Alcohol And Drug Rehabs That Take Aetna Insurance
Health insurance plans now cover treatment for substance use disorders, addiction, and mental health disorders. With the passage of the Affordable Care Act, more Americans now have access to these forms of treatment. Rehabs that accept Aetna insurance are situated across the country and present a great option for policyholders looking for access to care.
If you’re looking for treatment for alcohol or substance abuse and have Aetna Insurance, you will receive at least partial coverage for rehab. Plans can vary in terms of what type of insurance coverage they provide or how long they will cover alcohol or drug rehab.
Behavioral healthcare services such as inpatient or outpatient rehab are typically covered by most Aetna health insurance policies, but the amount of coverage available will vary based on the policy itself and the location, as well as the type of care, the level of care, and the duration of care.
In this article, we will look at Aetna insurance which covers a diverse range of mental and behavioral health services.
What is Aetna Insurance?
Founded in 1853 and active in all 50 states, Aetna is a healthcare company that provides a variety of health insurance plans and services to about 46 million members. The Aetna network of providers includes more than 700,000 doctors and specialists and about 1.2 million healthcare professionals.
In addition to a diverse range of mental and behavioral health services, Aetna insurance coverage includes options for policyholders that include detox, inpatient and residential rehabilitation, partial hospital treatment, and intensive outpatient treatment.
Does Aetna Cover Mental Health & Substance Abuse Treatment?
Unlike other insurance providers, Aetna recognizes that there are no one-size-fits-all substance abuse treatment plans for drug and alcohol abuse. As such, Aetna works with an individual’s needs to find the perfect addiction treatment solution.
Aetna offers drug and alcohol treatment coverage for a variety of types of treatment. The rehab facilities they work with are screened to ensure the quality of care as well as sufficient follow-up care. Facilities are also ensured to be up-to-date on the latest technology and practices for addiction treatment.
What types of treatment Aetna will cover, as well as how much coverage is offered, is dependent on a person’s plan with the insurance company. However, thanks to the Mental Health Parity and Addiction Equity Act of 2008, insurance companies are required to provide some level of coverage for addiction treatment.
Your coverage will also depend on which state you live in. Additionally, individual and family plans can vary greatly in the level of coverage they offer for addiction services.
Ensuring that your Aetna insurance plan covers addiction treatment is an important first step to getting on the path to recovery. There are several aspects of your plan to consider before choosing a rehab program.
To learn more about your Aetna substance abuse and mental health coverage, sign up for their online program that allows you to view your coverage details, make claims, search for providers, and much more.
Simply logging in gives you access to a wide variety of resources for Aetna users. You can also visit the Find a Doctor portion of their website to search for providers. You can find information on all types of providers there, including professionals and centers that treat substance abuse and substance addiction.
For mental and behavioral health problems, you are given access to psychiatrists, psychologists, counselors, therapists, social workers, psychiatric nurse practitioners, and primary care doctors. In many cases, mental health problems can co-occur with substance abuse, it is important to address mental health concerns if you are seeking care for substance abuse and addiction.
At Find Addiction Rehabs, we specialize in pairing individuals with addiction treatment providers specific to their needs. This means that not only will we help you or your loved one find a treatment center that accepts Aetna, but we will also provide a treatment program that will give you or them the best chance of long-term recovery.
Using Your Aetna Plan To Cover Drug And Alcohol Treatment
There are several factors to consider before using your Aetna plan for drug and alcohol addiction treatment. One of these factors is finding out if the treatment facility you plan on attending is covered by your plan.
Determining which treatment programs and services you will need is also an important step in using your Aetna plan. This will allow you to make educated decisions on the treatment you pursue and ensure maximum insurance coverage.
If you have medical insurance through Aetna, the easiest way to verify your insurance benefits is by contacting Find Addiction Rehabs. Our admissions specialists will contact Aetna for you, and within five minutes, explain to you what you can expect when using your plan to cover addiction treatment.
How Much Does Aetna Cover?
Aetna insurance covers a variety of different drug and alcohol addiction services. What exactly your plan covers and what you will be required to pay out-of-pocket will be based on the type of plan you have.
Some plans may require individuals to undergo a medical assessment before providing coverage for treatment. This is more common with intensive treatment services such as inpatient programs.
Types of addiction treatment that are typically covered partially or fully by Aetna include:
- Detox programs. Drug detox programs aid people who want to overcome their substance use disorder, safely and effectively through withdrawal.
- Residential rehabilitation. Residential rehabilitation provides care 24 hours a day, generally in non-hospital settings.
- Family counseling. This is a branch of therapy that encourages working with families and couples in intimate relationships to nurture change and development.
- Partial hospital treatment. This is an intensive, nonresidential, therapeutic treatment program that may or may not be hospital-based. The program provides clinical treatment services in a stable environment on a level equal to an inpatient program, but on less than a 24-hour basis.
- Continuing care programs. Continuing care involves a support plan after treatment for alcohol and drug use. This model addresses the chronic nature of SUDs by emphasizing long-term outcomes of treatment and recovery.
- Individual and group therapy. Individual therapy can only occur when one person is in therapy with a psychologist, counselor, therapist, or psychiatrist whereas group therapy occurs when more than one person is treated together in a formal therapeutic environment. Group therapy capitalizes on the social reinforcement offered by peer discussion.
- Drug testing. A drug test looks for the presence of one or more illegal or prescription drugs in your urine, blood, saliva, shed hair, or sweat. Urine testing is the most common type of drug screening.
Aetna additionally may provide coverage for more intensive addiction treatment such as inpatient and outpatient programs. Medication-assisted therapy is another common type of treatment covered by many Aetna plans.
Inpatient Rehab Programs
Inpatient programs are the most intensive form of drug and alcohol addiction treatment. This type of treatment requires patients to live at a treatment facility for an extended period of time.
Inpatient programs consist of 24-hour supervision as well as the management of medication and mental health conditions. Patients work simultaneously on an individualized plan of recovery that is catered to their specific conditions and needs.
Inpatient treatment services may consist of:
- detox programs
- medication-assisted therapy
- individual and group counseling
- 12-step meetings
- psychiatric care
- residential programs
- various forms of therapy
- relapse prevention
- family counseling
Aetna does not cover all addiction treatment programs, similarly, not every inpatient program accepts Aetna Insurance. As such, it’s important to call ahead before attending treatment to prevent unwanted costs.
Outpatient Rehab Programs
Outpatient programs are a step down from inpatient treatment and provide more freedom for patients. These types of programs are often recommended to individuals who are seeking treatment for the first time.
Outpatient programs allow individuals to incorporate treatment into their everyday lives without forfeiting work, school, or family responsibilities. Many of the same services offered in inpatient programs are offered in outpatient treatment on a less intensive basis.
Types of outpatient treatment include:
Standard Outpatient Programs — This is the least intensive form of outpatient treatment. Patients meet one to two times a week for a few hours to receive therapy.
Intensive Outpatient Programs (IOP) — This type of program meets several times a week, typically in the evening. Each session will last a few hours and may consist of group and individual counseling.
Partial Hospitalization Programs (PHP) — PHPs require patients to attend treatment for four to eight hours each day of the week. This type of treatment is the most intensive form of outpatient addiction treatment.
Many Aetna plans offer coverage for a variety of outpatient programs and services. The exact amount of coverage will vary from plan to plan, and from one state to another.
Types of Aetna Insurance Plans
Health insurance companies use a lot of acronyms (HMO, PPO, EPO, POS) and specialized terms which can be extremely confusing. In this section of the article, you will appreciate the different types of plans offered by Aetna and understand all available options. Hopefully, at the end of this, you will feel more confident about making the right decision.
These insurance plans include:
- Open-access plans. They allow you to choose your doctors; they neither require a referral nor a primary care physician.
- Copay-only plans. These will guarantee that your costs after paying your deductible are only copays, with primary care physician visits and generic drugs covered before you hit your deductible (don’t panic, these insurance terms are explained later on in the article).
- High-deductible plans. They offer preventative care services before the deductible is met, sometimes coverage through a primary care physician before the deductible is met (with copay), and the option of a health savings account.
Additionally, Aetna offers several local plans supported by the national network of providers to better support patients at the community level.
- Health Maintenance Organization (HMO) plan: This is one of the cheapest types of health insurance. It has low premiums and deductibles, and fixed copays for doctor visits. HMOs require you to choose doctors within the network. When you sign up for the plan, you’ll select a primary care physician (PCP), whom you’ll see for regular checkups. HMOs are a good choice if you’re on a tight budget and don’t have many medical issues.
- Point of Service (POS) plan: This plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist, just like HMO. This plan covers out-of-network doctors, though you’ll pay more than for in-network doctors. It especially comes in handy when you are managing a condition and one or more of your doctors are not in the network.
- Exclusive Provider Organization (EPO) Plan: This is a lesser-known plan type. Like HMOs, EPOs cover only in-network care, but networks are generally larger than for HMOs. They may or may not require referrals from a primary care physician. Premiums are higher than HMOs, but lower than PPOs.
- Preferred Provider Organization (PPO): It has pricier premiums than an HMO or POS. This plan allows you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network doctors are low. If you know you’ll need more health care in the coming year and you can afford higher premiums, a PPO is a good choice.
- High Deductible Health Plan (HDHP): It has low premiums but higher immediate out-of-pocket costs. Employers often pair HDHPs with a Health Savings Account (HSA) funded to cover some or all of your deductible. You may also deposit pre-tax dollars in your account to cover medical expenses, saving you about 30%. And remember, depending on your age, services such as mammograms, colonoscopies, annual well visits and vaccinations may be covered free of charge, even if you haven’t met your deductible. Learn more about preventive care.
A PPO policy is the best option for rehabilitation and addiction treatment because it provides a wider variety of treatment centers to choose from. With this, they can choose from in-network and out-of-network providers, as well as in-state and out-of-state providers, giving them a better chance of finding the right treatment center for their needs and, as a result, a better chance of a successful recovery.
People who are managing a health condition but can’t afford higher monthly premiums may find that an HDHP saves them money in the long run.
In some states such as Delaware, Aetna’s insurance plans are categorized into four insurance tiers known as metal levels. The metal tiers are Bronze, Silver, Gold, and Platinum.
The Affordable Care Act requires each metal tier to cover a certain percentage of your health care costs.
- Bronze plans cover about 60 percent
- Silver plans cover about 70 percent, unless you’re eligible for cost sharing reduction. Depending on your income, this subsidy means you could qualify for a silver plan that covers about 73, 87 or 94 percent of your health care costs.
- Gold plans cover about 80 percent
Simply put, if you choose a bronze plan, overall you’ll pay about 40 percent of your health care costs, and your insurance company will pay about 60 percent. If you choose a gold plan, overall you’ll pay about 20 percent, and your insurance company will pay about 80 percent.
Metal tiers also vary in terms of monthly payments and out-of-pocket costs.
- Bronze plans: lower monthly payments, but higher out-of-pocket costs.
- Silver plans: monthly payments lower than a gold plan, but more than bronze. Your out-of-pocket costs will be less than a bronze plan, but more than a gold plan, unless you’re eligible for cost sharing reduction.
- Gold plans: higher monthly payments, but lower out-of-pocket costs.
What States Does Aetna Insurance Cover?
Simply put, Aetna offers insurance coverage across all fifty states of the United States. While policy types and plans offered can vary substantially from state to state and by region, if you would like more information on finding addiction treatment services specific to your state, visit our complete guides to each state below:
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
How Do I Know What My Aetna Insurance Policy Will Cover?
The longer you avoid the substance abuse problem, the more of a problem it becomes. If you sprained your wrist tomorrow, you’d call your doctor for an appointment, so you should do the same thing when it comes to addiction.
We know that finding a rehab center is a confusing task, but we’re ready to help you navigate through the world of treatment centers. At Find The Best Rehabs, we help relieve part of the pressure that surrounds alcohol and substance abuse rehabilitation. Call us if you’re worried about a loved one or you’re ready to take action about your own problem. We will share with you some insights on what your Aetna insurance covers, and the necessary steps to kickstart the process.
I Just Lost My Job, How Do I Know if I am Still Covered?
If you’ve been laid off or furloughed from your job, you’re probably thinking about a lot of things right now. During the COVID-19 outbreak, health care is undoubtedly near the top of the priority list. Comprehensive health insurance can help protect your health and financial well-being, as well as make you feel safer, now more than ever.
You have options for continuing health coverage whether you are a displaced employee or a business owner looking out for your furloughed employees. For example, if your employer is subject to federal COBRA, you may be able to keep your group health plan coverage indefinitely. However, this coverage is only available when coverage is lost due to specific events.
The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is a federal law designed to provide families with an insurance safety net after a job loss. If you are already enrolled in an employer-sponsored medical, dental, or vision plan and your company has 20 or more employees, you are eligible. In most cases, you have 60 days after losing your coverage to enroll in COBRA.
How Can I Pay the Costs Not Covered By My Insurance Plan?
You may find that, although Aetna is accepted at a particular treatment facility and does provide coverage, you are left with a bill for part of the cost. There is a wide range of alternative methods to help cover any additional expenses. You can opt to pay through:
- Payment plans: You pay off rehab in affordable installments.
- Sliding scale: The rehab decreases your cost to something you can reasonably afford—typically based on your income level.
- Grants or scholarships: The Substance Abuse and Mental Health Services Administration (SAMHSA), as well as individual rehabs, offer grants and scholarships to pay for people who can’t afford treatment.
- Open a healthcare credit card or take out a specialized healthcare loan.
- Use your savings or a credit card.
- Crowdfunding websites, such as GoFundMe or IndieGoGo.
How Can I Get Aetna Coverage for Detox and Rehab?
There are a number of different costs associated with drug rehab. Making sure you get the right insurance can ensure you get into the best drug rehab. You can obtain Aetna coverage for rehabilitation through the following means:
- Through your work: The Affordable Care Act requires employers to provide health coverage to their workers if they have at least 50 full-time employees. The employer-sponsored health insurance is selected and purchased by your employer and offered to eligible employees and their dependents.
- Through the marketplace: individuals whose employers don’t offer health insurance as part of an employee benefits program, have the option of purchasing insurance policies directly from private insurance companies or through the Health Insurance Marketplace.
- Buying insurance yourself privately: If you are self-employed, the owner of a small business, or an employee of a business that either does not offer health insurance as an employee benefit, then you are unlikely to access employer-sponsored health insurance. Buying your own private health insurance is your best option.
- BCBC coverage: If you’re a young adult under the age of 26, you can get coverage through your parents’ health care plan, as long as their plan covers dependents. You can stay on their plan until you’re 26, even if you’re married, not living with your parents, attending school or not, not financially dependent on your parents or even eligible for your employer’s health insurance plan.
How Long Will Aetna Insurance Cover Rehab?
Aetna will cover various lengths of treatment in order to better serve you on your journey to wellness. Aetna will pay for the cost of, in whole or in part, the following lengths of treatment:
- 28-30 Day Residential Programs
- 60 Day Residential Programs
- 90 Day Residential Programs
- 6-month rehab
- 9-month rehab
- Long-Term Rehab
Aetna Drug Rehab Facilities: Finding Drug Rehabs That Accept Aetna
If you or someone you know is struggling with alcohol addiction, assistance is just a phone call away. Contact us at Find The Best Rehabs to learn more about Aetna-covered rehab centers in your area, your individual plan, and what coverage you can receive.
Will Aetna Insurance Cover Out of State Rehab?
It is not uncommon for people to seek treatment outside their home state. While this may initially seem less convenient, traveling for rehab can be extremely beneficial. One of the most significant benefits is that traveling for rehab allows you to take yourself out of your daily routine. By going somewhere new, you give yourself a fresh start in a safe environment that’s free of the distractions that may have initially caused your addictive behavior. It also brings more opportunities to find the right type of treatment program for your exact needs.
Aetna will pay for both local and out-of-state treatment. Depending on your plan, there are a variety of treatment facilities that are covered by Aetna nationwide. A facility need not be local to you to be in-network for your plan. Consult us at Find Addiction Rehabs to determine which facilities your insurance will cover for your alcohol addiction treatment.
Do Treatment Centers Need to be In-Network?
Even though not all Aetna plans require service providers to be in-network, programs that are out-of-network may cost more. In some cases, pre-certification or authorization of a treatment program will be required. Such cases may include:
- Inpatient admissions
- Outpatient detoxification
- Residential Treatment Center admissions
- Intensive Outpatient Programs
- Partial Hospitalization Programs
Pre-certification involves a review process to determine whether the requested service or program meets Aetna’s clinical criteria for coverage. Contact us at Find Addiction Rehabs to see if your substance abuse treatment will require pre-certification before you begin the program.
Definition of General Insurance Terms Used in this Article:
Out of pocket cost: This refers to the portion of the bill that the insurance company doesn’t cover and that the individual must pay on their own. Out-of-pocket healthcare expenses include deductibles, copays, and coinsurance.
Deductible: This is the amount you have to pay for covered services before your insurance starts to pay. For instance, if you have a $2,500 deductible, you will pay 100% of your healthcare expenses until the amount you have paid gets to $2,500. After you meet your deductible, some services might be covered at 100% while others would require you to pay coinsurance.
Copayment: This is a fixed dollar amount that you pay for certain healthcare services. Typically, you will have different copayment amounts for different types of service.
Coinsurance: Your share of the costs of a healthcare service is called coinsurance. Typically, this is figured as a fixed percentage of the total charge for a service, such as 15% or 30%. Coinsurance kicks in after you’ve met your deductible.
Out-of-Pocket Maximum: A plan’s out-of-pocket maximum (or out-of-pocket limit) is the most you pay during a policy period (typically a year) before your plan starts to pay 100% of the allowed amount.
In Network providers: In network healthcare providers have contracted with your insurance company to accept certain negotiated (i.e., discounted) rates. They are sometimes referred to as participating providers.
Out of Network Providers: When you go to a doctor or provider who has no contract with your insurance plan, then they are referred to as out of network providers. This can sometimes result in higher prices.
Finding Addiction Services That Are Covered By Aetna
Using your Aetna insurance to cover some or all of addiction treatment can significantly reduce any financial stress associated with seeking help. Many Aetna insurance plans can reduce or eliminate the cost of alcohol and drug rehabs and services.
Speaking with our recovery representatives as well as a treatment specialist can help you better understand the treatment you need and the level of coverage you will receive. Contact Find Addiction Rehabs now to explore your options and get started on the road to recovery today!
* Disclaimer: Find Addiction Rehabs is not affiliated with or endorsed by Aetna. Details about Aetna’s coverage are intended for informational purposes only. The specific details of your plan may vary and the specific treatment services you require may or may not be covered. Please call our representatives today for more definitive details on your plan and options.
Anna M. joined Find Addiction Rehabs with extensive experience in the field of addiction treatment. As a former Nurse Practitioner in Miami, she found her passion for addiction treatment when a family member was lost to his disease. With each article and resource, she hopes to save other families from experiencing the anguish of a loved one’s passing due to drinking or drugs.