Under the Affordable Care Act (ACA), most insurance companies must cover substance use treatment in some way.1 Aetna does cover many forms of addiction treatment. But exactly what they cover will depend on your plan and the state you live in.
Depending on your plan, the treatment types Aetna covers may include, but are not limited to:
Before you begin any substance use treatment program, it’s a good idea to check what Aetna will and won’t cover. You can do this a few ways:
The first step for many on their treatment journey is talking to their doctor (sometimes called a “primary care physician,” or PCP). Your doctor can assess your needs and refer you to specialists or other treatment.
Next, call Aetna to ask what they cover. Some good questions to ask them include: how many days of treatment they cover, what you will have to pay for (called “out-of-pocket” costs), and if you need to get special approval (called “pre-authorization”) first.
One of the easiest ways to find treatment centers in Aetna’s network is to use their Find a Doctor tool. Simply log in and search for drug or alcohol rehab centers.
Aetna is a well-known insurance company that contracts with many treatment centers, so finding one that takes your insurance shouldn’t be a problem. In fact, American Addiction Centers works with Aetna. But if Aetna doesn’t cover your first choice for treatment, don’t give up. Your well-being is too important, and there are many options to pay for treatment.
You don’t have to stay in the network with some types of Aetna insurance plans.2 But it will almost always cost more if you do choose a treatment center that is out-of-network.2 Remember, you can always check who is in network by calling Aetna or searching their online list of providers.
Aetna’s insurance plans fall into one of the following categories:3
Within each category outlined above, Aetna has several insurance plans to choose from. Each plan will give you different options in terms of how much you pay for addiction treatment and whether or not you’ll need referrals or can go out of network.
Medicaid offers low- or no-cost health insurance for people with lower incomes, special needs, or disabilities. Aetna offers Medicaid insurance plans in the following states:4
Aetna also offers Medicare Advantage plans, which combine original Medicare with other insurance coverage. Aetna has HMO-POS, HMO, and PPO Medicare plans. Some of these plans have no monthly premium.5
Insurance can be confusing, but we try to make it easier to understand. You can check online if Aetna covers treatment with us.
Note: We try to offer the most updated information available about insurance. But insurance health plan information does change quickly. Please check with your insurance company to ensure that you have the most recent and correct information about your coverage.