Author: James Anderson

Does Aetna Cover Drug and Alcohol Rehab?

Our team of experienced professionals will promptly reach out to your health insurance provider to validate your eligibility for rehab treatment. We will then contact you at your earliest convenience to go over your policy details and discuss the next steps. Other ways to help pay for the difference are reverse mortgages, annuities and trusts. You can also speak to your rehab facility to determine whether they have payment plans that will allow you to receive treatment without worrying about payment upfront.

Aetna provides coverage for drug and alcohol rehab to its members who need treatment for substance abuse and addiction. Aetna alcohol rehab and Aetna drug rehab encompasses a wide range of services, including detoxification, inpatient and outpatient care, and medication-assisted treatment. Additionally, members may receive cognitive-behavioral therapy (CBT), motivational interviewing, counseling, and aftercare support services for relapse prevention. An ASAM public policy statement on the ethical use of drug testing in addiction medicine (ASAM, 2019) states that drug tests should be selected based on an individualized clinical assessment of the patient. The scope of the analyte panel and the frequency of testing should be justified by the patient’s clinical status and the ordering clinician’s need for information. They state that clinicians should document the rationale for the drug tests they order and the decisions they make based on the test results.

IOPs deliver structured, intensive therapy and counseling sessions while allowing you to uphold your daily routines and responsibilities. Aetna’s coverage for PHPs often includes services such as therapy, medication management, group counseling, individualized treatment plans, and aftercare. Access to PHPs can be a crucial step toward sobriety and managing and recovering from mental health or substance use disorders. The ASAM appropriate use criteria for drug testing in addiction (Jarvis, et al., 2017) stated that the frequency of testing should be dictated by patient acuity and level of care. Clinicians should consider the tests’ detection capabilities, including the window of detection, in determining the appropriate frequency of testing.

Finding A Rehab Center That Accepts Aetna

If you or a loved one has inadequate insurance coverage and are seeking addiction treatment, you may be wondering what other options you have for payment. Aetna will also cover mental health treatment as well as dual diagnosis treatment for co-occurring mental health and substance use disorders. Aetna insurance covers multiple levels of care and a range of evidence-based treatment options. Below are some of the services people with Aetna insurance may or may not have access to. The extent of coverage for a rehab program will depend on the state, the healthcare plan, and whether the facility is considered in-network or out-of-network. Aetna has carefully selected the health care providers in its network to ensure that members receive high quality care.

1. This means you’ll be responsible for paying a portion of your care out of pocket, even with insurance coverage.
2. Speak to your insurance provider to find out what coverage limitations you might have.
3. Aetna’s in-network providers are less costly than out-of-network providers.

Aetna is a private insurance company that offers addiction treatment and mental health coverage. Insurance plans through Aetna cover an array of evidence-based treatments and levels of care. Its medical teams are trained to identify specific conditions and tailor a treatment plan based on what the individual needs.

Does Aetna Cover Mental Health Therapy Treatment?

In the past, the standard approach to substance abuse treatment included a referral to an inpatient or residential program that would span 28 days. Now, an individual can receive different modes of treatment depending on the stage of their substance use disorder. You can easily confirm your insurance coverage by completing our no-commitment, confidential online form.

Drug testing should be scheduled more frequently at the beginning of treatment, and less frequently as recovery progresses. They state that drug testing should occur on a random schedule, and recommend testing at least weekly during the intial phase of substance abuse treatment. They recommend at least monthly random drug testing once a patient is stable, with consideration of less frequent testing for patients in stable recovery. The appropriate use criteria noted that, although increasing the frequency of drug testing increases the likelihood of detection, there is insufficient evidence that increasing the frequency of drug testing affects the substance abuse itself. Aetna covers detoxification, inpatient, residential, partial hospitalization and intensive outpatient programs. It requires precertification of some behavioral and mental health services to ensure that the requested service meets the company’s criteria for coverage.

Our holistic approach integrates the latest clinical methods and evidence-based techniques for addiction and mental health recovery. These researchers stated that further studies are needed, because this information will be very valuable in understanding how much aberrant opioid use behaviors will influence treatment and response in real practice. The first step in using Aetna insurance for substance use treatment is talking to your primary care provider or the drug rehab facility directly. All Aetna insurance plans are required by law to cover some level of addiction treatment.

Aetna Insurance Coverage

Aetna insurance does cover medical detox, but members may need to get pre-certification or authorization prior to starting the program. Aetna’s in-network providers are less costly than out-of-network providers. The table below shows a breakdown of in-network costs versus out-of-network costs for a two-week stay for chemical dependency rehab. In-network providers require a person to pay only their deductible or coinsurance amount. The deductible is the amount you pay for covered services before Aetna begins to pay any expenses. Participants live on-site at the rehab facility and receive ongoing access to medical supervision and support.

Does Aetna Cover Rehab for Drugs and Alcohol?

They also stated that definitive testing should be done when the patient disputes the results of a presumptive test. However, when an individual goes out of network, the difference between the out-of-network healthcare provider’s bill and Aetna’s recognized amount does not count toward the deductible cap. Begin by thoroughly reviewing your summary of benefits documentation to understand your coverage.

The company collaborates with a network of healthcare professionals and facilities to ensure customers can access top-tier, evidence-based treatment options. Definitive tests G0482 (15 – 21 drug classes) and G0483 (22 or more drug classes) are rarely medically necessary for routine testing in the outpatient setting. The guidelines state that urine tests based on gas chromatography-mass spectrometry are considered the most specific for identifying individual drugs and metabolites and are often used to confirm positive immunoassay results. The length of your stay, the type of program you choose (inpatient or outpatient), and the services you receive are all factors that will also affect the cost. Some plans may have coverage limits on the duration of inpatient treatment or the number of visits, while others may not have any limits. Aetna health insurance plans cover some or all of the cost of addiction treatment.

Reach out to AddictionResource.net today for more information about substance use disorder treatment. Visiting the Aetna website and using its online provider directory can help you search for rehab facilities in your area that accept Aetna. You should contact the facility before arrival so you don’t waste the time and money to travel to the rehab center only to be denied. Reaching out to the rehab center of your choice with your insurance information in hand can be a quick way to confirm whether Aetna is accepted. Aetna also uses a screening, brief intervention, and referral to treatment (SBIRT) practice that helps identify, reduce, and prevent alcohol and drug use. Luckily, there are several resources that can help you get the recovery services you need.