Aetna Insurance for Alcohol and Drug Rehab

Does Aetna Cover Drug Rehab?

Aetna is a nationwide insurance provider offering plans that coverage for detox, rehab, and other forms of addiction treatment. The Affordable Care Act that was passed in 2010 requires most insurance plans to include alcohol and drug rehab coverage as an essential benefit.⁷

The details of Aetna rehab coverage vary by plan. However, you can expect Aetna therapy coverage to include approved Aetna alcohol rehab centers or detox programs for opioids. Opioid treatment may also include medication such as Suboxone that can help reduce the cravings for illicit drugs.⁸

Types of Addiction Treatment Covered by Aetna Insurance

The types of treatment covered by your Aetna plan will depend on the type of insurance you have, where you attend treatment, whether the treatment is deemed medically necessary, and how long and intense the treatment is. Your Aetna plan may cover services like:

• Detoxification Services.
• Inpatient or Residential Treatment
• Outpatient Treatment
• Aftercare or Sober Living.

How Much Does Aetna Cover?

While the Affordable Care Act (ACA) requires all insurance plans to provide some degree of coverage for medically necessary treatment for behavioral and mental health disorders, the extent of your Aetna coverage will depend on a variety of factors. The largest determinant is what type of Aetna plan you have. It’s always a good idea to reach out to an Aetna representative in order to check your coverage before committing to treatment. Other factors that may affect coverage include where you attend treatment, if a rehab is in-network with Aetna, how long treatment lasts for, how intense treatment is, and what accommodations and amenities are provided at the rehab.

How to Use Your Aetna Coverage for Drug Rehab

To enter a specific addiction treatment program, you may need a referral from your primary doctor. They may give you some medication to help with withdrawal symptoms before you enter the drug rehab program. Once you are in the rehab process, you’ll have a monitored detox to ensure that the drugs leave your system safely.

Aetna understands that sometimes multiple attempts at rehab may take place before someone is able to achieve sobriety. As a result, your treatment plan will be a combination of a rehab center’s recommendation and what rehab coverage is provided through your Aetna insurance plan.

Do Rehab Facilities Need to Be In-Network with Aetna?

In most cases, one will receive significantly more coverage if they attend an in-network facility. This is oftentimes true for Aetna insurance, and many benefits may only be available to those who seeking substance use disorder treatment at an in-network facility. Additionally, while Aetna may cover some of the costs for out-of-network treatment, coverage can be significantly reduced. It’s important to confirm that Aetna works with any prospective rehabs before committing to treatment.

How to Check Your Aetna Benefits for Drug Rehab

To know for sure whether or not your Aetna insurance plan covers substance abuse rehab, it’s important to verify your coverage. You can use access details about your Aetna rehab coverage by logging on to Aetna’s member care website.⁶ Once you register your account, you can search the Aetna rehab provider network to see what professionals are part of your insurance plan. You can also get coverage information, find out how much the copayment and deductible will be for your specific treatment, and more.

Additionally, many treatment providers, like American Addiction Centers, allow you to verify your exact Aetna rehab coverage details.

Types of Aetna Plans Covering Rehab Services

Aetna provides healthcare coverage for 39 million people in the United States. Aetna offers a variety of health insurance plans, Medicaid and Medicare coverage, and behavioral and medical management programs.^{1, 2}

Aetna’s offerings include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Point of Service Plans (POS), and Exclusive Provider Organizations (EPOs).

HMOs and PPOs are the most common. An HMO allows you to save money on premiums and deductibles by staying in Aetna’s insurance network and getting referrals from your primary care provider for specialized care. A PPO is more expensive, but you can see specialists and out-of-network rehab providers without a referral. Copayments and coinsurance for in-network rehab providers are still low, but you’ll pay more if you go outside the Aetna rehab provider network.

POS plans offer the advantages of an HMO but also provide access to providers outside the Aetna rehab provider network. However, Aetna policyholders with a POS plan will require a referral from their primary care provider in order to receive care outside the Aetna rehab provider.

Finding Rehab Centers That Take Aetna Insurance

Once you’ve decided to commit to treatment you’ll need to find a rehab that accepts Aetna insurance. A good place to start would be to reach out to your Aetna representative to verify your coverage. Understanding what your benefits are can help you determine what treatment facilities will work for you. They may also be able to refer you to rehabs in your area. Once you’ve verified your coverage, you may want to visit the SAMHSA treatment locator to find a rehab near you.

Additionally, you may consider reaching out to an addiction helpline. Addiction helplines, like the one owned and operated by American Addiction Centers (AAC), are 24/7 resources that can help answer questions you may have about rehab or insurance. If you want to check your Aetna insurance benefits, reach out to us at today.