Aetna

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Who is Aetna Insurance?

Aetna is one of the premier insurance companies in the United States and has been around for over a hundred years. Like other insurance companies across the country, Aetna can provide coverage for addiction treatment and recovery. They provide a holistic approach to healing instead of a one size fits all style program. While Aetna covers a range of insurance products one of their main focuses is health care insurance. Aetna provides 45 million people with medical insurance. This means that Aetna has a large pool of resources to pull from to help you start your recovery journey and to provide programs that will help you maintain your sobriety.

Can Aetna Insurance Cover Treatment for My Drug and Alcohol Dependence?

The Affordable Care Act of 1010 made it mandatory for all health insurance companies to provide at least some coverage for addiction and mental health recovery services. Recently Aetna has started to prioritize addiction recovery in their health care insurance. Besides basic coverage, most of Aetna’s mental health coverage works with more than just the treatment facility. They provide ongoing programs for their clients to help them maintain a support group and stay motivated on their healing journey.

Can I Attend Drug or Alcohol Rehab Without Anyone at Work Finding Out?

If your company offers health insurance through Aetna it can be handled anonymously and discreetly. Besides offering traditional insurance Aetna offers Medicare services and serves many companies ‘ health insurance needs. Working with Aetna through work or your addiction treatment clinic can make this process much easier. Addiction is a health issue just like cancer. And like cancer, some people would prefer to deal with their condition privately. Aetna and your recovery clinic can also work with companies that do not offer insurance to guarantee privacy.

Does my Aetna Insurance Cover my Alcohol and Drug Rehab?

Aetna covers drug and alcohol rehabilitation in many clinics. There are two different types of clinics. There are in-network clinics and out-of-network clinics. These in-network clinics are available to clients of Aetna for a lower cost than out-of-network clinics. In-network clinics are not only more affordable due to insurance coverage they are also carefully pre-screened by Aetna to ensure their quality. In a few cases, Aetna may fully cover the start of the addiction recovery journey as well as continuing to support you as you make your way through your new life.

What Types of Treatment Does Aetna Insurance Cover?

There are multiple steps at the start of your recovery journey that insurance can help pay for:

Detox:

It is important to seek a medically qualified recovery clinic in which to detoxify from drugs and/or alcohol. It can be very dangerous to try to detoxify on your own.  You need to check with Aetna to find out how many days of detox your particular plan will cover, how much of it they will cover, and at which facilities.

Residential Treatment:

In residential treatment, the patient lives in the treatment facility full time. This is very beneficial because the risk of relapse is kept to a minimum as narcotics and alcohol are not allowed in the facility. Aetna can cover residential treatment for a certain number of days depending on your plan. Depending on your progress you might not need to be in residential treatment as long as some other patients. The length of stay varies from client to client.

Partial Hospitalization Program (PHP):

After someone completes their residential treatment they move into the PHP. The PHP is less restrictive than the residential treatment program but it still keeps patients on a strict routine to help them learn how to keep a healthy schedule. Aetna health care addiction recovery insurance often provides for a certain number of days for PHP just like the rest of the programs.

Intensive Outpatient Program (IOP):

After the patient passes through the PHP, they are enrolled in an IOP. In the IOP patients attend therapy and other programs but they return to their home every night. Some people enter the IOP program right away without going through the residential treatment program, or a PHP. Enrolling in the IOP first instead of going through residential treatment and the PHP is not right for everyone. The process for Aetna’s IOP plan can change the total cost of the treatment if the patient is put straight into the OIP instead of residential care. However, going straight from detox to an IOP is sometimes not the best option for many clients. Please take the doctor’s advice seriously. It is their job to make sure that you are in no medical danger while you are in their care or at any point in your recovery journey with their clinic.

Aftercare:

Besides Aetna’s aftercare program many rehabilitation facilities offer their intense aftercare treatment. This often includes:

  • Drug Testing
  • Continuing Therapy
  • Social Events for Alumni of the rehabilitation program
  • And Much More

What Do I Do After My Drug and Alcohol Rehabilitation Starts?

Like other medical insurances Aetna insures not only your clinic’s intensive addiction rehab, it provides people with an additional aftercare program of its own on an ongoing basis. In Aetna’s aftercare program people who are just starting on their road to recovery are put in touch with a support system of people who are going through the same struggles they are. They often will meet up to celebrate a new recovery with a cookout or other festive activity. A good support system is critical to a patient’s road of recovery.

Can I Get Help After My Drug and Alcohol Rehabilitation?

Aetna not only provides its clients with insurance for the clinic and aftercare. They also help their clients find a licensed mental health care professional in their area who is certified to help their patients succeed in their addiction journey.

What is Preventative Care?

Preventative health care, or health care that prevents problems, has become increasingly popular in the healthcare field, including the mental care insurance field. Companies are starting to recognize that it is important to care for their clients and to get them to help in a way that prevents the need for costly procedures, instead of waiting for those procedures to be needed.

Am I Covered for Drug and Alcohol Rehab Under the Affordable Care Act?

The Affordable Care Act which was passed in 2010 mandated that all health insurance companies provide at least partial coverage for addiction recovery treatment. This includes treatment for co-occurring disorders like depression and alcoholism. Co-occurring disorders always have at least one addiction component and at least one mental health component. Some common dual diagnosis (the formal name for diagnosed co-occurring disorders) that are linked to addiction are:

These are not the only mental health disorders that can feed, and sometimes create, an addiction disorder, but they are a few of the most common. It is important to follow up with Aetna after your discharge from the rehabilitation clinic to see what therapists, therapy groups, and other mental health care centers are in your area and accepting patients.

Will Someone with Co-occurring Disorders Relapse?

If a person has co-occurring disorders it is important for the underlying mental health issue to be resolved. For example, if you treat someone for alcoholism who has depression without treating the depression, they will soon relapse. This is because what motivated them to develop alcoholism, major depressive disorder, is still there and will continue to be a motivating force that will impede their sobriety.

What Should I Ask My Insurance Company About Drug and Alcohol Rehab?

While our health care professionals at Sana Lake and professionals at other clinics will always be ready to help you through the insurance process guaranteeing that you get the best health care available there are some questions you can ask your insurance company ahead of time for peace of mind.

Some questions you might want to ask your provider are:

  • Is my assessment for drug and alcohol abuse fully covered?
  • How many days of detox treatment does Aetna provide?
  • Will both outpatient and inpatient drug rehab programs be covered by Aetna?
  • Will my insurance cover all of my programs and the whole length of my stay?
  • Is the rehab program I want in-network or out-of-network?

These are not the only questions you should ask your Aetna healthcare professional but they are a good start to refresh yourself on what your insurance plan does and does not cover.

What Are the Insurance Laws in Different States?

Every plan is different and different states place different limits and requirements on insurance companies. It is impossible for a plan in Missouri to be exactly the same as a plan in Texas.

What Should I Do If I Have Questions About My Aetna Drug and Alcohol Rehab Costs?

If you have any questions about your insurance you can either contact Aetna directly or you can contact us here. You can also reach us by calling us at (855) 745-3336

References:

https://www.aetna.com/individuals-families/find-a-doctor.html

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.