Aetna Rehab Coverage for Substance Abuse Treatment
Searching for alcohol and drug treatment facilities, for yourself or for a close friend, can be a challenging and frustrating. Identifying a center which will take your Aetna coverage and also, offer the treatment that fits your preferences, can take a lot of time. Thankfully, we are able to take the leg work out of this for you. We’ll work hard to determine the most ideal substance abuse facility possible that accepts Aetna rehab coverage to decrease or eliminate your out of pocket fees.
Does Aetna Cover the Price of Rehab
The vast majority of personal and company health insurance policies will have some type of mental health and substance abuse coverage, and that likely also includes your Aetna policy. The important thing is to figure out specifically what treatment center work with the plan, and what your out of pocket costs may be. Elite can certainly help out with this endeavor. It’s precisely what our company does. To get started, give us a call at 949-276-2886, or you can fill out our verification of benefits form linked below. A team member will drill down into your policy and give you a call with some good possible choices for rehab or detox, for you or your friend or family member.
Free Consultation to Discuss Your Rehab Opportunities with Aetna
No Cost Aetna Addiction Treatment Coverage Assessment
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Aetna Addiction Treatment Centers Through Elite Rehab Placement: What to Expect
The first step is to get your policy confirmed. The best way to do this is to either fill out our insurance form, see above for link, or call us on the phone. Then an insurance coverage pro from Elite Rehab Placement will confirm specifically what your plan will, and won’t cover. Once we have got this knowledge, we can easily begin the process for choosing a drug and alcohol rehab or detox that will work with your insurance.
Once we’ve locked in a number of ideal solutions, one of our addiction advisors will reach out to look at your possible choices and help you decide what sounds best. Once we find a treatment facility that works for you, we’ll start talking about a time frame that works with your personal calendar and get you the help that you need. We will also discuss any specific specifications that you have before choosing your best option.
How Long Does Aetna Cover Rehab
Overall coverage will likely vary from policy to policy, but the majority will provide for a length of stay based on necessity. Each scenario is distinctive and many demand an extended timeframe at treatment. That is identified during the treatment process by the medical professionals, treatment personnel, and insurance carriers. Sometimes, in the event the insurance company ascertains that there’s no longer a need for treatment, and the medical staff disagrees, the rehab center will allow clients to stay on a scholorship basis to be sure that the client leaves with complete tools to continue to be clean. A regular in-patient stay is between one and three months.
Inpatient Aetna Rehab Coverage
Virtually all medical insurance providers will cover both out-patient and inpatient drug rehab to some extent. The likelihood of ongoing sobriety are amplified should you continue with an outpatient treatment program and becoming active in the sober community. The vast majority of, if not all Aetna drug rehab coverage policies have both inpatient and outpatient substance abuse coverage for this very reason.
Choosing a Luxury Drug and Alcohol Rehab Program
While your Aetna benefits are likely to include alcohol or drug addiction treatment, it may not include all of the extras that frequently come with it. Some luxury substance abuse treatment centers charge additional for a private room, ocean side setting, massage, acupuncture, or numerous other comforts. We are equipped to break-down every one of these hidden expenditures for you so that you are going to know precisely what you are getting, how much your insurance benefits is going to cover, and how much your personal expenses would be.
Will Aetna Drug Rehab Coverage Work for out-of-State Treatment Centers?
This can be a tricky situation. Let’s pretend that your home is in Alaska and really want to go to a drug and alcohol rehab facility in Maine. You are not wrong for wanting to leave your local area for treatment, infact there are many benefits of traveling for rehab. Your insurance policy might or might not work. Allow our team to verify your benefits and give you a dependable answer on what your policy will or will not cover. It may possibly make more sense to stay closer to home if that’s all your policy is going to cover. You might even have other available options that you’re not aware of, that might be substantially more effective than your original plan. This question can really only be answered on a situational basis. Give us a call at 949-276-2886 so that we can make sure that you’re made aware of all of your practical solutions, prior to making any decisions.
Choosing a Specialty Treatment Facility
Many times, those in search of treatment are attempting to find something specific to their personal preferences. This is where our team can help. We have considerable knowledge of the rehab industry and can assist you in finding the proper treatment that fits your needs and your Aetna drug rehab coverage. Whether you, or your loved one, are looking for a non twelve step rehab program, holistic addiction treatment, or any other specialty treatment program, we can assist you in navigating through all of your possibilities and pick the most reasonable treatment center for you. Call us at 949-276-2886 to learn about your various options. The benefits of specialty addiction treatment can help keep patients engaged in treatment by giving them control of the way they would like to experience rehab.
Additional Health Insurance Pages
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.
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.
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
Finding Rehabs that Accept Aetna
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 long–term programs, 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
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.
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.Acute intoxication and/or withdrawal potential
- 2.Biomedical conditions and complications
- 3.Emotional, behavioral, or cognitive conditions and complications
- 4.Readiness to change
- 5.Relapse, continued use, or continued problem potential
- 6.Recovery/living environment
Aetna and Dual Diagnosis Rehab Centers
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.