Understanding Your Aetna Rehab Coverage for Addiction Treatment

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Aetna and the Cost of Rehab

The cost of drug and alcohol addiction rehabilitation treatment varies widely, from free to more than $150,000, depending upon a number of factors, such as to which drug or drugs you are addicted; whether you need to detox; if you have a co-occurring disorder/dual diagnosis; if you are getting outpatient or inpatient treatment; how long you need to stay; if you have a private room; what types of therapy you receive; where the treatment center is located; what amenities it offers; and what type of insurance (if any) you have. If you do have insurance, it may cover some or all of your treatment. If not, or you can’t afford the cost even with insurance, there may be government, church, or other charitable grants that will pick up some or all of the cost.

Yes, Aetna does cover rehab. According to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), “The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care.”

According to SAMHSA, Aetna should cover “intermediate levels of care, such as treatment received in residential or intensive outpatient settings,” such as treatment for alcohol dependence, prescription pill addiction, and other forms of substance abuse. There are limitations, depending on your particular insurance plan and doctor-evaluated health needs, and some exceptions for grandfathered and small-group plans.

How to find out if Aetna will cover drug rehab

To find out if Aetna will cover drug rehab and to what extent under your current insurance plan:

  • Ask an Aetna Member Services representative
  • Ask the substance abuse treatment center. It may understand the byzantine benefits process better than Aetna.
  • Ask a rehab placement agency such as Elite Rehab Placement. You can request a live telephone consultation or complete an online Aetna Addiction Treatment Coverage Assessment. Both are free.

How much Aetna does cover for drug rehab varies, depending on your particular insurance plan. In general, Aetna should provide the same level of benefits for substance use treatment and services that they do for medical/surgical care. For specifics, check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

Authorization was required for in-network care. For out-of-network care, prior authorization was required. For 2018, no information was available as of this writing.

How many times Aetna will pay for drug rehabilitation depends on your plan and doctor-evaluated needs. As long as your doctor believes treatment is needed and effective, it should pay for drug rehabilitation as many times as necessary, but check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

Aetna does cover alcohol rehab. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) states that “The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care,” but the extent and nature of the coverage depends on your health plan and doctor-evaluated health needs.

How much of the cost of alcohol rehab Aetna does cover varies, depending on your plan and doctor-evaluated health needs. Check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

Yes, Aetna does pay for substance abuse rehab, at least in part. Substance abuse is a catch-all term for the abuse of alcohol, opioids, other drugs, and even other substances. Under the Mental Health Parity and Addiction Equity Act of 2008, health insurers and group health plans are required to provide the same level of benefits for substance use treatment and services that they do for medical/surgical care.

Whether Aetna will pay for 45 days of rehab may depend upon your plan and doctor-evaluated needs, but most plans will provide for a length of stay based on necessity, not an artificial deadline.

To find out if Aetna covers substance abuse, and to what extent, under your current health insurance plan, check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

Yes, Aetna does cover residential treatment, though the amount and length of stay varies depending on your current health insurance plan and doctor-evaluated needs. At some point the patient might be required to move to intensive outpatient treatment.

Aetna and Detox

Yes, Aetna does cover detoxification from drugs when your doctor deems it medically necessary.

To find detox centers that take Aetna, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

To find substance abuse treatment centers in the Aetna treatment detox provider network, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

Finding Rehabs that Accept Aetna

To find find rehabs that accept Aetna, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find what rehab takes Aetna, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

To find what rehabs does Aetna pay for, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To make your own Aetna provider search – to look for rehab, mental disorder, or anxiety treatment – use the search engine on the Aetna website here, check with an Aetna Member Services representative, or contact Elite Rehab Placement.

 

Long-term drug addiction programs are sometimes used when a patient needs to be in a controlled environment for more than 90 days, usually after having relapsed or failed after a less-controlled, short-term program. To find Aetna drug addiction longterm programs, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find drug addiction service providers in Aetna, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find Aetna insurance innetwork providers for residential drug treatment, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

To find what rehabs are in network with Aetna insurance, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

Aetna and Inpatient Rehab

To find rehab facilities that take Aetna health insurance plans, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

To find what recovery treatment facility will Aetna insurance accept, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find what rehabs does Aetna pay for, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find what recovery treatment facility will Aetna insurance accept, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find what inpatient treatment facilities does Aetna cover, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

Find the Best Rehabs that Accept Aetna

When you are considering what are the best Aetna-covered rehabs, “best” depends on your specific substance abuse disorder, your doctor-evaluated health needs, and your specific health insurance coverage plan. For help, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or contact Elite Rehab Placement.

While there are many sites that claim to rate the best rehabs in the US, Aetna, or other insurance providers based on services, costs, and reviews by patients or their families, none are considered completely objective or authoritative. For help making your own determination, use the search engine on the Aetna website here or check with an Aetna Member Services representative or Elite Rehab Placement.

 

The best Aetna rehab facilities is a subjective judgment with no consensus. It depends on your substance abuse, insurance, and health needs. For help making your own determination, use the search engine on the Aetna website here or check with an Aetna Member Services representative or Elite Rehab Placement.

The best inpatient care for drug abuse, Aetna or elsewhere, requires careful examination of your specific substance abuse, insurance, and health needs. For help making your own determination, use the search engine on the Aetna website here or check with an Aetna Member Services representative or Elite Rehab Placement.

 

To find if there are Aetna-approved rehabs near me, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find if there is a rehab near you that accepts Aetna insurance, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find if there are local rehabs that take Aetna insurance, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find if there is an Aetna innetwork rehab, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

To find an Aetna rehab provider network, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

 

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Addiction Recovery

Aetna Insurance Plans and Addiction Treatment

Most Aetna plans cover rehab because the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires most plans provide the same level of benefits for substance use treatment and services that they do for medical/surgical care,” according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

Yes, Aetna bronze plus plan covers substance abuse for 2017. Patient’s cost was 20% for in-network services and 40% for out-of-network. No prior authorization is needed for outpatient care but is required for out-of-network inpatient care. Summary of benefits and coverage (SBC) for 2018 was not available as of this writing.

 

Aetna and Blue Cross Blue Shield do not cover rehab because they are competitors. They do not offer any joint plans. Aetna does cover rehab, but the extent of the coverage depends on your plan and doctor-evaluated health needs.

Yes, at least some plans of Aetna Choice II, or Choice POS II, do cover rehabilitation for substance abuse. Substance use disorder outpatient services have a co-pay of 20% in-network, 50% out-of-network. Inpatient care out-of-network requires prior authorization or there will be a $500 reduction in benefits.

 

Aetna and Blue Cross Blue Shield do not cover inpatient care because they are competitors. They do not offer any joint plans. Aetna does cover inpatient care, but the extent of the coverage depends on your plan and health needs.

 

Aetna guidelines for substance abuse

The Aetna substance abuse guidelines are based on The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, the American Society of Addiction Medicine’s nationally recognized guidelines for appropriate levels and types of care for dependency and substance abuse.

The Aetna guidelines for substance abuse are based on The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. The ASAM (the American Society of Addiction Medicine) and Aetna substance abuse guidelines are:

  1. 1.Acute intoxication and/or withdrawal potential
  2. 2.Biomedical conditions and complications
  3. 3.Emotional, behavioral, or cognitive conditions and complications
  4. 4.Readiness to change
  5. 5.Relapse, continued use, or continued problem potential
  6. 6.Recovery/living environment

 

Aetna and Dual Diagnosis Rehab Centers

Yes. Since Aetna covers both substance abuse and mental health conditions, Aetna does cover dual diagnosis rehab centers. The extent of the services covered at these centers may depend upon your current health insurance plan and doctor-evaluated health needs.

To find what rehab takes Aetna, use the search engine on the Aetna website here, check with an Aetna Member Services representative, or visit Elite Rehab Placement.

To find dual diagnosis centers that accept Aetna insurance, check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

For dual diagnosis centers that accept Aetna insurance, use the search engine on the Aetna website here, check with an Aetna Member Services representative, the dual diagnosis center in which you are interested, or Elite Rehab Placement.

There are no Aetna dual diagnosis centers per se because Aetna does not in itself own any, but there are dual diagnosis centers that accept Aetna insurance plans. Use the search engine on the Aetna website here, check with an Aetna Member Services representative, the dual diagnosis center in which you are interested, or Elite Rehab Placement.

 

Other common questions

Yes, Aetna does provide insurance coverage for anxiety and other disorders, though the extent of coverage may depend on your current health insurance plan. Disorders covered include:

  • Generalized anxiety disorder
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Social anxiety disorder

Aetna rehabilitation prior authorization – also called precertification, authorization, preauthorization, or certification – is the process by which patients receive approval for some forms of desired care – such as drug and alcohol rehabilitation – before receiving treatment. To determine if your health plan requires approval beforehand for a particular treatment, check with an Aetna Member Services representative, the substance abuse treatment center, or Elite Rehab Placement.

 

Technically residential treatment is not considered inpatient. While the terms are sometimes used interchangeably, inpatient refers to a short-term stay in a hospital or clinic with 24-hour medical monitoring. Residential treatment involves a more hospitable long-term home-like atmosphere, with less obtrusive monitoring and various therapies. A substance abuse patient might go through detox as an inpatient, then move to a residential location for rehab. Some residential substance abuse treatment centers have detox on site.

 

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