Guide to Aetna Health Insurance Coverage for Addiction Treatment

Last Edited: December 28, 2023
Claudia Rose
Clinically Reviewed
Andrew Lancaster, LPC, MAC
All of the information on this page has been reviewed and certified by an addiction professional.

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Click Here for a confidential benefits check or call (866) 578-7471 to speak to a addiction specialist.

Dealing with substance use disorder (SUD) is a challenging journey that requires a strong support system and the right resources for effective treatment. One crucial resource in this journey can be your health insurance plan. If you have Aetna Health Insurance, you may have access to various treatment options for SUD. This post explores how you can utilize your Aetna Health Insurance for SUD treatment and emphasizes the importance of verifying your insurance information to understand your coverage fully.

Understanding Aetna Health Insurance Coverage for SUD

Aetna, as one of the leading health insurance providers, offers coverage that often includes treatment for substance use disorders. This can range from detoxification programs to outpatient counseling. However, the extent and type of coverage can vary based on your specific plan.

Types of Treatments Covered

  • Detoxification: Aetna may cover medically supervised detox programs, which are essential for managing withdrawal symptoms safely.
  • Inpatient Rehabilitation: Inpatient programs that offer a structured treatment environment may be covered.
  • Outpatient Treatment Programs: This includes regular visits to a healthcare provider for counseling and treatment.
  • Counseling and Therapy: Sessions with therapists or counselors specializing in addiction recovery are often covered.
  • Medication-Assisted Treatment (MAT): Aetna may cover medications used in the treatment of opioid or alcohol dependence, along with accompanying therapy.

Understanding Your Plan

Each Aetna plan has different levels of coverage, deductibles, co-pays, and network requirements. Understanding these details is key to determining how much of your treatment will be covered.

You could also speak to the substance abuse rehab center you are considering and ask them to perform a check for you. This is free and confidential and will help you ensure you truly can gain a productive, healthy and meaningful life at a price that you can afford.

Aetna insurance has set itself the goal to make sure that individuals and the people they care about are able to maintain a happy and healthy life. If you or a loved one are struggling with addiction call: (866) 578-7471.

Coverage for Behavioral Health & Rehab

Aetna’s health insurance provision includes behavioral health. The company aims to ensure that medical and behavioral health treatment is offered in an integrated way with a focus on both prevention and early identification. They also cover any services that are deemed necessary. Aetna representatives work tirelessly to make sure that you can get the help that you need in order to become healthy. Some of the tools at your disposal include:

  1. The ability to identify disorders as early as possible and receiving treatment before they escalate
  2. The ability to create a health management plan suitable to your individual needs
  3. The ability to access integrated care in behavioral and medical health services

Benefits of Utilizing Health Insurance for SUD Treatment

  • Reduced Financial Burden: Health insurance can significantly lower the financial barriers to accessing quality SUD treatment.
  • Access to Comprehensive Care: Insurance coverage often enables access to a range of treatment modalities, improving the chances of successful recovery.
  • Support Through the Recovery Journey: Continuous support, from detox to therapy, is crucial in recovery, and insurance coverage can ensure ongoing treatment without interruption due to financial constraints.

Specific Aetna Rehab Policies

Not every program offered by Aetna includes substance abuse treatment. Only very few programs will cover you for intensive services above and beyond outpatient care. You will be able to find coverage with authorization and pre-certification if you have any of the following policies that Aetna offers:

  • Aetna Choice POS
  • Aetna Golden Choice
  • Aetna Golden Medicare Plan
  • Aetna Choice POS II
  • Aetna HealthFund
  • Aetna Open Access
  • Elect Choice HMO
  • Elect Choice
  • Aetna Open Access Managed Choice
  • Aetna Open Access HMO
  • USAccess
  • Managed Choice
  • Quality Point of Service
  • Open Choice

Some of the self-funded plans that Aetna offers have specific requirements for precertification, which you should have been informed of when you purchased your policy. Some plans are not owned by Aetna, although they do administer them, while there are others that will need you to seek pre-authorization for an outpatient service, as well as for all other possible services.

Aetna can be contacted 24/7, 365 days per year so that you would be able to get the answers you need in terms of what you are covered for. If you aren’t sure, you can contact them and they will give you all the answers you need. This service is 100 percent confidential, free with zero obligation. Your member ID card will list the telephone number for your Aetna representative. By calling (866) 578-7471 you can determine what your insurance plan covers to decide on how you will proceed with your rehabilitation.