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Aetna Insurance for Rehab

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Addiction treatment can be expensive, so you may wonder—does insurance cover drug rehab? Yes, insurance can offset a large portion of the cost at covered facilities. This page will provide more information about:

  • Aetna Insurance health plans.
  • Healthcare coverage plans that Aetna offers.
  • Checking your healthcare benefits.
  • If Aetna covers drug rehab.

Aetna Insurance company has been operating for more than 160 years and has become a major insurance provider in the United States.1 It became a part of CVS Health Corporation in 2017 and currently offers health insurance coverage to almost 40 million people.1, 2, 3 Insurance plans offered include medical, vision, dental, mental health, and prescription benefit coverage.3

Please note: American Addiction Centers (AAC) strives to provide you with the most current information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check directly with your insurance carrier to confirm your insurance coverage. AAC is not affiliated or endorsed by Aetna or any of its subsidiaries.


Aetna Insurance for Inpatient & Outpatient Rehab

Does Aetna cover drug rehab? Yes, although coverage options vary based on which Aetna medical insurance plan you have and which state you live in. Plans are divided into 2 main categories: health maintenance organizations (HMOs) and preferred provider organizations (PPOs).4 HMO plans only cover in-network providers and require referrals from your primary care physician (PCP) to see specialists. In addition, these plans have set copays and offer lower monthly premiums and deductibles.4 PPO plans allow you to visit any doctor you choose and do not require referrals to see specialists but have higher premiums, lower copays, and may require coinsurance payments.4

Aetna insurance plans are divided as follows:5

  • Bronze plans have the lowest premiums and the highest deductibles and out-of-pocket expenses. Once your deductible is met, you’re only responsible for about 30% of your medical expenses.
  • Silver plans have higher premiums and lower deductibles and out-of-pocket expenses than bronze plans. Once your deductible is met, you’re only responsible for approximately 20% of your medical expenses.
  • Gold plans have the highest premiums and lowest deductibles and out-of-pocket expenses. Once your deductible is met, you’re only responsible for about 10% of your medical expenses.

People with disabilities or special needs and those who have income under a predetermined level in some states are eligible for Medicaid, a health insurance program that is funded by states and the federal government.6 Aetna offers Medicaid insurance plans in 16 states across the country.6 Medicare is a government-funded health insurance program that covers adults age 65 or older and people under age 65 with disabilities in certain cases.7 Aetna offers 3 different types of Medicare Advantage plans:

  • HMO plans offer a network of providers and require a referral from your PCP to access specialist services.
  • PPO plans allow you to visit any provider you want, as long as they accept Aetna.
  • HMO-Point-of-Service plans offer some of the benefits of both HMO and PPO plans. You can visit some providers who aren’t in-network but might pay more.

Whether your insurance covers drug rehab depends on your Aetna medical coverage policy and the benefits it offers. With some policies, you may be able to seek treatment in a different area than you are covered in, such as if you have a PPO plan. However, if you have an HMO plan, you are limited to in-network providers, which may not be covered outside of your geographical area. Determining your Aetna Insurance mental health coverage is always a good practice before seeking treatment.


How to Check my Insurance Benefits?

You can check your insurance benefits by calling member services using the phone number on the back of your insurance card. Aetna also offers an online option, where you can create an online account and view your benefits.

Aetna provides insurance plans for current and retired federal workers, depending on where you live.9 You can learn more about the plans offered in your area on their site.


Does my Aetna Health Insurance Plan Cover Addiction Treatment?

The Mental Health Parity and Addiction Equity Act is a federal law that ensures that mental health and addiction treatment coverage is equivalent to the coverage provided for physical health conditions.10 Although this doesn’t ensure that Aetna Insurance therapy coverage includes all forms of treatment for substance use disorders, Aetna does cover many forms of addiction treatment. Your plan specifies which services are covered. Some may require precertification from your provider.11 You can click here to determine your insurance coverage, or you can fill out the form below.

Aetna provides healthcare benefits to millions of Americans, ensuring that they can access care for all their needs, including addiction treatment. A variety of insurance plans and coverage options are available, with varying services and providers. Checking your benefits before seeking treatment is always advised to ensure that your care is covered according to your plan.


Sources

  1. Aetna. (2020). Our corporate profile.
  2. Aetna. (2020). Our history.
  3. Aetna. (2020). Aetna facts.
  4. Aetna. (2020). HMO, POS, PPO, EPO, and HDHP with HSA: What’s the difference?
  5. Aetna. (2019). Aetna Life/Aetna Health 2020 small group plans.
  6. Aetna. (2020). Medicaid health plans.
  7. Aetna. (2020). What is Medicare?
  8. Aetna. (2020). Medicare Advantage plans.
  9. Aetna. (2020). Compare plans.
  10. National Alliance on Mental Illness. Mental health parity.
  11. Aetna. (2019). Behavioral health precertification list.

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