Aetna is an insurance provider that includes more than 1 million national providers, 24/7 virtual care, and walk-in care options throughout the country. Their wide network means they have options for every person at every stage of life, including alcohol rehab services. 

In this guide, you’ll learn which addiction treatment services are available through Aetna insurance plans and the benefits they provide to members. 

Does Aetna Insurance Cover Addiction Treatment?

Yes, most Aetna insurance plans cover addiction treatment for alcohol abuse.

Additionally, most Aetna health insurance plans cover some or all of the below services at addiction treatment centers:

  • Assessments and Screenings
  • Psychiatric Evaluation and Management
  • Detoxification (Detox)
  • Inpatient Treatment
  • Residential Treatment
  • Intensive Outpatient Program (IOP)
  • Outpatient Treatment (OT)
  • Group Therapy
  • Individual Therapy
  • Medical Evaluation and Management
  • Wellness and Prevention Services

Any medication costs during substance abuse treatment programs require a separate deductible amount to be met, depending on your specific health insurance coverage.

Does Aetna Cover Out-Of-Network Treatment?

For those seeking out-of-network addiction treatment, there might be plans available through Aetna with up to 50% coinsurance available. However, these plans will most likely have high premiums and deductibles. Aetna has a large in-network provider list nationwide, and in-network costs will almost always have lower out-of-pocket costs associated with them than out-of-network alcohol rehab facilities. For questions related to your alcohol rehab coverage and mental health services under your Aetna health insurance plan, contact our rehab advisors. We are here to help you navigate your policy while maximizing your plan’s benefits and minimizing your out-of-cost expenses. 

How Many Treatment Program Stays Will Aetna Cover?

Similar to other insurance providers, the exact number of inpatient rehab stays Aetna will cover will depend on your specific plan, as well as the recommended amount of time suggested by a medical team following your evaluation. If you are seeking treatment and have questions related to your Aetna plan’s coverage for alcohol treatment and/or mental health care substance abuse treatment, contact our rehab advisors. We are here to help.

Inpatient Aetna Rehab Coverage

The following inpatient rehab services might be covered, depending on your Aetna insurance plan:

  • Screenings and Assessments
  • Psychiatric Evaluations
  • Individual Therapies
  • Medical Examination and Treatment
  • Detoxification (Detox)
  • Inpatient Rehab Stay
  • Aftercare Services

Outpatient Aetna Rehab Coverage

The following outpatient rehab services might be covered, depending on your Aetna insurance plan: 

  • Partial Hospitalization (PHP)
  • Intensive Outpatient (IOP)
  • Group Therapy
  • Individual Therapy
  • Psychiatric Evaluation and Management
  • Assessments and Screenings

Which Types of Insurance Plans Are Available Through Aetna?

Aetna offers insurance plans for substance abuse that include inpatient and outpatient services. Some plans have a 0% coinsurance after the deductible is met, whereas other plans will have a higher coinsurance amount after the deductible. Many plans require a copay for inpatient and outpatient services. 

Aetna substance abuse treatment plans include open-access plans, copay only plans, and high-deductible plans. 

Open-access plans enable members to choose their doctors and no referral is required. Co-pay only plans ensure that after the deductible is met, the only costs remaining are copays for services. High-deductible plans offer some treatment services before the total deductible is met. 

Additionally, Aetna’s insurance plans cater to individuals, families, employers, and Medicare and Medicaid.

Will Receiving Treatment at an Alcohol Rehab Facility Cause My Insurance Premium to Increase? 

No. It is illegal for any insurance provider within the U.S. to increase insurance premium rates as a result of receiving treatment at an alcohol rehab facility. 

Do I Need a Referral From My Primary Care Physician To Receive Substance Abuse Treatment? 

This will depend on your plan. The Aetna open-access plan does not require a referral from a primary care doctor to receive addiction treatment. Other plans might require a referral. 

Addiction Resources with Aetna

Aetna offers 360 Behavioral Health, an in-network program that addresses mental health concerns and substance abuse. According to Aetna, this program takes into account not only substance use disorders but also physical health, mental health, financial issues, housing, and family and relationship dynamics of each individual to ensure they have their needs met. Through the 360 Behavioral Health program, Aetna connects members with inpatient and outpatient services that are in-network to help individuals receive the help they need. 

Affordable Care Act and Behavioral Health Treatment

If you’re worried about how you will pay for addiction treatment coverage, know that the Affordable Care Act made it mandatory for insurance companies to provide coverage for alcohol addiction treatment and other mental health conditions. As a result, you might have improved access to behavioral health treatment. This includes Medicaid, Medicare, private coverage, military insurance, and state health insurance. 

For assistance selecting an alcohol rehab facility that meets your needs, contact us.