Aetna Insurance Coverage for Drug & Alcohol Rehab Treatment Near Me
Does Aetna Drug Coverage Cover Drug Addiction Treatment?
Substance abuse epidemic, including opioid and drug abuse, is an epidemic present across the nation, responsible for the disappearance of as many as 50,000 lives every year.1 72% of all individuals who’ve suffered death by overdose stem from drug use. This is a 519.38% increase over the period of 20 years, proving an exacerbating problem.1
The only way to put a stop to these overwhelmingly negative outcomes is to provide individuals struggling with managing their substance abuse the help they need. All carriers of health insurance, such as Aetna, provide drug treatment coverage. This way, they’re providing assistance for individuals who need help.2
Different Aetna health insurance plans and drug treatment programs provide coverage for substance abuse, including drug treatment and rehab. Depending on the exact type of healthcare plan with Aetna and other important factors, an individual is likely to receive either complete or partial drug rehab and treatment coverage.3
Also, rehabilitation centers have the ability to check an individual’s drug treatment and rehab coverage based on the information provided. Finally, you can also call the Aetna helpline with the number provided on the back of your insurance card to receive additional first-hand information on the specific plans.3
Aetna provides healthcare insurance over several different plans and programs, including HMO (Health Maintenance Organization), POS (Point of Service), EPO (Exclusive Provider Organization), PPO (Preferred Provider Organization), as well as HDHP (High Deductible Health Plan) with a HSA (Health Savings Account).4
What Is Aetna Coverage?
Aetna is a provider of managed healthcare specializing in selling consumer-directed and traditional healthcare insurance. This includes coverage for drug treatment and rehab, as well as all other related services designed to help different individuals, including veterans, overcome their addiction and start a new healthy slate.5
Founded in 1853 in Hartford, CT, Aetna is committed to providing innovative healthcare benefits, services, and products to individuals in need. Now, Aetna is a subsidiary of CVS Health, granting this insurance provider an even wider reach and more possibilities to offer comprehensive services to their clients.6
Aetna offers different insurance coverage plans across the 50 states and features a network of over 46 million active members, 1.2 million certified healthcare professionals, 690,000 physicians in charge of primary care, as well as more than 5,700 modern hospitals and numerous insurance rehab providers within the Aetna network to ensure comprehensive coverage.3
What Does Aetna Cover for Drug and Alcohol Treatment?
Drug treatment and rehabilitation are typically conducted in the form of MAT, or medication-assisted treatment that has either complete or partial coverage under some of the Aetna insurance plans.7 This type of drug addiction treatment consists of using approved medication designed alongside counseling and behavioral therapy.8
Medication-assisted treatment is the main form of treatment for prescription pain reliever addiction and heroin addiction because it fosters the restoration of proper brain chemistry, reduces withdrawal symptoms, and relieves cravings. Some of the most commonly-used medications for MAT are buprenorphine, naltrexone, and methadone.8
Besides MAT, Aetna insurance coverage for drug rehab and treatment also covers part or entirety of the following programs:9,10
- Inpatient/residential rehab: Inpatient or residential treatment involves staying and living at the rehab facility. These types of treatment usually involve individual and/or group therapy sessions and are recommended for individuals with dual or co-occurring mental health issues, poor past treatment outcomes, non-encouraging home environments, and limited outside support.
- Outpatient rehab/therapy: Outpatient Aetna-approved drug treatment facilities allow individuals to meet with their therapists and doctors and attend recovery meetings and group sessions before returning to their homes at the end of the day.
- Intensive outpatient programs (IOP): Intensive outpatient drug treatment and rehab programs consist of frequent attendance of abuse treatment programs, approximately three nights every week, allowing individuals to go to work during the day and stay at their own home overnight.
- Partial hospitalization programs (PHP): This is a program that provides patients with the possibility to live in their own home throughout the duration of the treatment and spend their day involved in activities at their private and confidential treatment facility. Another name for this treatment is day treatment.
Does Aetna Provide Counseling and Mental Health Coverage?
Yes, Aetna offers mental health care coverage tied in with its drug treatment coverage. Under the ACA, or the Affordable Care Act, all drug treatment providers have to offer coverage for mental health care and treatment. This allows for professional treatment of co-occurring disorders, as well as professional drug counseling alongside rehab.11
Co-occurring mental health disorders are a serious issue that requires include:12
- ADHD (Attention deficit hyperactivity disorder).
- PTST (Post-traumatic stress disorder).
- Conduct disorders.
- Major depressive disorder.
- Bipolar disorder.
- Mood and anxiety disorders.
These types of co-occurring disorders are serious, recurrent, and very common in individuals battling substance abuse. They can shift the individual’s behavior, mood, and thinking, often affecting their decision-making ability. This is what makes treating these mental health disorders together with substance abuse essential for a complete recovery.13
Does Aetna Provide Coverage for Addiction Therapy?
Yes, Aetna provides either full or partial drug rehab and treatment coverage based on the type of health insurance the individual has and other important factors, including the type of rehab and the facility. Based on the exact Aetna benefits you’ve verified and insurance tier, there are different treatment options available to individuals looking for assistance overcoming their addiction, including:14
- Medication-assisted treatment as one part of drug rehab.
- Stay at one of the specialized sober living communities.
- Different inpatient services.
- Professional outpatient care.
- Detox treatment designed to minimize drug withdrawal symptoms.
The exact type of drug treatment program depends on several important criteria, such as the assessment of the individual’s current psychological and physical condition, which will evaluate the severity and the length of addiction, as well as diagnose any potentially existing co-occurring disorders that require additional treatment solutions.15
What Substances Does Aetna Cover?
Struggling with alcohol, opioid, or drug addiction can leave you feeling confused, overwhelmed, and scared. Nationwide insurance providers such as Aetna offer partial or full coverage for substance abuse treatment and rehab at specialized facilities while also including mental health and insurance coverage.3
21 million of Americans have at least a single addiction, while 19% of them who require treatment to overcome their addiction actually seek and receive it.16 Aetna offers drug rehab coverage through its numerous approved providers for the majority of the most common substances, including:17
- Stimulants, including cocaine and amphetamines.
How Long Does Aetna Rehab Coverage Last?
Every patient is different and every individual recovers at a different pace. Their progress through drug rehab and treatment will vary, and so will the duration requirements for their process. Generally, longer periods of active treatment provide more favorable outcomes for different individuals. Participating in treatment that lasts for 60 days or less offers lower rates of success when compared to longer treatment programs followed up by aftercare.18
Aetna substance abuse treatment coverage varies according to your individual set of benefits, so does the duration of the treatment it covers.14 The best way to check the details of your health insurance plan is to call the Aetna helpline with the number located on the back of your ID card and have a conversation with the team in charge of providing customer service.19
What to Do if Your Aetna Plan Does Not Cover Treatment?
Depending on the insurance plan you have, the type of drug treatment you require, and the treatment facility you wish to attend, such as men-only or women-only drug rehab and treatment centers, you might not be eligible for full substance abuse treatment coverage of all the expenses.20
In case this happens, it’s important to explore alternative options for financing your drug rehab and treatment. There are Aetna insurance drug treatment centers that offer sliding-scale and low-cost fees, while other facilities offer scholarships or grants. Finally, there are different state-funded programs you can enroll in.20
Your eligibility for different services also depends on the size of your household and your yearly income. These are the factors that will determine whether Aetna covers only a portion of your treatment or the entirety of it. Finally, they reserve the right to revoke your funding if you fail to complete your chosen program.20
90% of all rehabilitation facilities accept self-payment and cash, while 59% of centers offer fee scaling options. Finally, 44% of facilities across the nation offer completely free treatment options for individuals unable to pay for their drug treatment and rehab.21
Finally, it’s important to choose the most suitable financing option for your rehab and not postpone entering treatment after a potential intervention, since individuals who begin their treatment ase early on as possible receive better results at the end of the period.22
Do I Choose Aetna’s In-Network or Out-of-Network Providers?
In-network rehab facilities are those facilities that accept the health insurance plan you have. They’re otherwise known as participating providers.23
On the other hand, out-of-network facilities don’t have an agreement in place with Aetna, meaning they can be a lot more expensive. Out-of-network centers don’t accept approved amounts, leaving you responsible for paying the entirety of the difference between your plan’s approved amount and the full price of the treatment provider.23
That being said, your choice of facility is entirely your own decision. The best way to begin reaching your decision is to first Aetna and inquire about the drug rehab and treatment providers that accept their coverage.23
How Do You Verify Aetna Coverage for Inpatient Rehab?
Generally, a rehab provider has to be within the Aetna network to accept your insurance coverage. Otherwise, you have to enter an out-of-network facility and cover the costs of the treatment and rehab on your own. If you’re looking for information on which drug treatment programs Aetna insurance covers, you can contact their hotline and discuss their services with their care providers. Alternatively, you can also make use of SAMHSA’s treatment finder and explore all the different rehab facilities that might provide the best care for your individual needs.24
Finally, you can contact American Addiction Centers to verify your Aetna insurance coverage and benefits and explore all the financing solutions while going over the different payment options you could use to fund your rehab. Their team will be there to help you out, explore all the solutions available, and suggest which one of their leading rehab facilities and certified treatment programs would be the best fit for you. Their centers work with Aetna insurance plans, bringing exceptional evidence-based care across the nation.
Frequently Asked Questions
Does Aetna Insurance Offer Coverage for Drug Rehab?
Yes, Aetna is a health insurance provider that offers different types of plans that cover drug treatment and rehab, which may include individual and couple treatment facilities you might want to enter as well as other programs. The amount of coverage Aetna or one of its approved rehab providers in the network will provide depends on the plan you have, the facility you choose and the program you wish to enter.3
Does Aetna Provide Insurance Coverage for Detox?
Aetna does provide coverage for drug and medical detox treatment as a form of drug treatment at one of its numerous in-network facilities. However, whether or not Aetna will cover your drug or medical detox program depends on several factors, including your coverage plan and the level of insurance you have.14
Will Aetna Insurance Cover Luxury Drug Rehab?
Yes, Aetna insurance can provide either full or partial coverage for luxury drug rehab. The amount of coverage depends on the benefits you have as part of your package. However, it’s essential to state that health insurance generally won’t cover adjoining aspects of treatment deemed unnecessary for the actual recovery process.19
In case you’re unsure whether Aetna will provide coverage for rehab at a luxury treatment facility, you can use one of two ways to verify your Aetna benefits. First, you can contact the Aetna hotline with the number located on the back of the ID card or you can choose to call American Addiction Centers and allow their helpline to check the amount of coverage you could receive.19
Reputable drug treatment and rehab facilities offer same-day admittance into their programs. You can choose from short 3-to-7 day detox programs or choose a 30-day rehabilitation process. However, know that experts recommend longer treatment programs for enhanced results. Staying at a facility that explores the spiritual side of recovery together with the physical and psychological may also be beneficial for some patients.18
Does Aetna Provide MAT Coverage?
Some of Aetna insurance plans do fully cover MAT, or medication-assisted treatment, as the main Aetna insurance drug treatment program for helping individuals overcome their drug addiction.7 This process focuses on using approved medication to alleviate physical and psychological withdrawal symptoms alongside behavioral therapy and counseling which Aetna provides coverage for.8
Do Aetna Plan Include Suboxone Treatment?
Aetna does provide coverage for suboxone treatment as part of a drug rehab program at one of their in-network centers.19 The contribution that Aetna and its approved drug treatment providers will offer depends on the specificities of your insurance plan. There can be co-payments for every prescription depending on your coverage.3