Aetna Insurance Coverage for Alcohol Rehab
Aetna is a health insurance company that provides healthcare coverage to its nearly 22.1 million members.1 With 1.2 million healthcare professionals and more than 5,700 hospitals in their network across the United States, Aetna offers members many healthcare options—including drug and alcohol addiction treatment.1 Aetna insurance plans cover medical, mental, and behavioral healthcare and provide benefits for visual and dental care and prescription medications.
If Aetna is your health insurance provider and you’re seeking treatment for substance use disorder, some or all of your rehab costs will be covered, depending on the plan you have.
Does Aetna Cover Alcohol Rehab?
Yes. Aetna covers some alcohol rehab costs. The amount covered depends on which of Aetna’s medical insurance plans you have and where you live.
If you’re ready to find an alcohol rehab center to begin your journey to recovery, Aetna offers 24/7 member support and can help you find a facility quickly.2 Call the number on the back of your insurance card to talk with a customer service representative. Your conversation will be completely confidential. An Aetna Care Advocate can help you every step along the way with assistance, guidance, and answers to any questions you have about substance use disorder treatment—including what your insurance will cover and what supports are available after you complete treatment.
Aetna supports a combination of private therapy and 12-step programs to treat addiction to alcohol. The duration of your stay in rehab will be determined by your Aetna coverage. Most inpatient alcohol rehab centers suggest a stay from 15-90 days or more, depending on your needs and how long you’ve been experiencing addiction. No matter how long you stay in alcohol rehab, you can find peace of mind knowing that your Aetna insurance plan will help cover some of the costs once your deductible is met.
You can check your specific insurance coverage instantly by filling out the form below.
Does Aetna Cover Co-Occurring Mental Health Disorders?
The Mental Health Parity and Addiction Equity Act ensures that all healthcare insurance providers will cover mental health and addiction treatment.3 Mental health is just as important as physical health, and this federal law is a way to guarantee that people who need drug and alcohol treatment can get it.
Although Aetna may not cover all drug and alcohol addiction services, it does cover many forms of addiction treatment. Your specific plan determines what is covered. Some plans may require pre-authorization for rehab from your primary healthcare provider before insurance coverage kicks in.4
Is Aetna Insurance Accepted Everywhere?
In your search for an alcohol rehab facility, you have likely heard the terms in-network and out-of-network. When a treatment facility is in-network, this means they have an agreement with an insurance company—in this case, Aetna—to offer care for people at a lower rate than other providers do. Choosing an in-network facility generally means lower out-of-pocket costs for you.
Out-of-network facilities do not have an agreement with Aetna, so your costs may not be covered. If you choose an out-of-network facility, you will have higher out-of-pocket costs. In some cases, you may need to pay for all services yourself. Sometimes Aetna will provide some coverage for out-of-network facilities, but not always.5
It is best to choose a rehab treatment center that is in-network with Aetna whenever possible. This helps keep your out-of-pocket expenses lower. Choosing an out-of-network facility means you have to do a lot more paperwork, and it may require pre-authorization for more treatments you receive while in care. Aetna can help you find a drug and alcohol treatment center within their network to keep your costs lower and facilitate your experience in rehab.
Aetna Healthcare Plans
Aetna plans are divided into two categories:6
- Health maintenance organizations (HMOs) cover only in-network providers and services. When you access care from a specialist, you will need a referral from your primary care physician. HMOs offer lower monthly premiums and deductibles, and co-pays are fixed so you know what to expect in out-of-pocket costs for any services you receive.
- Preferred provider organizations (PPOs) allow members to visit any doctor they choose, in or out of the Aetna network. You do not need referrals from your primary care provider to see specialists. PPO plans have higher monthly premiums and lower copays and may require coinsurance payments.
Aetna insurance plans are available at different tiers, allowing members to choose the plan that works best for their budget. The plan you choose for you and your family depends on your healthcare needs and how often you access healthcare services.7
- Aetna bronze plans have the lowest monthly premiums, the highest deductibles, and the highest out-of-pocket expenses. Bronze plans are ideal for people who don’t visit the doctor frequently and prefer to keep their monthly healthcare expenses down. Once your deductible is met under a bronze plan, Aetna will cover 70% of your medical expenses.
- Aetna silver plans have higher monthly premiums, lower deductibles, and lower out-of-pocket expenses. Silver plans are ideal for those who visit the doctor more frequently. Once the deductible is met, Aetna will cover 80% of your healthcare expenses.
- Aetna gold plans have the highest monthly premiums, the lowest deductibles, and the lowest out-of-pocket expenses. Gold is ideal for those who see the doctor often, have ongoing medical issues that require professional attention, and are on regular prescription medications. Once you meet your deductible, Aetna will cover 90% of your medical expenses.
People with disabilities and/or have low-income may be eligible for Medicaid, a health insurance program funded by the government. Aetna offers Medicaid insurance plans in 16 states throughout the country.8
Medicare is a government-funded health insurance program for individuals ages 65 and older or people with disabilities.9Aetna offers 3 types of Medicare advantage plans.10
The amount of coverage for drug and alcohol addiction rehab depends on your specific Aetna policy and the benefits it offers. No matter which plan you have, at least some of your addiction treatment will be covered by insurance once you meet your deductible.
How to Check What Aetna Covers
Before you enter alcohol treatment, it’s a good idea to know what your insurance plan will cover. You can confirm your Aetna coverage for drug and alcohol addiction treatment by calling the number on the back of your insurance card to speak with a customer service representative. Alternatively, you can log in to the member portal on Aetna’s website and read about the details of your specific policy. Their online cost estimate can give you an idea of how much your treatment might cost and how much your policy will cover.
Paying for What Insurance Won’t Cover
Your health is more important than waiting for the “right time” financially. No matter what insurance plan you have, you will likely have some expenses related to drug and alcohol addiction treatment. However, there are many ways to help finance your treatment and ensure you get the help you need when you need it. Some options for helping with the cost of rehab include:
- Payment plans: Most rehab facilities offer payment plans so you can pay in affordable installments
- Sliding scale. Some rehab programs offer sliding-scale fees based on your income levels.
- Grants and scholarships. Grants and scholarships are available through the Substance Abuse and Mental Health Services Administration. Many rehab treatment facilities also offer these opportunities.
- Payment from savings or by credit card.
- Crowdfunding, in which you ask friends and family for financial support.
Cost should not be a deterrent to entering treatment and getting the help you need. There are many ways to pay for rehab, so lack of full insurance coverage shouldn’t be a barrier to accessing care and getting on the path to sobriety.
Verifying Insurance for Alcohol Rehab
Once you’ve found an alcohol rehab center that offers the treatments and services you are looking for, it’s time to verify your insurance. Call your insurance provider to verify your insurance coverage. You can also call us to verify your insurance for you while you’re on the phone—or complete the form below.