Kaiser Rehab Coverage

Kaiser Permanente is a health insurance provider with individual and family plans. With Kaiser, members can choose from doctors including adult medicine and internal medicine, family medicine and pediatrics. There are also preventative screenings and services offered at no cost, and the company features resources to promote health and wellness.

Also, Kaiser provides mental health and behavioral coverage that may include some or all of the costs of rehab and treatment for substance use disorders.

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Does Kaiser Have Rehab Coverage?

Some of the specific regions where Kaiser Permanente health insurance coverage is offered include:

  • N. California
  • S. California
  • Colorado
  • Hawaii
  • Md./Va./D.C.
  • Oregon/Washington

For people in these regions who are members of Kaiser, there are benefits related to treatment for substance abuse. Specifics, such as how much of the cost of an inpatient or outpatient rehab program would be covered vary based on the state where the insurance is issued.

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Kaiser Mental Health

Kaiser Permanent insurance covers most mental health services. Many of the Kaiser in-network medical providers offer behavioral health treatment to address issues like depression, sleep problems, mood disorders and relationship problems.

Is Kaiser Mental Health Covered By Insurance?

Kaiser mental health is covered by insurance. The approach at Kaiser is one focused on the concept that mental and physical health are intertwined with one another. Mental health services include psychiatric care for adults, adolescents, and children.

Psychiatric and mental health services that may be covered by Kaiser can include provisions from not just psychiatrists, but also psychologists, social workers, and marriage-family therapists.

Kaiser Behavioral Health

Kaiser offers behavioral health services, and with most policies members have direct access not only to mental and behavioral health care but also chemical dependency services, without a referral from a Primary Care Physician. If members want to arrange behavioral health services independently, with most plans, they can do so by contacting the Behavioral Health Access Unit.

Kaiser Behavioral Health Covered by Insurance?

Kaiser Permanente is one of the insurance companies offering products on state exchanges, created through the Affordable Care Act. That is an important component of understanding behavioral health coverage because the law requires companies selling products through the exchanges offer mental and behavioral health as an essential covered benefit.

For certain policies, such as plans offered to residents of California, there is no annual benefit maximum for mental health or substance abuse coverage. There are also no lifetime benefit maximums for mental health or substance abuse, and there is no copay for routine outpatient visits related to mental health or substance use. Also, with certain Kaiser plans, there is no copay for a certain number of non-routine outpatient visits related to behavioral health. For inpatient behavioral health services, there may be a copay per admission.

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What To Expect From Kaiser for Rehab

Kaiser coverage does include center-based services, in addition to outpatient chemical dependency treatment and mental health care. Members should contact the insurance company to determine where they may be able to obtain service.

Some of the substance abuse treatment options available include Intensive Outpatient Programs (IOP), acute care services, case management services, and also with many plans, there aren’t lifetime benefit maximums or annual benefit maximums for mental health or substance abuse care.

However, if someone with a Kaiser insurance plan wants to be covered at the In-Network benefit level, the services must be Clinically Necessary, in addition to being covered by an In-Network facility or care provider.

For covered services, while a referral from a primary care provider isn’t required in most cases, there are requirements for preauthorization. Also, Kaiser members can use covered in-network mental health and substance use services to meet their In-Network Out-of-Pocket Minimums. Kaiser defines inpatient treatments as acute inpatient, residential treatment, and detoxification services.

Popular Locations for Kaiser:

  • Kaiser Foundation Health Plan of Colorado
  • Kaiser Foundation Health Plan of Georgia
  • Kaiser Foundation Health Plan of Northern California
  • Kaiser Foundation Health Plan of Ohio
  • Kaiser Foundation Health Plan of Southern California
  • Kaiser Foundation Health Plan of the Mid-Atlantic
  • Kaiser Foundation Health Plan of the NW
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.