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Aetna Rehab Coverage for Addiction Treatment

Aetna Insurance provides health care coverage for beneficiaries in more than 15 states across the U.S. under a variety of health plans. Plans include insurance coverage for drug and alcohol rehab, and the company’s policies are accepted by a variety of treatment centers throughout the country.

Florida-based Behavioral Health Centers is a rehab treatment facility that accepts Aetna insurance. If you’re insured by Aetna, you may be eligible to have a portion of your substance abuse treatment costs covered by your plan

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Verify Your Benefits for Addiction Treatment

What is your addiction really costing you? Getting clean is within your reach. Behavioral Health Centers (BHC) is here to help.

Your insurance may cover all or some of your rehab at a BHC facility.

About Aetna's Substance Abuse Coverage

American insurance providers are required to provide substance abuse disorder coverage by the  Affordable Care Act, as well as the Mental Health Parity and Addiction Equity Act. As such, Aetna health insurance plans do include coverage for drug and alcohol rehab. Aetna mental health insurance is also available.

However, it’s important to note that the amount of substance use disorder coverage does vary from plan to plan, so patients should expect to pay some out-of-pocket costs for their alcohol and drug rehab in treatment facilities. Additionally, while some plans only include detox, others cover both detox and ongoing rehabilitation services.

Aetna Insurance

At Aetna, some policies cover out-of-network providers, but as with all insurance provider plans, it’s important to check with your administrator to find out what’s covered. In some cases, authorization from a health care provider or pre-certification might be required before insurance coverage is authorized in treatment centers. Pre-certification is conducted by Aetna to confirm that treatment is provided by qualified addiction counselors, medical professionals and licensed treatment centers.

Aetna rehab coverage may be under a Health Maintenance Organization (HMO) or Preferred Provider Organization plan through an employer. Alternatively, Aetna substance abuse treatment also administers Medicare and Medicaid plans with support from the federal government for seniors, disabled persons and low-income individuals.

The substance abuse insurance coverage you have will vary depending on which type of Aetna plan you have, as well as a variety of other factors, including the services you need during your stay at a treatment center and how long your inpatient treatment plan is.

In the information that follows, you’ll learn more about accessing substance abuse treatment at Behavioral Health Centers while using your Aetna health insurance plan.

If you have questions about your Aetna rehab coverage or other ways to pay for our treatment options and services, our representatives are always available to help you access the treatment you need and make recommendations for other resources that may be available to help you pay.

Making Sense of Aetna Insurance

While understanding your unique Aetna rehab coverage is important, there are several common insurance terms you may need to understand first. These include:

Coinsurance/Copay:

Once Aetna rehab coverage kicks in, this is the amount you need to pay for each health care service. For example, if your coinsurance rate is 30%, Aetna will require you to pay 30% of all covered costs while your policy pays the remaining 70%.

Deductible:

The amount of out-of-pocket health care costs you need to pay your treatment provider each year before your policy begins to cover you.

Out-of-pocket maximum:

This is the limit on how much your Aetna rehab coverage policy requires you to pay before your plan will cover the total cost of your healthcare services.

Aetna Insurance Premium:

The premium is the monthly or annual amount you pay to your insurance provider for coverage.

Aetna insurance for mental health and substance abuse treatment- A group therapy session

Aetna Rehab Coverage: Medicare Plans

Aetna provides a variety of  health insurance options for those who are qualified for Medicare coverage. These plans may be HMO or PPO plans, and while they do vary depending on where you live and which plan you select, you can expect deductibles and premiums to be relatively low. Plans may include medical coverage, prescription coverage or both.

As with all Medicare plans, Aetna’s coverage includes primary and hospital care as well as specialized services in a rehab center, such as drug and alcohol detox. Although each plan’s coverage is different, most of Aetna’s Medicare plans include drug and alcohol detox, inpatient addiction treatment, outpatient services and individual and group therapy sessions when required as part of an authorized treatment plan.

It’s worth noting that Medicare plans are typically only offered for those aged 65 and older, as well as those with end-stage renal disease or other severe disabilities.

Verify Your Benefits Today

What is your addiction really costing you? Getting clean is within your reach. Behavioral Health Centers (BHC) is here to help.

Your insurance may cover all or some of your rehab at a BHC facility.

Aetna insurance provider for group of all sizes - Image of a group therapy

Aetna Group Insurance Plans

Aetna is one of the country’s largest group insurance providers. It offers a broad range of plans for businesses of all sizes, ranging from small companies that employ fewer than 10 people up to enterprise-sized businesses with hundreds or even thousands of employees. As such, you can expect substance abuse treatment options coverage to vary based on a variety of factors, including the size of your company, the plan your employer has chosen and where you live.

To provide you with an idea of what Aetna may have available, we’ll look at one of the company’s most common group insurance policies: the Basic HMO Copay Plan 1.

This plan is designed to meet the needs of smaller businesses. It comes with a $2 million lifetime maximum benefit and out-of-pocket maximums of $5,000 for single policyholders or $10,000 for families.

Substance abuse treatment is covered to a lifetime maximum of $2,000 and is subject to a $750 co-payment per day for inpatient care or a $25 co-payment per visit for outpatient care. Outpatient care from accredited treatment centers is covered to a maximum of 44 visits.

What Else to Know About Aetna's Coverage for Substance Abuse Treatment

Most Aetna plans require your primary care physician to authorize your treatment provider. Aetna will also conduct a review of your treatment plan prior to authorizing coverage.

When accessing care, Aetna plans that include a co-payment require you to pay your portion at the time of treatment.

If you need help navigating your insurance policy to determine what you’re covered for, reach out to speak with one of our representatives today.

The Affordable Care Act made it a requirement for insurance plans sold via the Health Insurance Marketplace to cover 10 essential benefits. One of those benefits is mental health care, including treatment for substance use disorders. Due to this requirement, many major insurance carriers, including Aetna Inc., provide some type of mental health coverage to plan members.

Admission for Behavioral Health Treatment

At Behavioral Health Centers, our knowledgeable staff members aim to help you get the mental health services you need at the lowest possible out-of-pocket cost. We have extensive experience working with Aetna Inc. and figuring out exactly what your plan covers in terms of mental health benefits.

If you need mental health care and have Aetna insurance, you can expect the following during our admissions process:

  • You’ll talk with one of our mental health experts to determine what type of treatment you need to improve your mental well-being.
  • Based on your needs, you’ll select a treatment program. We offer inpatient treatment for obsessive-compulsive disorder, anxiety, depression, substance use disorders and other mental health conditions.
  • Our staff members will research the mental health benefits available under your Aetna health insurance plan. Aetna tends to cover a wide range of mental health services.
  • You’ll learn more about the financial assistance options available for paying your out-of-pocket mental health expenses.

Residential Mental Health Benefits

Aetna Insurance

Behavioral Health Centers offer residential treatment programs for a variety of mental health disorders, including addiction, anxiety, depression, personality disorders, body dysmorphic disorder and panic disorder. These behavioral health conditions cause different symptoms, but they all have the potential to interfere with your personal relationships or make it more difficult to do the things you love.

Depending on what mental health condition you have and what kind of help you need, you may benefit from one of the following services:

  • Drug and alcohol detox
  • Inpatient addiction treatment
  • Residential mental health treatment
  • Behavioral health treatment specifically for veterans
Verify Your Benefits For Behavioral Health

What is your mental health really costing you? Find the balance in your mind, body & soul. Behavioral Health Centers (BHC) is here to help.

Your insurance may cover all or some of your behavioral health treatment at a BHC facility.

Residential Mental Health Services

If you have a moderate to severe mental health condition, it’s helpful to seek residential care. Residential treatment gives you an opportunity to get away from the stresses of daily life and focus on your recovery. We work with your health insurance company to determine how many days of inpatient mental health care are covered and estimate how much you’ll have to pay out of pocket. If your Aetna insurance plan has coverage limits, we’ll make sure you understand what those limits are and how they might affect your care.

Whether you’re having a mental health crisis or need a little help recovering from a mental health disorder in a supportive environment, it’s important to complete a customized treatment plan. While you’re at Behavioral Health Centers, you have access to the following services:

  • Individual therapy
  • Family therapy
  • Support groups
  • Medications
  • Therapeutic activities

Behavioral Health Treatment for Veterans

Veterans are more likely than members of the general population to develop substance use disorders. The risk is especially high for veterans who participated in active combat or witnessed violence while serving in the Armed Forces. Veterans also have an increased risk of developing post-traumatic stress disorder (PTSD), which may cause flashbacks, nightmares, anxiety and other symptoms that interfere with your ability to work, go to school or enjoy your hobbies.

To address these unique risk factors, Behavioral Health Centers offers a recovery program specifically for veterans. As part of this program, you’ll have access to therapy, medications and other services to help you cope with your trauma and recover from PTSD or addiction. Aetna Inc. covers a wide range of behavioral health services, making it easier to access residential care.

Coverage for Outpatient Mental Health Services

Coverage for Outpatient Mental Health Services

Once you complete your residential treatment, it’s important to receive follow-up care to ensure you stay on track. Our aftercare program includes regular assessments, community support and other services customized to your needs. We also assess your risk of relapse and provide training to help you manage stress without relapsing. Overall, aftercare makes it easier to transition from residential treatment back to your regular environment.

Get Help Today

Don’t let the cost of substance abuse treatment deter you from getting the help you need. Behavioral Health Centers is a treatment facility that is committed to taking every step necessary to ensure your treatment is accessible and affordable. If you or someone you love is struggling with an addiction to alcohol or drugs, reach out today and take the first step in your recovery journey.