In 1853, Aetna was first established as a healthcare company that provided coverage to employers and individuals aside from its wide array of behavioral and mental health services. This includes various coverage options to its policyholders including detoxification, residential and inpatient rehabilitation, intensive outpatient, and partial hospital treatment. The company also covers continuing care treatment programs for its policyholders suffering from substance abuse and addiction.
Does Aetna Cover Drug and Alcohol Rehab?
Many people have no idea what their health insurance plan actually contains, or how their plan differs in terms of benefits on mental health and substance abuse from the coverage of general health care. If you are using Aetna insurance, this is one of the insurance policies that offer better options and coverage for the treatment of drug or alcohol abuse. For one, Aetna covers the bigger part of costs for drug rehab. Aetna could even allow the patient to stay for a longer time in the drug rehab facility if it is required.
Aetna offers coverage for drug and alcohol rehab in different types of settings. This includes detoxification as well as admission to inpatient rehab facilities. The Aetna insurance coverage for substance abuse also includes rehab through residential treatment centers. Aetna has a wide network of rehab providers that offer therapy and treatment for those suffering from alcohol or drug abuse and addiction. These network programs undergo screening to assure that they indeed offer quality care, observance to the best practices about contemporary treatment, as well as their capacity to offer follow-up and post-rehab care.
The company is working with CRC Health Group and also offers coverage for opioid treatment. It is important to note that the duration of the drug rehab treatment covered by Aetna depends on the type of plan you have and on your needs. If you have Aetna insurance but would like to choose a facility that is not included in the company’s network of providers, it will be costly. Aetna insurance coverage further states that treatment might not be the same in terms of the level of facilities and services under their network of providers.
Each policyholder is provided with different options in terms of treatment. In fact, Aetna is recently endorsing its newest program using different rehabilitation and treatment centers in Texas, South Dakota, and California. These programs accept anyone regardless of status. So, whatever is your work or position, you are welcome to check into various centers located in these areas if you have Aetna insurance and if you agree to be in that program.
These centers are luxurious and have expensive facilities that will make you feel like you are in a resort. In these centers, you can enjoy swimming; soaks in the hot tub, the feast of four-star food, and enjoy other offers that are only exclusive in this type of program.
Length of Addiction Treatment Aetna Covers
If you are not yet ready to be treated because you are anxious, you will be happy that you have Aetna health insurance. The company provides members with the support that anyone can access at any time of the day. The support can help you look for a doctor, psychiatrist, or drug rehab, or treatment facility. Most importantly, whatever you say to the customer service representative is kept with the utmost confidentiality.
In addition, the company will handle your information with discretion. Currently, the company is now involved in combining the 12-step programs with private therapy to treat those who are suffering from substance abuse and addiction. The duration of the stay depends on the type of policy.
When you contact Aetna, you can ask different useful questions to know more about your policy. This includes asking if your Aetna policy covers assessment for substance abuse. You can also ask if Aetna has counselors, or if your policy covers detoxification and for how many days. You can ask if Aetna covers therapy, or if Aetna covers counseling.
You can also ask if your policy covers outpatient rehab or inpatient rehab and how many days in the rehab it can cover. Another important question that you can ask the customer service representative, is the kinds of programs in your area that accept Aetna.
Does Aetna Also Cover Mental Health?
If you are suffering from PTSD, anxiety, depression, or other mental health issues, you do not have to worry if you have an Aetna insurance policy, since it also covers mental health treatment. The company believes that many people visit clinics, hospitals, or see their doctors because of stress and other emotional and mental issues. Because of this, Aetna offers coverage for behavioral health and mental health. The mental health coverage of Aetna’s insurance policy differs for every patient. It also depends on the type of patient’s policy and the location where he is residing.
Aetna also provides phone access 24 hours a day, so that policyholders can talk to the customer service agents any time to get answers for the questions related to Aetna mental health coverage, Aetna mental health providers, get a copy of the list of Aetna mental health providers, or a list of mental health services covered by Aetna. The customer care representative can also assist you in finding a behavioral or mental health professional that could help you. The company does not only offer coverage for different mental health services but also a combination of information from the mental and physical health records to make sure that proper care is given and coordinated. In addition, this significant data could also help medical practitioners and doctors in making important decisions.
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Aetna Behavioral Health Insurance
Aside from coverage for drug rehab and mental health, Aetna also offers coverage for behavioral health and a wide variety of programs for rehab treatment. In many cases of behavioral health coverage, the company requires pre-authorization or precertification. You can get this by reaching out to Aetna Member Services or through Aetna Behavioral Health’s phone number. If you are looking for Aetna behavioral health providers, you can find them online by searching for Aetna behavioral health providers.
However, if you are using Aetna behavioral health insurance for services under the outpatient category, preauthorization or precertification is no longer required in most cases. Members can easily reach out to their physician for the referral to a particular behavioral healthcare provider to access various outpatient services. Services that require preauthorization or precertification include biofeedback, inpatient admissions, outpatient detoxification, neuropsychological and psychological testing, and home care services for psychiatric patients.
Aetna Inpatient Rehab
Treatment for drug and alcohol abuse and addiction are usually offered through Inpatient Rehab or Outpatient Rehab. The good thing about Aetna is that it offers plans that cover both inpatient and outpatient rehab. You can choose various locations you decide to be admitted to an inpatient rehab facility. Through Aetna coverage, these facilities can greatly help you on your road to rehabilitation and recovery.
Aetna Outpatient Services
In addition to inpatient rehab, Aetna also covers outpatient services based on the policy that you have and the location of the treatment facility. The treatment offered is enough for situations that include addiction that ranges between mild and moderate levels. Patients are handled during the daytime and are given the chance to go back to his home after the treatment session.
Does Aetna Cover Suboxone?
Suboxone is a type of treatment usually given to patients suffering from addiction to heroin. This is a good medication that lessens the effect of withdrawal symptoms. Aetna offers coverage for various prescription drugs linked with addiction to opioids. You can check if your plan covers Suboxone treatment by talking to one of their customer service representatives.
Does Aetna Cover Methadone Treatment?
Methadone is known to many as a narcotic drug. Like Suboxone, it is used to treat patients that are addicted to heroin because it decreases the effects and symptoms of withdrawal. Depending on your plan, Aetna can cover this medication and you can avail of this in various treatment centers and clinics.
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What You Can Expect from Aetna In Rehab
If you are planning to use your Aetna insurance policy to cover the cost of rehabilitation, this will be included under the category of mental and behavioral health services that may require pre-authorization. It is crucial that this is included in your plan before admitting yourself to treatment. The insurance company also invites its policyholders to benefit from lower costs through Aetna behavioral health care providers that are in the network of the insurance company.
Let’s assume you needed to be in the drug rehab or treatment facility for 14 days after you have been met your deductible, you were billed in-network $14,152. With the negotiated rate by Aetna, that rate would go down to $ 9,729. Your insurance plan will pay 80 percent of that amount. This will leave you with your coinsurance responsibility of only $1,946. For instance, instead of in-network, you opt for an out-of-network facility or a provider that is not included in the list of Aetna rehab provider network, your coinsurance responsibility will amount to $ 6,957.
This scenario simply shows that your insurance plan pays 80 percent of the in-network facilities, along with behavioral health consultations and counseling, and only 60 percent of the out-of-network. As a patient, you will have to pay 20 percent in an in-network facility or 40 percent in a provider that is not included in your insurance network of providers.
Affordable Care Act
Two of the rapidly growing problems that the United States government is facing are substance use disorder and mental health illness. In 2014, in the US alone, there were 20.2 million Americans who were suffering from substance use disorder. A staggering 7.9 million had mental illness and substance abuse disorder. Addiction to alcohol or drugs is a mental disorder because it alters the priorities and desires of the person. While this could be a big problem, this can still be treated through drug rehab.
The problem is, aside from the stigma of going to drug and mental health facilities; many are apathetic to admitting themselves to these facilities because of the expense. But, according to Obamacare or the Affordable Care Act, health care providers are mandated to offer the essential health benefits to form part of their services. This consists of the inclusion of basic services like the treatment of mental health.
The treatment for substance use is under the behavioral and mental health treatments as assured by the Affordable Care Act. Insurance companies, therefore, are required to offer coverage for the treatment of substance disorders, the equivalent of which should be that of primary care. The problem is the ACA does not stipulate the exact figures that the insurance company should cover. What is stated is that it should be tantamount to the services offered for primary care. According to Obamacare, the amount of coverage a patient can receive will be based on their insurance company, the type of plan that they have, and the particular state where they live.
Paying for Services That Are Not Covered by Aetna Insurance Policy?
If you are unable to pay for the copayments or deductibles, there are other ways to make it more manageable. This includes patients paying their remaining bills on a monthly basis. There are also several instances where rehab and treatment facilities make special arrangements if the patient is in a financial crisis. There are several others that provide a scholarship to their patients to solve the problem.
You can also borrow cash from family, friends, co-workers, banks, or other financial institutions to pay for the deductibles, copayments, and other financial obligations connected with treatment for drug or alcohol use and abuse disorder. While this may sound like an unusual way to utilize credit, a great treatment program for drug or alcohol use disorder is really worth your time and investment.
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.