Rehab Centers That Accept Aetna Insurance

If you’re considering rehab for an alcohol or drug addiction, you may be wondering whether your insurance company will cover the cost of treatment. The types of treatment available to you may change depending on your insurance coverage.

The Affordable Care Act (ACA) made healthcare and insurance available to many people who previously couldn’t afford them. This law also applies to addiction treatment and substance abuse screening. Understanding Aetna insurance coverage for substance abuse treatment can help you figure out which types of addictions are covered and how to find a rehab that accepts it.

Aetna insurance coverage extends to drug rehab because substance abuse treatment generally falls under mental health treatment. The Mental Health Parity and Addiction Equity Act of 2008 states that insurance providers must provide the same coverage for mental healthcare that they do for other types of medical care.

The amount of coverage depends on your specific plan. Each plan has a different level of coverage, which can affect your out-of-pocket expenses.

When you or a loved one are considering seeking alcohol and drug abuse treatment, it’s helpful to understand your insurance benefits and coverage. Many evidence-based treatment programs are available, including inpatient and outpatient services. The following drug and alcohol treatment services are at least partially covered by Aetna insurance.

Medical detox is the first step in addiction treatment. It helps alleviate withdrawal symptoms for people with a substance use disorder.

Most Aetna insurance plans cover medical detox, but you may need a doctor’s referral. This is called “prior authorization”, and it requires a doctor to fill out paperwork that proves the procedure or program is medically necessary.

Medication-assisted treatment (MAT) is often used to treat alcohol and opioid addiction. The medications used help with cravings and withdrawal symptoms.

Most Aetna insurance plans cover at least some of the cost of medication-assisted treatment. Approved medications include Vivitrol (naltrexone), Suboxone (buprenorphine), disulfiram, acamprosate and methadone.

Inpatient rehab, also known as residential treatment, is for people who need around-the-clock supervision and care. It’s one of the most successful rehab programs.

Aetna insurance plans cover at least some of the cost of inpatient rehab. However, the amount of coverage varies, depending on which plan you have, where you live and other factors. Prior authorization from a doctor can help in some cases.

In many cases, people with a substance use disorder also have a mental health condition, which is called a dual diagnosis. Treating the mental health problem is usually a critical step in treating the addiction. Aetna typically covers medications prescribed for co-occurring disorders, such as anxiety and depression, during addiction treatment.

Outpatient treatment programs offer a less-intensive level of care than inpatient care and are for people who don’t 24/7 supervision.

Types of outpatient rehab programs include:

• Partial hospitalization programs (PHP)
• Intensive outpatient programs (IOP)
• Standard or general outpatient programs

All Aetna plans cover at least a portion of outpatient care. You may need to cover co-pays or coinsurance fees, but the exact amount you’re responsible for will vary depending on your plan.

Many addiction programs offer various types of counseling and behavioral therapies as part of their treatment curriculum. These therapies include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), individual therapy and group counseling. Plans such as Aetna HMO, Aetna Select, Aetna Managed Choice, and Aetna Open Choice cover evidence-based addiction therapies for those who need them.

Once you complete inpatient or outpatient treatment, you may decide you still need assistance through aftercare programs, such as sober living. Sober living homes provide a drug-free, low-stress environment to help you maintain your sobriety before returning to your everyday life. While some Aetna plans cover sober living programs, most don’t cover continuing care.

Aetna insurance has multiple policies that provide different amounts of coverage for drug and alcohol addiction treatment. This means it’s likely that Aetna has an insurance policy that best fits your specific needs.

However, certain factors can affect your rehab coverage, such as:

• Your plan’s benefits
• The type of treatment you’re interested in
• The treatment provider’s network status
• Your plan’s required co-payments and deductibles
• Your diagnosis
• Specialist referral and medical necessity requirements

Some Aetna insurance policies cover out-of-network rehab programs, primarily in emergency situations. However, addiction treatment centers that aren’t in-network with your plan may charge you more than what Aetna is willing to cover, increasing your out-of-pocket costs.

Aetna Health Insurance has several plans to choose from, and each offers its own coverage options to meet each customer’s unique needs. While Aetna offers treatment plans in every state, each has its own laws and regulations for insurance coverage. However, some plans are the same across the country. Be sure to familiarize yourself with your state’s Aetna insurance policies.

Aetna HMO is a Health Maintenance Organization plan, which means if you need to see a specialist or any type of doctor outside of your primary care physician (PCP), you’ll need a referral. These plans only cover in-network providers.

Aetna Select is similar to Aetna HMO. If you need medical service coverage, you’ll need a referral from your primary care physician.

Aetna Managed Choice is one of Aetna’s network option plans. While these plans provide some coverage for out-of-network medical providers, you’ll still need a referral to see a doctor other than your primary care physician.

Aetna Open Choice PPO plans are the company’s most flexible options. This Preferred Provider Organization plan doesn’t require you to have a primary care physician or get referrals for specialty care. It also provides coverage for out-of-network medical care.

If you’re battling substance abuse, you may be unsure what your Aetna policy will cover. Alcohol and drug addiction treatment falls under mental health services, so these plans cover many addictions.

Some addictions covered by Aetna Insurance include:

• Opioids
• Alcohol
• Marijuana
• Methamphetamine
• Prescription drugs
• Cocaine
• Benzodiazepines
• Heroin

If you are still unsure whether Aetna covers your addiction, call your provider to have a specialist walk you through your insurance coverage.

Understanding your treatment coverage can help you narrow your options when you’re looking for addiction or behavioral health rehab treatment. One way to find out which rehab centers accept Aetna insurance is by calling the company and speaking with a representative. You can also find rehabs in your area by logging into the member’s website and using the search bar to find a treatment center in your network.

If your policy requires you to have a referral to see a specialist, you’ll need your primary care provider to refer you to an addiction treatment center. Keep this in mind if you are considering an out-of-state treatment facility.