Below are some of the services people with Aetna insurance may or may not have access to. The ACA requires that all insurance companies offer some form of coverage for substance use treatment. Insurance coverage is a major consideration in choosing a drug rehab facility. Many people cannot commit to addiction treatment before sorting out the financial details first.

Aetna Plan Types

All Addiction Resource content is medically reviewed or fact checked to ensure as much factual accuracy as possible. The price will differ does aetna drug test depending on the level of coverage and state where insurance is purchased. Log in to your secure member website to check your personal coverage and benefit costs. Recovered was previously found on ncadd.org the home of National Council on Alcoholism and Drug Dependence INC (NCADD). Visiting the Aetna website and using its online provider directory can help you search for rehab facilities in your area that accept Aetna.

1. We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
2. Typically, referrals aren’t required, however some states may require it.
3. Participating health care providers are independent contractors and are neither agents nor employees of Aetna.

Aetna Medicare plans

Another important consideration when searching for Aetna insurance is whether the plan is an HMO, PPO, or POS.

A health maintenance organization (HMO) is the most affordable type of insurance, with low premiums and deductibles as well as fixed copays. HMOs require clients to use only doctors in the HMO network, however. Nonresidential treatment programs such as day treatment, also known as PHPs, are in-network with most plans offered by Aetna. The extent of coverage for a rehab program will depend on the state, the healthcare plan, and whether the facility is considered in-network or out-of-network. Contact Aetna to find out which medications are covered by your plan.

Dual diagnosis treatment is essential for people with co-occurring mental health and substance use disorders. IOPs are structured programs that are usually two to three hours per day, three to seven days per week. They include medical and nursing services and various types of therapy. Outpatient treatment allows clients to continue living at home and working while receiving treatment. Typically, referrals aren’t required, however some states may require it.

Blue Cross Blue Shield Drug and Alcohol Rehab Coverage

And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost. The first step in using Aetna insurance for substance use treatment is talking to your primary care provider or the drug rehab facility directly. Aetna insurance covers multiple levels of care and a range of evidence-based treatment options.

Does Aetna health insurance cover substance use disorder treatment?

Insurance plans through Aetna cover an array of evidence-based treatments and levels of care. If you’re enrolled in Aetna Medicare Plan (PPO)You have the flexibility to receive covered services from network providers or out‐of‐network providers. Out‐of‐network/non‐contracted providers are under no obligation to treat Aetna Medicare members, except in emergency situations.

Necessary medications will likely be covered, which can include medications for alcohol use disorder and opioid use disorder detox and maintenance. Individuals undergoing detox treatment may require medications to ensure their safety during this time and to manage withdrawal symptoms. Similarly, some people may require long-term medications as a maintenance treatment. Participating providers who treat patients with Aetna medical benefits can use the SBIRT method to help people get substance use treatment.

Aetna may or may not authorize treatment for the full recommended length of stay. Getting approval for tests, procedures and more helps Aetna ensure that any care you receive is backed by the latest medical evidence. If you get coverage from an out‐of‐network provider, your plan won’t cover their charges. The helpline at AddictionResource.net is available 24/7 to discuss the treatment needs of yourself or a loved one.

The cost of deductibles and co-pays will vary depending on what type of coverage you have. You can contact an Aetna representative to learn more about the co-pays and deductibles for substance use disorder treatment. If no referral is necessary, the intake staff at a rehab program will confer with Aetna during the admissions process and confirm the details of your coverage. When purchased on the Health Insurance Marketplace, plans come in Gold, Silver, and Bronze coverage levels. Intensive outpatient programs are partially or fully covered by Aetna plans, depending on which tier of coverage you have.