Author: John Carter
Aetna Insurance Coverage For Drug Rehab
You can contact an Aetna representative to learn more about the co-pays and deductibles for substance use disorder treatment. A deductible is the amount of money paid out-of-pocket for covered services before the health plan kicks in. For example, if the deductible for your plan is $1,500, you will need to pay that amount out of pocket before insurance will start covering services. Point of service (POS) plans will typically require clients to get a referral to see a specialist. POS plans do have higher premiums than HMOs, but they do cover out-of-network doctors. When purchased on the Health Insurance Marketplace, plans come in Gold, Silver, and Bronze coverage levels.
- Reach out to AddictionResource.net today for more information about substance use disorder treatment.
- POS plans do have higher premiums than HMOs, but they do cover out-of-network doctors.
- The ACA requires that all insurance companies offer some form of coverage for substance use treatment.
- Services are often based on medical necessity and may require a referral and prior authorization to be approved.
Inpatient treatment offers full-time, around-the-clock care and supervision. Aetna’s in-network providers are less costly than out-of-network providers. The table below shows a breakdown of in-network costs versus out-of-network costs for a two-week stay for chemical dependency rehab. To find a treatment program, browse the top-rated addiction treatment facilities in each state by visiting our homepage, or by viewing the SAMHSA Treatment Services Locator. You can also download the Aetna Health mobile app and manage your benefits from your phone, including the option to search for in-network rehab centers near you.
Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Richard is stronger now and ready to continue on his journey to recovery from substance use disorder. He’s living with a supportive family member and has re-entered a recovery program. The road ahead may be long; however, Aetna offers continued support to maintain positive momentum. Aetna partners with MAP Health Management, a national recovery program that offers support from others with a history of substance use disorder. This program helps members resolve their substance use issues in the long term and avoid possible relapses.
HMO plans cover only in-network providers, and that may be limited by geographic area, while PPO plans may provide more coverage for providers outside of your state. However, checking with your plan to ensure that you will be covered first is always a good idea. Aetna therapy coverage can be confusing to navigate, but a wide range of plans is available.
Aetna Rehab Coverage
Medical detox programs often include prescription medications that ease withdrawal symptoms and speed up the recovery process. Reaching out to the rehab center of your choice with your insurance information in hand can be a quick way to confirm whether Aetna is accepted. Aetna also uses a screening, brief intervention, and referral to treatment (SBIRT) practice that helps identify, reduce, and prevent alcohol and drug use. If no referral is necessary, the intake staff at a rehab program will confer with Aetna during the admissions process and confirm the details of your coverage. Detox can last up to two weeks, depending on the substance used and other factors. Aetna insurance does cover medical detox, but members may need to get pre-certification or authorization prior to starting the program.
Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member’s benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Insurance coverage isn’t always enough for the entire cost of addiction treatment. Anyone struggling to pay out-of-pocket costs for rehab shouldn’t give up.
Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Clients may need to seek a referral from their primary care doctor before their Aetna plan will kick in. Aetna covers medication-assisted treatment for all members using a list of approved drugs. While Suboxone was removed from the list in 2023, there is a generic form of the drug that Aetna will cover.
Aetna Rehab Coverage Aetna Drug & Alcohol Treatment Plans Accepted
It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern. This online service can help reduce stress, anxiety and depression through exercises designed by experts. As Michelle says, talk therapy is very important for people in recovery, because “there’s a lot of life going on!
A preferred provider organization (PPO) has higher premiums but lets holders see specialist and out-of-network doctors without a referral. Intensive outpatient programs are partially or fully covered by Aetna plans, depending on which tier of coverage you have. Nonresidential treatment programs such as day treatment, also known as PHPs, are in-network with most plans offered by Aetna. This information is neither an offer of coverage nor medical advice.
Aetna’s Continuing Care Support
” Care Advocates can anticipate this need and make sure you are connected to a counselor to support your journey in the long term, even if you’ve never received therapy before. Aetna rehab coverage helps reduce the cost of addiction treatment in a variety of settings. You can also contact the rehab facility you’ve chosen to get information about what you’ll need to pay. Services are often based on medical necessity and may require a referral and prior authorization to be approved. If you aren’t sure if your insurance will be accepted at American Addiction Centers (AAC) rehab facilities, you can check on this page.
Explore Aetna sites
Members should discuss any matters related to their coverage or condition with their treating provider. Treatment providers often provide ways to cover the gap between your coverage and what you owe. Other treatment centers accept incremental payments or credit card payments, so you won’t pay the entire amount upfront. Aetna health insurance plans cover some or all of the cost of addiction treatment.
Aetna insurance benefits do cover treatment for drug and alcohol addiction, although what is covered and where you can seek treatment may depend on what type of Aetna plan you have. It is always a good idea to confirm your alcohol and drug rehab insurance coverage before starting treatment. Aetna covers detoxification, inpatient, residential, partial hospitalization and intensive outpatient programs. It requires precertification of some behavioral and mental health services to ensure that the requested service meets the company’s criteria for coverage.