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Kaiser Insurance

When you or a loved one suffers from a substance use disorder, overcoming the barriers to treatment can be daunting. The stigma of addiction is not merely social. It can also be part of the medical and insurance industries.

But the idea of getting treatment for addiction may cause questions to arise in your mind. Will insurance cover your treatment? Will the schedule of inpatient or outpatient rehabilitation be compatible with your employment? Do you have to disclose your substance use disorder to your employer? Can your employer terminate you for disclosing?

This guide answers these questions in a way that gives you information, essential steps, and hope. You are not alone. You can find an addiction treatment program that works for you right here at Free by the Sea. If you’re looking to learn more about how Kaiser Permanente insurance works in regards to addiction rehab payment, we can help!

About Kaiser

When it comes to getting treatment using insurance, it’s important to know as much as possible regarding your coverage options. Kaiser Permanente offers health insurance to many; their plans include options for individuals and families. This insurance provider offers coverage for mental and behavioral health services. So, those who suffer from mental health concerns or behavioral health disorders (such as addiction) may find that Kaiser will provide at least a portion of coverage for treatment.

According to a 2017 report, Kaiser Permanente received 39 number 1 rankings in National Committee for Quality Assurance (NCQA) quality measures. The same report states that Kaiser had 11.8 million members, 211,000 employees, 22,000 physicians, and 682 medical offices and other facilities.

Kaiser Permanente offers coverage to the following areas:

  • Washington
  • Oregon
  • Colorado
  • California
  • Hawaii
  • Georgia
  • Virginia
  • Maryland

Free by the Sea is located in the state of Washington and offers services to those in Oregon. So, we are ready and willing to assist those who have Kaiser insurance plans.

Will My Kaiser Insurance Cover My Treatment for a Substance Use Disorder Treatment?

The short answer is “yes,” although there are some conditions. Insurance policies do not always provide full coverage, and they may not cover some forms of treatment at all. In other words, you may be responsible for some of the costs of treatment. The important thing is to look at your policy closely.

The longer answer is that most policies will cover most conventional substance abuse treatments, at least in part. This is not just because the Affordable Care Act mandates it. Health insurers will often consider it in their best interest to provide full or partial coverage for treatment. Why? Because it helps prevent later insurance claims based on the health effects of long-term drug and alcohol use.

Types of Substance Use Treatment That May be Covered

Before you can determine what your insurance covers, you need to know all your options. This list is not exhaustive, but it does explain the most common types of treatment cover by the majority of insurance plans.

Medical Detoxification

For some substances, the withdrawal period can painful or even life-threatening. Medical drug and alcohol detoxification (or detox) is a service that uses medication, a controlled environment, and close monitoring to help you through withdrawal symptoms. When you speak with your doctor about treatment, you should always ask if the substance you were using requires detox.

Drug and Alcohol Counseling

Psychotherapy is a tested and true method for substance use recovery. It can be a series of one-on-one sessions, family therapy, or group therapy made up of a mental health professional and others with substance use disorders. Like many other treatment courses, therapy is completely confidential under the law.

Inpatient Rehabilitation (Rehab)

Many people are intimidated by the idea of rehab. However, you should understand that it is designed to help you get on the road to recovery quickly. Rehab usually takes place in a peaceful, secluded, and discreet environment. The time period of your stay is usually 30-60 days. Rehab centers offer a variety of programs, from AA and NA to detox, counseling, meditation, and many holistic therapies. Rehab gives you the time and space to reflect and begin your recovery in the best possible environment.

Outpatient Addiction Treatment Services

For some, “rehab” is a scary word, because it can mean you are away from your job and might not get paid. There is also the social stigma of “going to rehab.” However, there are now discreet outpatient programs through hospitals and rehab centers that can accommodate your work schedule. Evening counseling, group therapy, and Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are often a part of this outpatient system (see below).

Other Options

Some individuals may consider joining Alcoholics Anonymous and Narcotics Anonymous meetings. Both organizations are based on the 12-Step Program. They are completely confidential, hence the names. They also have a few benefits. They are free and take place in many discreet locations at a variety of times. It is hard not to find a program at the right time near you. While AA and NA are free and therefore not covered by insurance, they often make up part of the treatment your insurance company covers.

Know Your Rights

Understanding your rights is vital as you prepare to seek treatment for substance use. In order to ensure those rights, you must have a diagnosis. Before that can happen, you must first admit there is a problem and seek help.

Once you are past that first stage, you will require a diagnosis to receive treatment. This can be done by a primary care doctor, psychiatrist, psychologist, or a licensed drug and alcohol counselor. Next, you will need to select your type of treatment. You will find them below in detail in the “Types of Substance Use Treatment” section).

These are the steps you need to take at this point:

  1. Once you are ready to accept that you have a problem, talk with your doctor.
  2. If you are diagnosed with a substance use disorder, you can then begin discussing treatment options with your doctor.
  3. Consider whether to inform your place of employment that you will need time off for treatment.
  4. Find out what types of treatment are available and affordable for you.

Even after you have taken these steps, you may still have many questions. Below you will find answers to some common questions about substance abuse, the law, treatment options, and insurance coverage.

What are my rights as an employee?

If you suffer from a substance use disorder but are no longer actively taking the substance, you are already on the road to recovery. It is illegal for your employer to fire you for simply having a substance use disorder. However, if you are under the influence in the workplace, while driving a company vehicle, or out on company business, they can terminate you.

Whether you disclose to your employer is entirely up to you. However, under federal and state laws, you do not have to disclose any diagnosis, such as a disability, to your employer, unless you request sick time, need employee health insurance coverage, or to determine your eligibility for worker’s compensation.

When seeking treatment while employed, several laws protect you. These include the Family and Medical Leave Act of 1993. This law states an employer cannot terminate you simply for having a substance use disorder. Under this law, you can take medical leave for substance use treatment.

However, you cannot take leave and continue drug or alcohol use while doing so. Your employer cannot act against you for taking medical leave to seek treatment. To keep these protections in place, a medical professional or referred program or treatment center must treat you for substance use throughout this time.

The Americans with Disabilities Act (ADA)of 1990 also protects you from discrimination based on a substance use disorder. Again, this is on the condition that you are not engaging in illegal drug or alcohol use at the time. You are also protected because substance use disorders qualify as disabilities under the law.

Your Payment Responsibilities

Again, this depends upon the type of insurance plan you have. The best way to figure this out is by asking us here at Free by the Sea. We can work to provide you with cost estimates before you begin treatment. Taking those first steps are vital to this process.

The Affordable Care Act adds to laws like the Mental Health Parity and Addiction Equity Act (2008). These laws require insurance providers to offer treatment coverage that is monetarily equal to and accessible as coverage for medical or surgical treatments.

While these laws have helped many Americans get on the road to recovery, they do not specify exactly what qualifies as substance use treatment. This means you must ask, either by contacting your insurer directly or by requesting your treatment center do so. This allows you to go into treatment with a clear estimate of your out-of-pocket costs.

Once you make the choice to seek help for a substance use disorder, you begin to reclaim your life. No matter how difficult it may seem, we are here to offer you the resources and guidance you need.

You no longer have to fight alone. Free by the Sea is ready to help you fight substance abuse and overcome it for good. Please contact us today. Let us walk you through this new and healthy chapter of your life!

Resources:

https://healthy.kaiserpermanente.org/health/care/!ut/p/a0/FchNDsIgEEDhs3iAyUBVLO5oUy7gQmE3IaQQ-Qshnt929fI-tPhBW-gXdxqxFkrHG-fL8P2Zj1CC4CmNgG-0aL_t5am7gIaSq6GmE1unPROaUsGRC_406iO65NGIO-NSMAGaTzfgfGMg1WMDreQyr1xOmi3Ycp6vWV3-QSk0hg!!/

https://healthy.kaiserpermanente.org/static/health/annual_reports/kp_annualreport_2017/#/numbers

https://about.kaiserpermanente.org/who-we-are/fast-facts

https://www.ncbi.nlm.nih.gov/books/NBK384923/

https://webapps.dol.gov/elaws/whd/fmla/10c9.aspx

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