Aetna Insurance Coverage For Alcohol And Drug Addiction Treatment

Aetna insurance providers offer health care plans that cover behavioral health services, like addiction treatment. Learn which drug rehab services may be covered by your Aetna plan and how to verify coverage.

Aetna health insurance companies offer health care plans which cover essential health benefits. Aetna covered services include behavioral health services like mental health treatment and drug and alcohol rehab treatment.

If you’re an Aetna policyholder, you can use your Aetna insurance to pay for substance abuse treatment services. These could include inpatient treatment, outpatient treatment, medical detox, and more.

Learn which drug and alcohol addiction treatment services are covered by Aetna and how to find a Massachusetts rehab center that accepts your insurance policy.

Aetna Insurance Coverage For Massachusetts Drug Rehab

The amount of coverage for alcohol and drug treatment will depend on the plan you have. Coverage may also be affected by the treatment center you attend.

Plan coverage will vary by state. Aetna health insurance typically offers access to both the Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans.

Percent of drug rehab costs covered can range from 40 percent to 80 percent. Aetna coverage will not pay for your portion of treatment costs (coinsurance) or treatments not covered by Aetna policies.

Using Aetna Insurance To Pay For Massachusetts Addiction Treatment

Before using your Aetna plan to pay for alcohol and drug treatment programs, you may want to review your deductible amount and other factors. Helpful things to know when using Aetna insurance for the cost of drug rehab centers include:

knowing if you need to stay in-network with your Aetna insurance company’s treatment network providers
knowing what your coinsurance or copayment amount will be
understanding which substance abuse treatment services will be covered by your Aetna insurance

Do I Have To Stay In-Network To Use My Aetna Insurance For Massachusetts Drug Rehab?

Some Aetna insurance will pay for drug and alcohol rehab costs that are not in-network with health care providers. This could mean a higher copayment for you, though.

It is far easier to figure out insurance when using Aetna’s approved treatment network providers. However, if you find a rehab center that is out-of-network, you may have other payment options.

Out-Of-Pocket Costs After Aetna Coverage

Before starting treatment, it’s important to know what your portion of treatment expenses will be. First, you may have to meet a deductible. Even the best Aetna plans may come with a deductible. This could mean higher costs at the start of treatment until the amount is paid.

You may also need treatments not covered by your Aetna insurance provider. Fortunately, many treatment facilities design payment plans so you or a loved one can get the care you need. Private pay options could include a sliding fee scale, scholarships, grants, lending services, and more.

Finding A Massachusetts Rehab Center That Accepts Aetna

Aetna is an insurance carrier that currently provides coverage to more than 39 million people. With such widespread coverage, it may be fairly easy to find drug rehab centers that accept your insurance coverage.

As you start considering treatment options, look over your Aetna insurance policy to see what your plan covers. The following are rehab programs and rehab services which may be covered.

Does Aetna Cover Massachusetts Inpatient Alcohol And Drug Treatment?

Inpatient treatment services may be covered by your Aetna plan. To qualify for inpatient drug rehab coverage, you may have to get prior authorization for treatment. This is also known as precertification.

First, you’ll need a full medical assessment, which shows your need for addiction treatment. Inpatient rehab services vary in length and intensity, but may offer detox, medication, therapy, and more.

Whether your Aetna plan covers short-term inpatient rehab or long-term residential treatment may depend on your treatment needs.

Is Detox Covered By Aetna Insurance Policies?

Massachusetts detox centers may be covered by your Aetna insurance plan. Medical detox and other detox programs are often included as part of inpatient rehab treatment to help ease withdrawal symptoms.

If medications are needed during detoxification, Aetna may offer coverage for this form of treatment under pharmacy benefits.

Does Aetna Health Insurance Cover Outpatient Treatment?

Outpatient treatment is often covered by Massachusetts Aetna health plans. However, coverage may vary by the type of rehab program you choose and your insurance policy.

Outpatient programs range in format, treatment approach, and intensity. Many addiction treatment providers offer a continuum of care for substance abuse that includes outpatient services and programs.

Is Partial Hospitalization Covered By Aetna?

Massachusetts partial hospitalization programs can be covered by Aetna insurance providers. Coverage may require precertification or a referral for care. Partial hospital treatment helps those who no longer need inpatient care.

Is Massachusetts Intensive Outpatient Treatment Covered By Aetna?

Intensive outpatient treatment may be covered by Aetna insurance policies as well. Like other rehab services, these programs may come with a copay. Intensive outpatient programs are useful for patients who have completed residential treatment and are ready for an outpatient program.

Verify Your Aetna Coverage For Alcohol And Drug Rehab

If you’re an Aetna member, check into your insurance coverage before looking at a rehab facility. This process can be overwhelming, which is why our Massachusetts rehab center can help.

Spring Hill Recovery Center can:

  • help verify your Aetna insurance policy
  • let you know which addiction treatment services are covered by your plan
  • help you find the rehab program that’s right for you

We offer intensive outpatient, residential treatment, access to detox, and other treatment programs for substance use disorders at our Massachusetts rehab facilities. Learn how we can help you or a loved one start the road to recovery when you call today.

  1. Aetna—Drug and Alcohol Treatment http://www.aetna.com/docfind/cms/assets/pdf/Alcohol_and_Drug_Treatment.pdf
  2. National Institute on Drug Abuse (NIDA)—Types of Treatment Programs https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs
  3. Substance Abuse and Mental Health Services Administration (SAMHSA)—Medication-Assisted Treatment (MAT) https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

Written by Spring Hill Recovery Editorial Team

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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