Will Aetna Insurance Cover Treatment for Addiction?

If you’ve made the vital decision to seek treatment for addiction, you should feel incredibly proud. Not only are you choosing to change your life, but you’ll also be making your loved ones happy. We understand that one of the aspects of rehab that you’re most interested in at this stage is how much it’s going to cost. The good news is that the Affordable Care Act (ACA) means all marketplace, private and Medicaid insurance plans are obligated to cover substance use disorders to some extent.

Exactly which treatments and how much of your care are covered depends on your policy. Aetna works with each person to figure out how much they’ll pay, as there’s no one-size-fits-all when it comes to addiction. It offers open access plans, high-deductible plans and co-pay-only plans. Aetna may cover you for the following services:

  • Detox
  • Residential treatment
  • Partial hospitalization programs
  • Intensive outpatient
  • General outpatient
  • Aftercare

Does Health Insurance Cover All of My Costs at Rehab?

In some cases, your insurance policy could cover you for the entire cost of drug or alcohol treatment; in other cases, you may need to pay for a portion of your care. It all depends on the insurance policy you have in place, as well as several other factors. Below are some of the most notable factors to take into consideration when an insurer decides what proportion of your addiction treatment it can cover.

Would Treatment Be Considered a Medical Necessity?

While the ACA deems that mental health conditions such as substance use disorders must be covered to some extent by insurance, the company can decide precisely what is included based on the severity of your condition. For example, if you’re opioid, alcohol or benzodiazepine dependent, detoxification is likely to be covered by insurance. Aetna will deem any aspect of your care that you couldn’t recover without to be necessary.

This means certain aspects of rehab such as complementary therapy, individual accommodation and extended stays may not be paid for by your insurance provider.

Is This an Empirically Validated Treatment?

Psychotherapy and counseling methods that have sufficient documentation to back up their effectiveness are usually included by your policy. However, many rehab facilities understand the importance of using complementary therapies such as art and music therapy, exercise classes and nutrition courses. They help you to relax, bond with your peers and care providers and put you in a mindset conducive to receiving treatment. Insurance may not cover the costs of these services.

Being in or out of Network

Aetna’s coverage extends to 1.2 million health care professionals. Although not of their plans actually require your chosen rehab to be in-network, an out-of-network program may cost more. Aetna carefully screens in-network programs to ensure their practices are up to date and the care they provide is of high quality.

Meeting Your Deductible

Of course, in order for you to have access to insurance services, you need to have qualified for them by meeting your deductible with qualifying health care expenses. By law, your company only has a single deductible that is inclusive of all treatment, including care for drug and alcohol addiction.

Beachfront Rehab in North Carolina Is Within Reach

In spite of the optimism and happiness that lies ahead, the process of seeking treatment for addiction is fraught with many challenging choices. Money is one of the main concerns for most people, but never let this stop you from reaching out for help. You can fill out our insurance verification form to verify your Aetna insurance and find out exactly how much of your treatment your insurance plan covers. If you’d like any help or advice on filling out the form from our friendly counselors here at Changing Tides, call us today at 252-715-3905.