Aetna Insurance Coverage for Drug & Alcohol Rehab Treatment
Aetna rehab coverage can help you cover the costs of drug and alcohol misuse treatment at The Recovery Village at Baptist Health.
Choosing to seek addiction treatment is challenging enough without worrying if your insurance will cover it. This page provides an overview of Aetna’s health insurance plans and how to determine your Aetna rehab coverage.
Aetna Provider Overview
Aetna, based in Hartford, Connecticut, is an insurance company that has served patients for 170 years and counting. Founded in 1853, Aetna has been at the forefront of transformative initiatives in health care, from diabetes and mammogram screenings to women’s heart health. They joined CVS Health Family in 2018.
Aetna offers several health care plans with different options. Your plan will determine your coverage.
Aetna Coverage Levels and Plans
Aetna’s health insurance plans are state-specific and divided into two types, HMO and PPO.
- HMO (Health Maintenance Organization): These plans offer low premiums and out-of-pocket costs but require you to see in-network doctors and obtain a referral to see specialists. PPO (Preferred Provider Organization) plans have higher premiums but offer lower coinsurance and copays, allowing you to see out-of-network specialists without a referral.
- Aetna PPO insurance plans: PPO plans offer a three-tier option with Bronze, Silver and Gold. Bronze plans have the lowest premium but the highest deductible. You will have a 30% coinsurance once your deductible is met. Gold plans have the highest premium but the lowest deductible. You will have a 10% coinsurance.
- Aetna also offers government-funded Medicaid and Medicare plans: Medicaid is provided to people with certain income requirements or special health needs, while Medicare is offered to adults 65 and older or with disabilities.
How To Check Your Aetna Insurance Benefits
There are a few different ways to check your Aetna insurance coverage, including:
- Website: You can check your Aetna insurance benefits through the Aetna member website.
- Member ID card: You can register for free at the Aetna member website. Their member portal allows you to check your coverage using the member ID on the back of your member ID card.
- Phone: You can also check your eligibility by calling the customer service number on your ID card. A representative will discuss your eligibility and benefits.
Does Aetna Insurance Cover Drug and Alcohol Rehab?
All health insurance plans must offer coverage for qualifying mental health and substance use disorder treatment services under the Affordable Care Act. Both Aetna’s HMO and PPO plans include coverage for substance abuse treatment. Covered services might consist of medical detox, inpatient rehab, outpatient rehab and behavioral therapy. Coverage is based on your plan and medical needs.
Aetna Substance Abuse Guidelines
Aetna closely follows the American Society of Addiction Medicine’s criteria for diagnosing substance use disorder. You may be asked about the following to determine what kind of treatment your insurance will cover:
- Your substance use history
- If you have previously sought treatment
- If you are seeking long-term recovery
Addictions Covered Under Aetna Policies
Aetna covers a range of substance misuse treatments. While each policy differs, rehabs covered by Aetna may include alcohol use, cocaine addiction, methamphetamine addiction, opioid addiction and prescription medication addiction. The best way to find out about your Aetna drug rehab coverage is by contacting your insurance provider.
Does Aetna Cover Mental Health and Counseling Services?
Most Aetna plans offer some coverage for mental health and counseling services. Depending on your plan, you may be eligible for popular therapies offered at The Recovery Village at Baptist Health, including eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT). You can check your benefits through Aetna’s membership portal or by calling the number listed on your member ID card.
Does Aetna Cover Medication-Assisted Treatment (MAT)?
The medications that Aetna covers will depend on your plan. You can search Aetna’s prescription drug list to learn which medications your insurance policy covers.
While not every patient needs medication-assisted treatment (MAT), it can be helpful for people facing alcohol or opioid addiction. The Recovery Village at Baptist Health offers MAT for eligible patients as needed.
Aetna Suboxone Coverage
Suboxone is an opioid use disorder treatment covered under Aetna pharmacy plans. Your insurance plan and deductible will determine the exact amount Aetna covers. A referral from your primary care provider may be required if you have a Medicaid or Medicare plan.
Aetna Methadone Treatment
Methadone is an opioid use disorder treatment covered by Aetna. Unlike Suboxone, it is distributed at a methadone clinic and covered through your medical plan. This may affect your coverage.
Aetna Disulfiram Treatment
Disulfiram is a prescription medication that helps treat alcohol dependence. It is typically covered under Aetna pharmacy plans. Your insurance plan and deductible will determine the exact amount Aetna covers.
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Speak with a Recovery Advocate today to talk about your treatment options.
What Length of Treatment Does Aetna Cover?
The length of treatment Aetna covers depends on the setting and the individual’s recovery plan. Aetna may cover up to six weeks of inpatient and 12 weeks of outpatient care. However, coverage depends on your policy and whether you have met your deductible during treatment. The best way to determine your addiction treatment coverage is by contacting Aetna.
Rehab Accepting Aetna in Florida
If you are seeking an addiction rehab facility that accepts Aetna insurance, The Recovery Village at Baptist Health can help. Our facility accepts Aetna and offers comprehensive, physician-led care at every step of recovery. Contact us today to verify your insurance online and learn about our payment options.
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Aetna. “HMO, POS, PPO, EPO and HDHP with HSA: What’s the difference?” Accessed April 22, 2023.
Aetna. “Member Login.” Accessed April 22, 2023.
Aetna. “Opioid FAQs for individuals and families.” Accessed April 22, 2023.
Aetna. “170 Aetna.” Accessed April 22, 2023.
America Society of Addiction Medicine. “About The ASAM Criteria.” Accessed April 22, 2023.
Healthcare.gov. “Essential health benefits.” Accessed April 22, 2023.