Overview of Aetna Insurance Plans
There are a variety of different insurance plans available through Aetna. You might get your insurance policy through your employer, or you might have an individual or family plan through your state’s Health Insurance Marketplace.
The most common types of health insurance plans are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
An HMO has a lower monthly premium. However, you will need to get care from doctors and treatment centers that are in-network with your insurance plan — there are generally no out-of-network benefits. You will also define a primary care provider, which is generally your primary care physician. This provider will provide referrals for specialist care, including appointments with therapists or addiction professionals.
A PPO is more expensive each month, but you have more freedom in choosing your care. You don’t need a defined primary care provider, and you can see any in-network specialist without a referral. You may also have some out-of-network benefits, although you will have higher out-of-pocket costs if you go outside the network.
What is a Provider Network?
What does it mean that some doctors and facilities are in-network or out-of-network? Health insurance companies have specific doctors, providers, and facilities that are contracted with an insurance plan. These providers are “in-network” with the plan, and in-network coverage means you’ll pay less out of your own pocket if you choose these providers.
Aetna works with a variety of professionals and facilities. However, if a doctor or facility isn’t part of the contract for your plan, they are “out-of-network” for your Aetna coverage. Depending on your plan, you may have no coverage for care by out-of-network providers, or you may have to pay much more out-of-pocket in deductibles and copayments.
To verify whether or not Woburn Addiction Treatment is part of Aetna’s national network for your plan, you can contact Aetna directly, or you can reach out to us. Our team would be happy to review your coverage details in just a few minutes and answer any questions you have about rehab.
Drug and Alcohol Rehab Treatments Covered By Insurance
All insurance providers focus on covering medically necessary care. That means coverage depends on having a doctor’s diagnosis and treatment plan that shows what types of treatment are best for your needs. Each individual’s insurance plan is different, so knowing the details is important.
You may also need preauthorization from Aetna before you start treatment. And, of course, you’ll pay less if you choose a facility that’s in-network with Aetna insurance plans.
Detoxification Services
For many types of substance abuse disorders, the first step in treatment is medical detox. Medical professionals will monitor you During this process to ensure your safety. They will treat withdrawal symptoms with medication-assisted treatment and other approaches.
Beginning treatment in detox takes up to 10 days, and you’ll also get group and individual therapy, nutrition meals, and treatment planning for your next steps.
Does Aetna cover detox? If it’s a medically necessary part of your treatment plan, your insurance should cover at least some of the cost. Our rehab facilities have staff that can help you verify your coverage and ensure we’re part of Aetna’s network for your plan.
Does Aetna Cover Inpatient and Outpatient Rehab?
Inpatient treatment allows you to live at the facility 24/7 throughout the program. You get focused, structured rehab treatment as well as holistic treatment options, outings, and a variety of other activities. These programs can last up to three months and provide you with a solid foundation for ongoing recovery.
Outpatient rehab treatment for substance abuse includes multiple programs, depending on the intensity of care you need. You might seek treatment through a partial hospitalization program (PHP), which is a full-day or part-day program that meets five days a week. Or, you might need an intensive outpatient program (IOP), which is more flexible and meets a few hours per session, with three sessions per week.
While the details depend on each individual’s insurance plan, Aetna plans typically cover inpatient and outpatient rehab if it’s medically necessary. You may also need to ensure that the facility is part of Aetna’s health networks so you can take advantage of in-network coverage.
Medication Assisted Treatment (MAT)
Medication-assisted treatment (MAT) can help those who are struggling with opioid or alcohol substance misuse. MAT can be part of detox, but it can also be an ongoing treatment approach as well. MAT helps manage cravings and reduces the chances of relapse while you go through individual and group therapy to establish long-term recovery.
If MAT is part of your doctor-recommended treatment plan, your Aetna plan may cover some or all of the cost. Aetna insurance covers drug prescriptions most of the time as well.
Aftercare Support
Most aftercare support is either free or self-paid, but some elements are covered by insurance. For example, if you have ongoing counseling, that might be covered.
Peer support is generally free of charge, and they can connect you to community resources and social services that are either free or low-cost. Sober living isn’t covered by insurance, but they generally have affordable fees for residents.
If you’re concerned about specific services and whether you can receive coverage, you can contact an Aetna representative or the service provider to get the details about what your plan covers.
Find Out If Your Insurance Will Cover The Cost of Treatment
Are you wondering if your insurance will cover the cost of treatment? At Woburn Addiction Treatment, we understand that navigating insurance coverage can be challenging. Our dedicated team is here to help you understand your Aetna insurance benefits and determine what is covered. Take the first step towards recovery by contacting us today. We’ll assist you in verifying your coverage and exploring your options so you can focus on what truly matters—your path to healing.
Mental Health Services Covered by Aetna Insurance
The ACA requires most health insurance companies to provide at least some coverage for both addiction and mental health treatment because these are considered essential health benefits. As a result, your Aetna insurance will likely cover mental health services as well as substance use rehab.
It’s common to have co-occurring mental health and substance use disorders. In fact, at Woburn, we specifically offer integrated treatment that addresses concerns at the same time. That’s the best way to help you reach long-term recovery because your mental health and substance use both impact each other.
Here are some other psychiatric services that may be covered by Aetna insurance:
- Psychiatric evaluations and assessments
- Dual-diagnosis treatment
- Therapy and counseling
- Crisis intervention services
- Medication management
Coverage depends on the details of your specific insurance policy. If these services are part of your treatment plan, our team can work with Aetna to help ensure you receive coverage according to what Aetna offers.
What is the Cost of Substance Abuse Treatment When Using Aetna?
Whether you’re getting inpatient rehab or outpatient services, you’ll want to know what to expect in terms of out-of-pocket costs. Fortunately, while that information varies from one plan to another, it’s easy to find out what costs are associated with your plan.
There are two types of out-of-pocket costs when you use health insurance coverage for rehab. The first is your deductible, and the second is your copayment or coinsurance.
- Deductible: The amount you pay before your insurance provider starts coverage
- Copayment: A flat amount you pay each time you receive a type of care, such as seeing a doctor or entering an outpatient treatment program
- Coinsurance: A percentage you pay for your care, and the insurance company pays the rest
Your out-of-pocket costs generally include your deductible and either a copayment or coinsurance, not both. Often, you’ll see the coinsurance if you use out-of-network benefits and a copayment if you use in-network providers.
Because most Aetna insurance covers some or all of the cost of addiction treatment, using your insurance plan can make getting treatment much less financially stressful.
Get The Addiction Treatment You Need and Deserve
Don’t let uncertainty about coverage delay your recovery. Contact us now to verify your insurance benefits and start your journey to a healthier, happier life.
Committing to Recovery with Woburn Addiction Treatment
Committing to recovery is a significant and courageous step, and Aetna policies can make the journey more manageable and less financially burdensome. Aetna plans’ coverage for substance use disorder treatment centers helps ensure that individuals have access to essential treatment programs tailored to their specific needs.
At Woburn Addiction Treatment, we offer top-notch addiction treatment services. Our programs provide personalized care, addressing both the physical and psychological aspects of addiction. If you or your loved one is seeking help, it’s time to begin the journey to a healthier, addiction-free life. Call or fill out our online form today.
