Aetna Health Insurance Coverage for Addiction Treatment

Using Aetna Health Insurance Coverage to pay for addiction treatment: There are many drug and alcohol treatment centers that accept Aetna insurance. Depending on your plan and the treatment provider that you choose will determine what Aetna will cover. With so many addiction rehab centers that accept Aetna insurance, it is best to know exactly what your coverage will pay before deciding which program to choose for your recovery. Some rehabs we work with are in-network with many providers including Aetna, which means that your treatment may be fully covered or partially covered depending on your insurance plan. You can also call us to find out if there are any drug rehab centers nearby that take Aetna Insurance. Most insurance plans will cover drug and alcohol rehab treatment programs. When the Affordable Care Act was passed, it helped more Americans have access to most forms of addiction treatment. If you would like to find out more about drug rehab programs near you, give us a call and we can get your insurance verified today. 

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What you will learn:

• How to use Aetna insurance for drug or alcohol rehabilitation
• Will Aetna insurance cover mental health and substance abuse treatment?
• Types of treatment covered by Aetna
• Does Aetna Cover outpatient rehab?
• Does Aetna cover therapy programs?
• How to know what your plan will cover

How to use Aetna insurance for drug or alcohol rehabilitation

When using your insurance for treatment at a substance abuse program there are a few steps you must follow. The first thing to find out is if there is a copayment that you are responsible for before your insurance kicks in. Is the program you have chosen to enter an in-network provider or an out-of-network provider? There is a difference in costs and coverage from center to center and that can be a determining factor in which program you will want to enter. To find out if one of the centers that we work with is in-network with Aetna insurance, you can give us a call and we see if your specific insurance plan will cover your stay at one of the facilities that we work with.

Will Aetna insurance cover mental health and substance abuse treatment?

To find out more about your Aetna insurance plan's coverage for mental health and substance abuse we recommend that you access their online portal that will allow you to view your coverage, make claims, and search for providers. By logging in you can access a wide variety of resources available to you. The portal for mental health and behavioral health problems will give you access to psychiatrists, psychologists, therapists, social workers, and primary care doctors. It is common for those with a substance abuse disorder to have mental health concerns as often they are intertwined. Seeking help for mental health concerns is important if you are seeking help for substance misuse or abuse. The ACA made it so all health insurance providers must offer substance abuse disorder and mental health services. Any plan that is purchased through the Healthcare.gov marketplace will have to offer substance abuse or mental health treatment for their insured.

Types of treatment covered by Aetna

• INPATIENT REHAB CENTERS: Aetna covers Inpatient treatment centers. Inpatient treatment programs offer a safe place to stay with 24-hour supervision while you undergo therapy at their center. These programs can last from 2 weeks and up to a year depending on your chosen program. Aetna may limit the number of days you can receive treatment for addiction by calendar year.

• DETOX CENTERS: Aetna covers detox. Patients in a detox program are medically monitored while under the supervision of a healthcare provider. Detox is there to help you rid your body of substances as comfortably and safely as possible. If you need detoxification services, you may need to see your primary care provider to ensure it is medically necessary before being covered by your insurance plan.

Does Aetna cover outpatient rehab?

Aetna covers outpatient rehab programs. In outpatient treatment programs, patients live at their residence or a sober living home while they attend meetings and therapy sessions. Usually, there is a set number of hours in a calendar year that insurance will cover. Copayments and deductibles may have to be paid by you before insurance kicks in. Outpatient services can include a wide variety of services and levels of care based on the (ASAM) continuum of care. Their basic outpatient programs are at level 1 which range from .5 up to a 4 with level 1 being basic outpatient services. Level 1 treatment programs generally involve fewer than 9 hours of treatment per week. Level 2 is also considered outpatient rehab services that include intensive outpatient rehab services, and partial hospitalization day treatment programs. IOP treatment programs are very similar to level 1 outpatient services, but they are more of an intensive program and are considered a midway point between outpatient rehab and inpatient rehab. These programs allow you to stay at your own residence and go to therapy or meetings while enrolled in the program. PHP programs provide less intensive care than inpatient rehab but offer higher levels of care than outpatient programs. Some PHP programs will have a residence with 24-hour support, recreational activities, sober fun, and monitoring for those who want to recover without the added pressures of being at home during treatment. The best way to determine what your coverage is for outpatient treatment is to contact Aetna directly or reach out to us and we can help. We can help verify your insurance for you. Navigating the insurance plans can be overwhelming. Our staff have over 20 years of experience in getting people covered for drug or alcohol treatment programs. To learn more just reach out to us, and one of our insurance specialists will help you determine your coverage and get you started on the road to recovery.

Does Aetna cover therapy programs?

Aetna and other insurance providers do generally cover therapy including substance abuse counseling. As aforementioned, the insurance coverage amount is dependent on the plan you have chosen. Coverage may be limited to a set number of hours covered in a calendar year.

How to know what your plan will cover

Aetna Insurance has a few different types of plans, all with different coverage rates and deductibles. Depending on your plan your addiction treatment program may be covered. We can help you find a drug rehab center near you, or anywhere in the country that will accept your Aetna insurance.  These facilities offer various levels of care including detox, inpatient treatment, outpatient, and more. To find out what your Aetna insurance plan covers, how much your deductible will be, if any, or if you need help finding in-network programs, we can help.


Sources

Mental Health Screening tools 

Mental health & substance abuse coverage

Erik Epp – Content Author