Kaiser Insurance for Eating Disorders

Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are dangerous and potentially deadly conditions. If you or a loved one are struggling with an eating disorder, it’s imperative to get help.

These conditions generally don’t go away independently and often worsen with time. However, finding appropriate treatment can be a stressful and confusing experience in itself.

If you or a spouse has Kaiser Permanente health insurance, you may have a number of options for seeking help.

How Does Kaiser Insurance Work?

Kaiser Permanente is an HMO, a type of health insurance system that generally limits coverage to doctors and programs within its network. Outside doctors or treatments are usually not covered, even with a referral, except in an emergency. Members must have Kaiser insurance to be treated at Kaiser facilities.

That being said, Kaiser has a robust and inclusive offering of services, from outpatient to hospital-based care. The company has locations in several states, including: (1)

California
Colorado
Georgia
Hawaii
Maryland
Oregon
Washington

These locations may include medical offices, labs, offices for specialists, pharmacies, and hospitals, among other services. If you or one of your family members has Kaiser Permanente insurance, you can utilize any of these facilities and expect your treatment to be covered.

Is There a Kaiser Eating Disorder Program?

Among its network, Kaiser Permanente works with many doctors and specialists who can treat eating disorders and other behavioral health issues.

Kaiser members don’t need a referral to see behavioral health specialists. They can schedule an appointment directly with the physician they want to work with. (3) However, prior authorization will be needed to obtain coverage for higher-level care programs, including: (3)

Inpatient care
Residential treatment
Partial hospitalization programs
Intensive outpatient care

If you or a loved one are struggling with an eating disorder, you should see a mental health specialist first for an analysis or diagnosis and advice on the next best steps.

Kaiser also offers several programs for helping with common eating disorders. (2) Details on the programs, where/when they’re offered, and whether/how much coverage is available are specific to location and the details of your policy, but you can find the list of currently available programs by searching for “eating disorders” on Kaiser’s website and then clicking the tab for “Programs & Classes.”

How to Check if Your Treatment is Covered by Kaiser

Checking to see if your treatment is covered by Kaiser is simple, thanks to the company’s HMO structure.

In nearly every case, your treatment will be covered so long as you remain within the Kaiser network of doctors, programs, and specialists. If you seek help outside of these programs, it will most likely not be covered.

Still, every plan and program is different. If you’re considering going out-of-network for eating disorder care, ask the program directly if they work with Kaiser Permanente. And even if you’re staying in-network, it’s important to check how much coverage you can expect.

Different plans offer different co-pays, deductibles, and other coverage details and incentives. For more specific questions, you can check directly with your policy or call a Kaiser representative.

What if Your Treatment Isn’t Covered?

While Kaiser offers a range of doctors, programs, and specialists, you may find a program or care provider outside of the network that you prefer to work with. In these cases, Kaiser likely won’t cover your care, but you should still check with the program directly.

Many eating disorder programs offer other forms of help, including financial aid or payment schedules. They often have employees dedicated to helping patients organize and understand their insurance and payment options.

If there’s a specific program you’re interested in working with that is outside the Kaiser network, you should call them directly and ask about your options.

How to Find Help for an Eating Disorder

Eating disorders are serious mental health conditions that generally get worse when left untreated. It’s very important to seek help if you or a loved one are struggling.

To enroll in a Kaiser eating disorder program, you must first have Kaiser Permanente health insurance. The next step is getting evaluated for an eating disorder.

You can ask to be scheduled directly with a mental health specialist or stick with your primary care physician if you prefer. However, an official diagnosis is often needed to enroll in an eating disorder program or higher form of care.

Once diagnosed, you can work with your doctor to develop a treatment plan. This should address not only any disordered eating habits you’re struggling with but also account for any additional mental health concerns, including depression or anxiety.

The team at Kaiser should help guide you through the rest of the process, and they should be able to answer any additional questions you may have about ongoing insurance coverage.

Resources

Fast Facts. (n.d.) Kaiser Permanente. Accessed March 2024.
Eating Disorders. (n.d.) Kaiser Permanente. Accessed March 2024.
Behavioral Health Services. (n.d.) Kaiser Permanente. Accessed March 2024.

Published on May 24, 2024, on EatingDisorderHope.com