Aetna Drug and Alcohol Rehab Coverage

Aetna rehab coverage often pays for some of the cost of addiction treatment for Aetna members struggling with substance use disorder.

When someone needs addiction treatment, they often wonder if insurance will cover it. Aetna is one of the largest insurance providers in the nation, and in many cases, they cover at least a part of rehab costs. 

Aetna Provider Overview

Aetna is an insurance company initially founded in the mid-1800s and has become one of the three largest insurance companies in the country based on membership. CVS bought Aetna in 2018 and has been expanding treatment options in their retail locations for people with Aetna insurance.

Aetna rehab coverage is available as part of many of their plans. The specifics of what’s covered and the length of treatment Aetna covers depend on a person’s insurance plan, benefits and state.

Aetna Plans and Coverage Levels

Health insurance plans from Aetna differ depending on the state where you live, and they’re divided into a couple of types and tiers. A health maintenance organization (HMO) plan lowers premiums and deductibles and has set copays. With an HMO, you have to see in-network doctors and get referrals from your primary care doctor if you need to see a specialist.

A preferred provider organization or PPO plan will have a higher premium but a lower copay and coinsurance amount. You can see specialists or get care out-of-network without referrals. PPO plans are divided into three tiers. 

• Bronze plan: These plans offer lower premiums but higher deductibles. Bronze plans require that you pay the highest out-of-pocket, with Aetna covering around 70% of treatment costs once deductibles are met.
• Silver plan: These plans have a higher premium and lower deductible than a bronze plan, requiring the plan holder to pay less out-of-pocket expenses overall. If you have a silver plan, Aetna will usually cover 80% of care costs after the deductible is reached.
• Gold plan: Gold plans have the most expensive premiums and the lowest deductibles, with Aetna covering around 90% of your care costs after you meet your deductible.

Additionally, Aetna offers Medicare and Medicaid plans, which are government-funded insurance programs.

Does Aetna Insurance Cover Drug and Alcohol Rehab?

Under the Affordable Care Act, substance misuse and addiction treatment became an essential covered benefit. Insurance providers under the Affordable Care Act were required to cover rehab, behavioral therapy and treatment similarly to comparable physical health care. Services are frequently based on medical necessity and may need prior authorization and referral for approval, which our Recovery Advocates can help with.

Does Aetna Cover Mental Health Services?

Under the Affordable Care Act, Aetna covers mental health services. However, how much coverage is available and the limitations on what’s covered or what’s required out-of-pocket depend on the plan. Aetna may cover specific types of mental health treatment like cognitive behavioral therapy or dialectical behavioral therapy.

Aetna and Medication-Assisted Treatment (MAT)

Medication-assisted treatment can be part of a rehab program for some people. With MAT, clinicians provide medications approved for treating certain substance use disorders, including alcohol and opioid use disorders. These medications can reduce withdrawal symptoms and cravings, helping a person as they begin their treatment and recovery process.

In some cases, Aetna covers the costs of addiction treatment medications. For example, Aetna might cover Suboxone or methadone, which are approved for treating opioid use disorder. Tapering drugs like Ativan or phenobarbital are also possibly covered by your Aetna insurance. Usually, these medicines are covered under a pharmacy plan, with the exact amount of coverage dependent on the plan and deductible requirements.

Aetna Treatment Duration

Every person and treatment plan is unique at The Recovery Village Ridgefield. With that in mind, some standard lengths of time people might spend in an addiction treatment program can be 30, 60 or 90 days or longer. Often, different care levels are part of a treatment plan. For example, you might begin with a medical detox, then spend time onsite in an inpatient rehab before starting outpatient treatment as you’re ready.

The coverage available through your Aetna plan might differ depending on what level of care you need. Other factors that affect how long Aetna will cover treatment include the facility you go to, where you live and the state where you will receive treatment.

Washington State Rehab That Accepts Aetna

The Recovery Village Ridgefield is a Washington rehab center accepting Aetna insurance. We can work with you to verify your insurance benefits. Our Recovery Advocates can help you navigate the insurance process, or you can contact Aetna directly to learn more about your coverage and plan. Contact our Recovery Advocates today if you have questions or are ready to take the next step.