The Affordable Care Act (ACA) signified a turning point for treating substance use disorders and mental health. This act stated that all health insurance plans must offer coverage for substance use disorders and mental health issues—similar to other health conditions. This means Aetna insurance drug rehab coverage is available for many rehabilitation programs, including those at the United Recovery Project.

Depending on your specific policy, Aetna may cover various parts of your addiction treatment, reducing your total cost. At the United Recovery Project, we understand the stress often associated with financial burdens and are here to help. Together, we can determine how you can effectively use your Aetna insurance coverage to get the care you need and deserve.

Aetna Insurance Coverage for Drug and Alcohol Rehab - United Recovery Project
Source: www.aetna.com
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Understanding Aetna Insurance Coverage for Rehab

Aetna insurance offers comprehensive coverage for addiction treatment, recognizing the importance of addressing substance use disorders as part of overall health care. Their approach includes coverage for various levels of care and services, ensuring members can access necessary treatments.

As such, the types of rehab services that may be covered, depending on your specific policy, include:

  • Detox programs
  • Inpatient programs
  • Outpatient programs

Again, the scope of coverage varies from plan to plan. Some facilities and policy types may also offer aftercare; knowing the specifics of your policy can determine if this is part of your coverage.

Coverage Specifics for Different Levels of Care

It’s always essential to verify your individual coverage specifics. Our caring and compassionate team at the United Recovery Project can help you confirm relevant information regarding your specific plan. If you need further assistance, contact us at 888-960-5121. For more information on coverage specifics, read the sections below.

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Detoxification

Insurance plans often deem detoxification programs as a medical necessity. This involves safely coming off of the addicted substance and managing withdrawal symptoms in a medically supervised setting. As such, most Aetna policies cover medical detox programs, offering help with the first phase of addiction recovery.

Inpatient and Residential Rehab

Inpatient rehab programs involve 24/7 care in a structured environment. It allows individuals to receive the intensive support and therapy they need to overcome addiction.

As such, Aetna policies typically cover partial or full costs of these programs. However, it will depend on your specific policy as to how much you pay out of pocket. For more intensive and longer programs, the costs may be higher; thus, you may be required to pay more.

Outpatient Programs (PHP, IOP)

Outpatient programs include Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP). PHPs provide day treatment but allow individuals to return home in the evenings. Meanwhile, IOPs provide multiple intensive therapy sessions each week while allowing individuals to attend to their daily obligations or responsibilities.

Aetna plans may cover partial or full costs, depending on your individual policy. The best way way to determine your specific coverage is to contact Aetna directly. Alternatively, the United Recovery project team can help verify your insurance coverage.

Eligibility and Pre-Authorization

Checking your eligibility and obtaining pre-authorization when it comes to your addiction treatment through Aetna can potentially reduce your out-of-pocket expenses, as well as take away any additional stress.

Pre-authorization involves contacting Aetna and having them review and approve your specific services before they are provided. Without pre-authorization, you risk denial of coverage, resulting in higher costs.

Before obtaining pre-authorization, however, it’s essential to verify your coverage, such as what treatments are covered, associated costs, and what providers are available. With this in mind, here are some steps you can take to get started:

  1. Review Your Plan Documents: Start by examining your insurance policy documents or logging into your Aetna member portal to understand your benefits related to addiction treatments.
  2. Contact Aetna Member Services: Call the number on the back of your insurance card to speak with a representative who can provide detailed information about your coverage, including any pre-authorization requirements.
  3. Consult Your Healthcare Provider: Your doctor or treatment facility, such as the United Recovery Project, can assist you in obtaining pre-authorization by submitting the necessary information to Aetna on your behalf. Contact our team today at 888-960-5121 to learn more about how the United Recovery Project can help you with this process. Alternatively, if you want to learn more, continue reading the section below.

Using Aetna for Rehab at United Recovery Project

The United Recovery Project accepts Aetna insurance for various treatment protocols. By working with many different insurance companies, we’re able to provide accessible addiction treatment options to those who need it the most.

Verifying your insurance benefits beforehand can ensure a smooth admission process. However, if this sounds overwhelming, our team at the United Recovery Project is here to help. We can help verify your insurance, confirming your specific policy and coverage options.

For coverage assistance, fill out our form or call us at 888-960-5121.

Out-of-Pocket Costs and Coverage Limitations

When using any insurance plan, it helps to understand the costs involved, which may include:

  • Deductibles: This is the amount you pay for covered services before your insurance plan begins to pay. For example, if your plan has a $1,500 deductible, you must pay that out-of-pocket before your insurance coverage kicks in.
  • Copayments (Copays): These are fixed fees for specific services, such as a $30 fee for an outpatient visit. Copays can vary depending on the service and your specific plan.
  • Coinsurance: After meeting your deductible, you may be responsible for a percentage of the costs for covered services. For instance, with a 20% coinsurance rate, you would pay 20% of the service cost, and Aetna would cover the remaining 80%.
  • Out-of-Pocket Maximums: This refers to the maximum amount you would pay during a policy period (usually a year) before your insurance covers 100% of covered services. Knowing this limit can help you anticipate future financial responsibility and avoid surprises down the line.

Conclusion

At the United Recovery Project, we are proud to accept Aetna insurance coverage for drug and alcohol rehab. If you’re unsure of what your coverage includes, our expert team is here to help verify your insurance plan and ensure you get the most out of it. Together, we can break down the financial barriers involved in accessing effective recovery treatment. For more assistance, contact us at 888-960-5121.

References

https://www.aetna.com/health-guide/explaining-premiums-deductibles-coinsurance-and-copays.html

Popular In-network Insurances at United Recovery Project:

Aetna
Blue Cross Blue Shield
NYSHIP
Cigna
United Healthcare
Anthem Blue Cross
Beacon
Presbyterian
Highmark
Optum