Aetna is a national insurance provider offering coverage in all 50 states. The company’s health plans insure more than 22 million members, and their vast network includes 1.2 million health-care professionals, nearly 700,000 primary care doctors and specialists, and more than 5,700 hospitals.
Aetna offers private health insurance plans, subsidized marketplace plans through the Affordable Care Act (ACA), and Medicare and Medicaid plans.
All these plans cover some or all the cost of drug and alcohol rehab programs. They also cover screening, brief intervention, and referral to treatment programs.
If you have an Aetna insurance policy and are searching for a drug and alcohol treatment facility that is covered by your plan, you’ve come to the right place. Adelante Recovery Center accepts Aetna insurance policies and will work with the company to help you get the most out of your coverage.
How to Check Your Insurance Benefits
Our administrative team can help you determine what is covered and how much, but it’s always a good idea to contact your insurance company directly to find out.
Log in to your account online to check your benefits, or call the number on the back of your insurance card.
Here are some questions to ask when you call:
- Do you cover substance abuse assessment?
- Do you cover detox services? How many days?
- Do you cover outpatient rehab?
- Do you cover inpatient rehab?
- How many days of rehab do you cover?
- Which programs in my area accept Aetna?
Make sure to write down the name of the person you speak with and the details of your conversation.
Knowing what your insurance plan covers before you enter a rehab program will give you greater peace of mind so you can focus completely on treatment.
Aetna’s Coverage Levels and Plans
Aetna offers several types of plans, which allow members to prioritize what’s most important to them—for example, keeping costs down or the freedom to choose any doctor.
PPO plans (open-access plans) allow you to choose your own doctors. You don’t have to choose a primary care provider (PCP) or get referrals to specialists. The tradeoff is that these plans typically come with higher out-of-pocket costs.
HMO plans (co-pay only plans) guarantee that in-network medical costs will be completely covered after you pay for copays and meet your deductible. You must choose a primary care physician and get referrals to see specialists. Office visits to your PCP and generic drugs are usually covered before you meet your deductible.
High-deductible plans are designed to keep premium costs lower. These plans cover preventative services before you meet your deductible. Some plans also cover visits to your primary care provider before you meet your deductible. Most high-deductible plans allow you to enroll in a health savings account, in which you can save pre-tax funds for medical expenses.
Exclusive provider organization (EPO) plans are designed to help you save on out-of-pocket costs. You must choose a primary care provider and get referrals for specialists. Care takes place exclusively within a network designed to keep costs contained.
This is only a partial list of Aetna plans. The company also offers many local plans to help patients at the community level.
Which Aetna Plans Cover Addiction Treatment?
Private Insurance Plans
Aetna’s private insurance plans cover at least some of the cost of addiction treatment. How much they will cover depends on which plan you have, and the coverage limits on your policy.
Marketplace Plans (Affordable Care Act)
The Affordable Care Act (ACA) requires all insurance companies, including Aetna, to provide some coverage for alcohol and drug treatment. All ACA plans must cover:
- Behavioral health treatment (psychotherapy and counseling)
- Mental health inpatient services
- Substance use disorder (SUD) treatment
If you have a plan through your state’s marketplace or the federal marketplace (healthcare.gov), your plan must cover at least some of the cost of these services.
Medicare and Medicaid
Aetna works with federal insurance programs to provide treatment for substance use disorders.
Which services they cover and at what level depends on the program and the specific plan. For example, Medicare Advantage plans may offer additional coverage beyond what is covered by Original Medicare Parts A and B.
Aetna offers Medicaid plans in 16 states through their Better Health® plans. These plans cover some or all the cost of drug and alcohol rehab.
Which Types of Rehab Programs Does Aetna Cover?
Everyone needs a different level of care in rehab depending on the substance they use, how long they’ve been using it, and other factors.
Some people can continue working or going to school while attending an outpatient treatment program. Others need day treatment (partial hospitalization) or round-the-clock care in an inpatient residential program.
Most Aetna plans cover detoxification services and at least some of the cost of these different levels of care. Talk with your doctor or an addiction specialist about which type of treatment is best for you.
Do Treatment Centers Need to Be In-Network?
In most cases, you must seek treatment at an in-network facility to receive your full benefits. You still may be responsible for some costs.
If you choose an out-of-network treatment center, you may be responsible for the total cost of treatment.
What If Aetna Won’t Cover All of My Treatment Costs?
Even if your plan doesn’t cover everything, it’s important not to let that stop you from getting help. There are alternative ways to finance your treatment. Here are some options:
- Payment plans that allow you to pay in monthly installments
- Sliding scale fees that allow you to pay what you can, based on your income level
- Grants or scholarships through the Substance Abuse and Mental Health Services Administration (SAMHSA) or participating rehab centers
- Healthcare loan or credit card
- Savings, or a money loan or gift from trusted family members
Get Help Now
Adelante Recovery Center offers comprehensive drug and alcohol rehab programs at our Orange County drug treatment center. We create individualized therapy programs for our clients. Individual counseling, group therapy, and family therapy form the core of our inpatient residential programs.
If you’re concerned about a loved one or you’re ready to begin a treatment program, contact our administrative team to find out about coverage for rehab with Aetna. Help is just a phone call away.