an addictive substance) to a long-term inpatient stay. Behavioral therapy and counseling will likely be part of the healing process.
Kaiser Permanente representatives can explain which services are covered and to what extent under an individual’s policy. With this information paired with an outlined recovery plan, a person can make an informed decision on choosing a rehab center that best fits their treatment needs and financial circumstances.
For more information on drug and alcohol rehabs that accept Kaiser Permanente, contact us today.