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Reviewed by Addiction recovery can be overwhelming, and the path to recovery isnโt always straightforward. Finding a rehab facility that aligns with your needsโand your insuranceโshouldnโt add more stress to the process.
Aetna, a leader in managed healthcare and part of the CVS Health family, offers extensive coverage options to help individuals access effective addiction treatment without added financial strain. With a network of over 690,000 healthcare professionals and 5,700 hospitals, Aetna makes quality care more accessible, connecting members to specialized substance abuse and mental health services.
Keep reading to explore some of the top rehab facilities that accept Aetna insurance. This will help you determine your options so you can focus on what matters most: a successful recovery.
Table Of Contents:
About Aetna Health Insurance Coverage
Aetna Health Insurance offers a broad spectrum of coverage options to support members through various health journeys, from preventive care to specialized treatment.
As part of CVS Health, Aetna leverages its robust provider network to offer several coverage options for individuals, families, and employees through employer-sponsored plans and Medicare, providing flexible solutions for diverse needs.
Aetnaโs plans include comprehensive benefits across several areas:
- Aetnaโs Medicare plans may include added services like prescription drug coverage, wellness benefits, etc.
- Aetna provides guidance and resources for individuals and families seeking quality coverage options.
- Aetnaโs network includes primary and specialized care, outpatient and inpatient, emergency, and preventive health services.
- Aetnaโs dental and vision plans support preventive and routine care, covering exams, cleanings, and more.
- Aetna offers plans that cover certain long-term care needs, disability benefits, and chronic condition management.
Aetna aims to make healthcare accessible and affordable, empowering members to pursue well-being with various in-network options. These offerings support members in managing their health proactively and achieving the best possible outcomes in recovery, chronic care, and everyday wellness.
Does Aetna Cover Rehab?
Aetna covers rehab services as part of its behavioral health benefits, which align with the Affordable Care Act (ACA) guidelines. Under the ACA, substance use disorder services are considered an essential health benefit, which means that most insurance plans, including Aetnaโs, are required to provide coverage for addiction treatment and rehabilitation. This coverage includes various services, including:
- Drug detox: Managing withdrawal symptoms under medical supervision.
- Inpatient rehab: Intensive treatment in a structured living environment.
- Outpatient rehab: Less intensive program allows patients to receive treatment at home.
- Intensive Outpatient Programย (IOP): Less intensive outpatient care with regularly scheduled sessions.
- Partial Hospitalization (PHP): Intensive outpatient program with daily structured treatment.
- Medication-Assisted Treatment (MAT): Combines therapy with medications for opioid orย alcohol addiction.
With Aetna, members can access rehab services through an extensive network of in-network providers, helping to keep out-of-pocket costs manageable. The ACAโs requirements help ensure that individuals seeking addiction treatment receive medically necessary care without facing significant financial barriers.
Does Aetna Cover Therapy?
Aetna covers a variety of therapy modalities, including family therapy, psychodynamic therapy, cognitive behavioral therapy, and dialectical behavioral therapy. Aetna also covers online therapy through Talkspace.
The mental health resources available for you may include:
- MinuteClinic: Confidential counseling by phone or video
- Telehealth: Talk to a counselor or psychiatrist about concerns like depression, substance use, eating disorders, or suicidal thoughts
- Teladoc Health: Online therapists, psychologists, and psychiatrists are on call 7 days a week
- Medication: Aetna typically covers medications related to diagnosed mental health conditions.
The cost of therapy sessions depends on your plan’s rehab coverage and may include deductibles, copays, and coinsurance. Aetna does not cover some types of therapy, including hypnotherapy and non-traditional methods, such as biofeedback therapy.
If you’re having a behavioral health crisis, call Aetna’s crisis line at 1-855-232-3596 (TTY: 711) and choose option 9.
How Long Will Aetna Pay for Rehab?
The length of time Aetna will cover rehab services depends on several factors, including the specific plan, the type of treatment required, and theย medical necessity determined by healthcare providers. Aetna typically covers rehab if it is deemed medically necessary, meaning that the patient shows a need for continued treatment to progress recovery or prevent relapse.
Aetna plans often cover different stages of treatment, such as:
- Detox: Coverage may vary, but it is usually covered for a period that allows the patient to withdraw from substances under medical supervision safely.
- Inpatient Rehab: Coverage usually spans 30, 60, or 90 days, depending on the patient’s needs and healthcare providers’ recommendations.
- Outpatient Programs: Outpatient care is often covered for extended periods, sometimes up to several months.
Members should consult their specific Aetna plan documents or speak with Aetnaโs customer service to understand the exact coverage duration and any requirements for pre-authorization.
How Long Will Aetna Medicare Pay for Rehab?
The length of time Aetna and Medicare plans will pay for rehab depends on the type of rehab and the plan you have. For example, Medicare Part A usually covers up to 60 days of inpatient rehab per benefit period. After the deductible is met, Medicare typically covers 100% of the first 60 days.
From day 61 to day 90, you may be responsible for a daily coinsurance amount. If your stay exceeds 90 days, you may use โlifetime reserve daysโ with a higher coinsurance amount. As for Medicare Part B, it generally covers a certain number of visits per year for outpatient rehab services.
Paying for Rehab with Aetna Insurance
Paying for rehab with Aetna insurance can be manageable when you understand how your coverage works and the costsย involved. Here are vital steps to help you maximize Aetnaโs benefits and manage out-of-pocket expenses effectively:
Reach Out Anytime
Start by calling the toll-free number on your Aetna member ID card, which isย available 24/7. Our support team is ready to guide you, answer your questions, and assist at any time that works best for you.
Connect with Your Aetna Care Advocate
Beyond your healthcare provider, you can work with an Aetna Care Advocate who will help you set personalized goals and create a treatment plan that fits your needs. Your Care Advocate is there to support you throughout your recovery journey.
Explore Treatment Options
You can review and weigh different treatment options with your Aetna Care Advocate. Based on your specific needs and treatment goals, your Advocate can offer tailored resources and advice, helping you find the right care level, whether outpatient counseling, detox, or inpatient rehab.
Involve Your Support Network
Recovery is a team effort. Lean on friends and family for encouragement and keep them updated throughout your journey. With your Care Advocateโs help, youโll stay connected and empowered to achieve your goals.
Rely on Ongoing Support
Your Aetna Care Advocate is committed to being there every step of the way. Theyโll provide continuous support and guidance, helping you stay on track and adjust your care for the best possible outcome.
Taking these steps helps you access the support and care you need, ensuring youโre not alone in your journey to recovery.
Rehabs that Take Aetna Insurance Coverage
As a leading insurance company, Aetna connects individuals seeking addiction treatment with a vast network of healthcare providers nationwide. Check some of the available UMR in-network options:
- River Oaks Treatment Centerย in Florida offers evidence-based rehabilitation with hotel-like accommodations.
- Laguna Treatment Hospitalย in California with experiential therapies and recreational activities.
- Greenhouse Treatment Centerย in Texas provides specialized treatment and medication management.
- Oxford Treatment Centerย in Mississippi follows a clinical-based therapy offering medical detox and co-occurring disorder care.
While this list provides a couple of options, always verify insurance coverage directly with the facility before starting treatment.
Check Your Aetna Benefits
You can check your Aetna benefits online by logging into your Aetna member website.ย You can register for the website with your member number on your member ID card.
Once you’re logged in, you can use the member website to:
- Check coverage and benefits
- See claims
- Manage prescriptions
- Find a doctor, pharmacy, or hospital
- Estimate costs
- Access your digital ID card
- Take a health assessment
You can also view your Explanation of Benefits (EOB) statements online by logging into your Caremark.com account.ย You can also get benefits and coverage information by calling the number on your member ID card or by contacting your company’s benefits department.
Donโt Get Caught in Addiction
Finding the right rehab options with Aetna insurance can be straightforward when you know your coverage, work closely with Aetnaโs Care Advocates, and have a strong support network.
By understanding your plan details, choosing in-network providers, and seeking the right level of care, you can manage rehab’s financial and logistical aspects, ensuring a smoother path to recovery. If you or a loved one is ready to take the next step toward a healthier, addiction-free life, reach out today to explore your rehab options with Aetna. Start your recovery journey now!
People Also Ask
Does Aetna have a good reputation?
Aetna has an A (Excellent) rating from AM Best, reflecting its strong financial stability and reliabilityโpositive assessments from multiple financial rating agencies back this high rating.
Does Aetna Medicare pay for inpatient rehab?
Aetna Medicare plans generally cover inpatient rehab if deemed medically necessary, often including detox and rehab services. However, specific coverage details depend on individual plans and the required care level.
How do I check the status of my Aetna claim?
Check your Aetna claim status through your online member account, Aetna’s mobile app, or by calling Aetna customer service with your member ID for real-time updates on processing and payments.
Page Sources
- AETNA Group of Companies | AETNA. https://www.aetna.com/about-us/aetna-facts-and-companies/aetna-companies.html
- Isola, S., & Reddivari, A. K. R. (2023, July 10). Affordable Care Act. StatPearls - NCBI Bookshelf.ย https://www.ncbi.nlm.nih.gov/books/NBK549767/
- Inpatient rehabilitation care. Medicare. https://www.medicare.gov/coverage/inpatient-rehabilitation-care