Rehabs in the United States generally take Aetna’s insurance. But not all Aetna plans and policies are equal in their coverage of rehab and other addiction treatment services.
Keep reading to find out what services are covered by rehabs that accept Aetna insurance plans and learn several reasons to choose Catalina Behavioral Health along the way!
Using Aetna Health Insurance for Alcohol and Drug Rehab
Many people’s primary goal when looking into substance abuse treatment facilities is whether or not their insurance will cover the costs. When contemplating therapy for themselves or a loved one, many individuals have to formulate a way to cover the costs.
Many people who need substance abuse treatment cannot afford the services because of their high price tag. Substance abuse treatment is covered on a regular basis more often than not these days, so finding a resource for help is much easier than in previous years.
Free Insurance Coverage Verification
Finding insurance coverage for addiction treatment and receiving an accurate quote can be difficult. Aetna is a major player in the market for health insurance, and its plans frequently include coverage for substance abuse treatment. Understanding the rehabs that accept Aetna and the possibilities for coverage for substance abuse treatment is crucial, as every policy is different.
What is an Aetna Addiction Treatment Facility?
In what ways do rehabilitation facilities determine if they will participate with Aetna? It is common for addiction treatment centers to have one of two rules in place regarding acceptance: As long as the policy qualifies and the individual’s treatment needs are met, rehab centers will take any insurance that pays for addiction treatment.
Without as many restrictions, this allows more individuals to receive the care they require. It’s possible that a certain rehabilitation facility only works with a small handful of insurance providers. If this is the case, individuals will need to ensure that the facility they choose accepts their insurance plan.
At Catalina Behavioral Health, we can verify your insurance acceptance with a quick and completely confidential phone call, often within minutes. If you’re wondering about your costs for attending rehab, reach out now and have peace of mind for your rehab planning!
A Brief History of Aetna Insurance
Aetna, which began operations in 1853, has grown to become one of the country’s most important private health insurance providers. By virtue of its reputation alone, many inpatient drug and alcohol addiction facilities will gladly be among the rehabs that accept Aetna clients.
At Catalina, we proudly believe ourselves to be a top resource among Arizona rehabs that accept Aetna policies and our welcoming Admissions team can let you know, often within minutes, what your policy offers for treatment at our facility.
Rehabs that Accept Aetna for Substance Abuse Treatment
There are many levels of coverage available through Aetna for those seeking help for substance abuse. Aetna members who are interested in learning more about the drug and alcohol rehab coverage that may already be included in their policy can do so by referring to the policy’s “mental and behavioral health” section.
Referring to their specific health insurance plans will provide more information regarding substance abuse treatment coverage. Again, currently, most insurance providers on the Medicaid network provide health insurance plans that cover most forms of therapy at a treatment facility.
Does Aetna Pay for Residential Addiction Treatment Services?
Usually, inpatient treatment centers are covered by rehabs that accept Aetna policies. However, your level of protection is determined by the details of your particular policy.
Does Aetna Pay for Outpatient Drug and Alcohol Treatment?
Certain programs of outpatient rehabilitation are covered by rehabs that accept Aetna. This insurance company covering outpatient service at drug rehab centers is dependent on several things:
- Whether you’ve tried outpatient services at drug rehab centers
- What type of outpatient drug rehab
- If you require prescriptions during your outpatient treatment
Before certain health insurance policies cover residential treatment for substance use disorders, policyholders must first participate in an outpatient program. Some insurance plans may only pay for inpatient drug rehab.
Partial Hospitalization Programs and Aetna
Partial hospitalization, intense outpatient programs, outpatient therapy and counseling, and so many more are all types of outpatient care. Addiction outpatient treatment is covered in full under Aetna’s insurance policy in many cases.
The Aetna plans may cover up to $75 per therapy session if, for instance, you have finished the whole continuum of care and merely require counseling or mental health coverage to maintain your sobriety.
Aetna provides coverage for several types of outpatient rehabilitation, including partial hospitalization programs (PHP). Partial hospitalization programs are a less intense form of addiction treatment for:
- Clients who are prepared to exist inpatient services
- Clients who are unable to participate in residential treatment programs because of commitments associated with their employment, education, family, or other obligations
- Clients whose drug misuse problems can be managed outside of a hospital setting
PHPs, which are also known as day programs, provide rigorous therapy over the course of 8-16 weeks, 3–5 days per week, and 3–7 hours per day. There is a significant distinction between residential treatment and PHP in those patients in the latter do not have to live at the treatment facility during their recovery.
Either at the end of residential treatment or before beginning addiction therapy, an evaluation will assist in establishing if you require inpatient treatment or are ready for partial hospitalization, or simply require primary care physician visits without regular therapy.
Does Aetna Pay for Intensive Outpatient Programs (IOP)?
Aetna’s health insurance policies include intensive outpatient programs (IOP), but coverage varies by a plan like any other insurance company. Individuals who have progressed enough in their recovery that they no longer require residential treatment or day programs are the target population for IOPs. One to three hours a day, twice a week, for a set number of weeks, maybe all it takes for treatment to be effective.
Aetna and Suboxone Coverage
Suboxone is a drug prescribed by doctors in opioid treatment programs for the management of opioid addiction and the treatment of opioid withdrawal. In several locations, including California and Michigan, Suboxone is covered by insurance plans at many rehabs that accept Aetna. Opioid addicts typically include Suboxone in a more extensive treatment program.
While Aetna’s pharmacy plan does cover many common medications, there is a chance that this particular prescription won’t be covered at all. This is a question that only the insurance company can answer, as every insurance provider handles medication-assisted treatment coverage in their own way.
Licensed Addiction Treatment
Does Aetna Pay for Methadone Maintenance?
Methadone maintenance therapy, the first medication-assisted treatment for opioid use disorders, is included in most plans at rehabs that accept Aetna. Individuals who are looking to recapture a normal way of living without worrying about the side effects of detox can benefit from methadone treatment.
Methadone is administered once daily at a clinic that’s opened specifically for providing this form of treatment. Each daily dose is typically priced between $12 and $20 per day, which includes access to a counselor, drug testing, and of course, the medication. Generally, any insurance provider through Medicaid covers the cost of this treatment.
Normally, most methadone treatment programs accept Aetna insurance.
What About Aetna Coverage for Sober Living?
Aftercare, or sober living, is a type of continued care that follows from inpatient or outpatient treatment. Some Aetna insurance policies may cover part of the expense of a sober living facility. However, the exact percentage and period of coverage may vary by policy. Once again, the specifics of each policy’s protection will differ.
Aetna could demand pre-approval for inpatient or partial hospitalization programs. This type of permission is often not necessary for outpatient treatments.
Does Aetna Require In-Network Treatment Facilities?
Aetna does not require a rehab provider to be in-network with them for their treatments to be reimbursed but doing so will result in considerable cost savings and improved coverage. Most plans cover 80 percent of in-network services but only 50 to 60 percent of those received outside of the network.
Members can save a lot of money by seeing doctors who are part of their insurance network since such doctors often charge lower out-of-network fees. If you have Aetna insurance and want to know more about your in-network and out-of-network coverage and expenses, you can call Catalina for a confidential call at any time.
Although there may be restrictions, most insurance will cover rehabilitation therapies received from providers outside of their network.
Primary Coverage Areas for Aetna Insurance
All fifty states have access to Aetna’s extensive range of health insurance options. Healthcare services that fall under this umbrella range from those provided by private insurance companies to those provided by employers to those provided by government programs like Medicare and Medicaid, as well as those related to mental and behavioral health.
Some packages are restricted to residents of certain states alone. Some of these plans are provided by businesses, while others can be purchased by individuals or families.
Included in Aetna’s most popular packages are: Choice and Open Access from Aetna (PPO or HMO) QPOS by Aetna (Quality Point-of-Service) Choose HealthFund from Aetna, an HMO or PPO Choice Managed Health Care from Aetna, either as an HMO or PPO at rehabs that accept Aetna. Their companies also provide Medicare coverage plans in more than 30 states, in addition to its usual individual and employer-sponsored insurance.
Because Aetna provides so many different insurance options, it might be challenging to discover information without having specific coverage.
One of the first steps in getting sober is learning what services are covered by a member’s insurance plan. If you have questions regarding your coverage, you can always contact Catalina Behavioral Health, and we can help you discover whether your specific policy covers a type of our treatment. Staff members are ready to answer questions about coverage and access to our program.
24 Hour Drug Addiction Rehab Hotline – Get Help Now
Long Term Recovery with Catalina Behavioral Health and Aetna Insurance
Together with recipients of Aetna insurance plans, we can provide the help that other treatment centers may not have made available to you. It’s easy to run into restrictions, especially if you have uncertainties about your insurance plan.
When you’re ready to take that brave step and reclaim your independence, contact a member of our admissions team. We’ll provide all the information you need to enroll at our facility and provide a preview of what a normal day is like in our treatment program.
Give yourself or your loved one a firm foundation in recovery, and reach out today for a confidential call with Catalina!
Aetna Insurance FAQs
Does Aetna insurance require prior authorization for most types of treatment?
Rehabs that accept Aetna insurance may require prior authorization, depending on the procedure in question. Normally, there are a few main procedures that require a client to obtain a pre-approval form before treatment is covered. Typically, these events would include medication-assisted treatment with Suboxone or Methadone, any type of aftercare services such as a sober living facility, or any form of holistic treatment.
It’s worth noting this also depends heavily on your policy specifically. Whether your policy is through Medicaid or otherwise makes a significant difference as well. For any questions regarding prior authorization or your coverage, we encourage you to contact a member of our admissions team at Catalina Behavioral Health today.
Does Aetna cover mental health services?
Your Aetna plan does cover a range of mental health services. This includes time spent within a treatment program. Whether the program entails inpatient, outpatient, PHP, or any other level of care, Aetna provides some level of coverage. However, there is no guarantee that the coverage is 100%. This is a matter to take up with your agent assigned to your specific policy.
Things that might affect whether you receive 100% coverage include your work status, whether you have a policy through Medicaid, self-paid, or through your employer, and lots of other factors. It’s possible that you might have a small copay or some type of out-of-pocket expense associated with your policy, and it’s important to be prepared for this before leaving for any form of mental health or substance abuse treatment.
We can help you find out at Catalina Behavioral Health, so everything is clear before you leave for our facilities and fully begin the admissions process.
Does Aetna cover every type of substance abuse treatment?
While it’s difficult to say that Aetna covers “every type” of substance abuse treatment, they do cover plenty of treatment types. In addition, if there’s a certain form of treatment that they’re not sure about, they might ask for a prior enrollment form before coverage is provided.
That said, the most standard levels of care are always covered in some form by your Aetna provider. These include services like inpatient drug treatment, outpatient services, partial hospitalization, and intensive outpatient services. Detox is also covered by almost all plans at rehabs that accept Aetna.
By law, any insurance provider has to provide coverage for mental health and substance abuse/behavioral health services. This has been a law since the CARES Act was passed under President Obama. However, there’s no law stating that 100% coverage must be provided. If you’re uncertain about how much coverage you’ll receive from Aetna, contact Catalina Behavioral Health services today. We can help you provide prior approval if needed and help you clarify any confusing language regarding your policy.
How long can I stay in treatment under my Aetna coverage?
Ultimately, this depends on your policy specifically, which weighs heavily on the recommendations given by professionals. Normally, most insurance companies take into account the opinions of a professional before making a decision on whether to provide coverage.
If you’re in a situation that entails your insurance company not providing the coverage you require to finish a portion of our program or service we believe you need, we’ll do everything within our power to help you provide proof of the need for said treatment services to your insurance providers. That said, if you are denied coverage, there’s no need to stress.
Generally, a simple faxed letter or a quick phone call is enough to satisfy any approval issues you might be met with along your road to recovery at most rehabs that accept Aetna. We work closely with top insurance providers and carry a good working relationship, just for the sole fact of being able to assist our clients when they need it the most. For more information about our insurance and billing process, contact a member of our team today.