Aetna Detox & Rehab Benefits Guide
Aetna is a health insurance company that covers nearly 39 million people in the United States. Aetna offers a variety of health insurance plans, Medicaid and Medicare coverage, and behavioral and medical management programs.1, 2 Many may wonder what aspects of substance abuse treatment Aetna insurance covers. This page will help you understand how to use your Aetna insurance plans to access detox and rehab services for drug and alcohol addiction.
Types of Aetna Insurance Plans
Aetna offers a variety of health insurance plans.3 These include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Point of Service Plans (POS), and Exclusive Provider Organizations (EPOs).
HMOs and PPOs are the most common. An HMO allows you to save money on premiums and deductibles by staying in Aetna’s insurance network and getting referrals from your primary care provider for specialized care. A PPO is more expensive, but you can see specialists and out-of-network providers without a referral. Copayments and coinsurance for in-network providers are still low, but you’ll pay more if you go outside the network.
POS plans offer the advantages of an HMO but also provide access to out-of-network doctors with the referral of a primary care provider. An EPO allows only in-network care, but the network is larger than usual. The premium for an EPO is more than an HMO but less than a PPO.
Aetna & Medicare
Aetna also offers Medicare Advantage plans, which supplement your Medicare Part A and B with additional coverage and, many times, lower deductibles and copayments.4 Medicare Advantage plans are HMOs, HMO-POS plans, or PPOs.
Finally, Aetna provides Medicaid plans in 17 states.5 From California to New York, you might be able to access low-cost coverage through this insurer. The specific coverage you’ll receive will vary depending on which state you live in.
How to Check Your Aetna Benefits
To know for sure whether or not your Aetna insurance plan covers substance abuse rehab, it’s important to verify your coverage. You can use access details about your Aetna therapy coverage by logging on to Aetna’s member care website.6 Once you register your account, you can search the Aetna rehab provider network to see what professionals are part of your insurance plan. You can also get coverage information, find out how much the copayment and deductible will be for your specific treatment, and more.
If you have any questions about Aetna rehab insurance, you can always call Aetna to verify coverage. Their representatives can review your plan and help you connect with rehabs that accept Aetna.
Do Aetna Plans Cover Detox & Rehab?
Understanding your Aetna drug rehab coverage will help you select the treatment facility and program that’s best for you. The Affordable Care Act that was passed in 2010 requires most insurance plans to include substance abuse coverage as an essential benefit.7 Exactly how that works varies from plan to plan.
Aetna therapy coverage may include approved Aetna alcohol rehab centers or detox programs for opioids. Opioid treatment may also include medication such as Suboxone that can help reduce the cravings for illicit drugs.8
To enter a specific treatment program, you may need a referral from your primary doctor. They may give you some medication to help with withdrawal symptoms before you enter the program. Once you are in the rehab process, you’ll have a monitored detox to ensure that the drugs leave your system safely.
The Aetna insurance plan understands that multiple attempts are often needed before someone is able to stay clean, so don’t feel like you can’t seek treatment if you’ve been in a program in the past.9 In some cases, an inpatient treatment program is the best option, but you may also find coverage for outpatient or online therapy covered by Aetna.
- Aetna. (2020). Company history.
- Aetna. (2020). Aetna facts.
- Aetna. (2020). HMO, POS, PPO, EPO and HDHP with HSA: What’s the difference?
- Aetna. (2020). Medicare Advantage Plans.
- Aetna Better Health. (2020). Medicaid plans.
- Aetna. (2020). Member website information.
- Healthcare.gov Mental health & substance abuse coverage.
- Aetna. (2020). Opioid treatment options.
- Aetna. (2020). Opioid video key takeaways.