Aetna Insurance and Drug Rehab at AspenRidge Recovery

If you are in need of drug rehab, and you have Aetna health insurance, you probably have a lot of unanswered questions. It is not always easy to know what your plan will cover, and you may be unsure about whether it will cover any treatment at all.

Fortunately, there are laws in place that protect you, and ensure that you can get the help you need. No one should have to live with an addiction. If you have the desire to get treatment, recovery is possible.

We would like to take this opportunity to talk with you about your insurance in more detail, and answer many of your questions. We are confident that you will get all of the information you need to make an informed and educated decision about how to proceed.

About Aetna Health Insurance

Aetna takes a lot of pride in their core values. They are what drive every decision they make for their members’ care. Their Chairman, CEO and President, Mark Bertolini says, “Everything we do at Aetna starts with our values – a clear, strongly held set of core beliefs that reflect who we are and what you can expect from us. We created our core values together, as a company and with guidance from our customers. Our values carry through our thoughts and actions every day, inspire innovation in our products and services, and drive our commitment to excellence in all we do.”

As an Aetna member, you benefit from the processes they use to process claims and provide services. They believe in a simpler healthcare process. They make it a point to let their members know how much procedures cost before they commit to them. By focusing on your overall health, they encourage doctors, hospitals and all health personnel to do the same.

Does Aetna Cover Drug Rehab?

Yes, Aetna does offer coverage for drug rehabilitation programs for their members. Your level of coverage will differ depending on the type of plan you have. This company recognizes the fact that drug addiction is a disease and it needs to be treated like one.

The type of coverage you receive may also depend on various factors having to do with your addiction. For example, the following will all be taken into consideration:

  • How long you have been using
  • The type of drug you use
  • Whether or not you have been using more than one drug
  • Any mental health conditions you may have
  • Any health conditions you may have

Fortunately, as an Aetna member, you will be able to utilize your benefits to help cover the costs of drug rehab. This is one of the best parts of choosing them as your health insurance company.

What Types of Addiction Treatment Will They Pay for?

Sometimes people are concerned that they may suffer from a type of addiction that Aetna will not cover. If that has been one of your worries, allow us to put your mind at ease. Your health insurance will provide you with coverage for any type of rehab you need. This includes, but is not limited to:

Does Aetna Offer Benefits for Alcohol Rehab?

Sometimes people are worried that if their problem is alcoholism, their insurance will not cover treatment. That is not the truth at all when you are an Aetna member.

Aetna will provide you with benefits to help pay for alcohol rehab. This will include detox (which we will talk about in more detail in a moment), therapy and any other form of treatment that may be needed.

Like drug addiction, alcoholism is also considered to be a disease. Alcohol is also one of the most dangerous drugs to recover from. Aetna recognizes this, and their primary goal is to make sure their members can quit drinking safely.

What are Aetna’s Addiction Treatment Benefits Like?

It is difficult to answer this question with certainty only because every insurance plan is different. When you decided to opt in to Aetna, you were given several choices for the type of insurance you wanted. You may pay a higher monthly premium in exchange for having many services completely covered. Or, you may pay a lower monthly premium in exchange for copays or co-insurance amounts when you receive a service.

Either way, Aetna does work very hard to keep all out of pocket costs down as low as possible for their members. They do not want to see you spend a lot of money for the services you need when you have to go to rehab. You can rest assured that they have your best interests at heart.

It is important to get more information about your policy so you know how much you need to pay for treatment. We will talk in more detail about the best way to do that in just a moment.

What Forms of Treatment Will They Cover?

As you may be aware, there are different levels of treatment offered to people who need help with addiction recovery. As you consider what type of assistance you need, you may be curious about how much your insurance will cover for each one.

The reality is that the cost of treatment is very important. You need to know how much you will need to pay out of pocket before agreeing to rehab.

Inpatient Rehab

When you think of rehab, you probably think about inpatient treatment first. If this is something you need, your health insurance company will cover it, at least in part.

An inpatient program will require you to stay at a facility for a period of around 28 days. Some may run longer, and some may run shorter. This type of treatment is intensive, which means that it generally costs more. You will stay at the facility while you receive care. You will work with a therapist and in different group settings. On top of that, your housing and meals will also be an added expense.

Because of this, health insurance companies usually pay less for inpatient programs. This leaves the patient with a higher portion of the cost to pay on their own. But there is always the chance that your Aetna plan will cover it in full as well. Again, it all depends on the type of policy you have.

Intensive Outpatient Treatment Programs

Intensive outpatient programs (IOPs) have become much more common in the United States, and for good reason. These programs provide clients with a lot of care, but with a shorter time commitment. They usually run for about 12 weeks, depending on the patient’s needs, and the individual attends three to five times per week. While some IOPs are held during the day, the majority of them are held in the evenings. This makes getting treatment more convenient for people who work, or have other daytime commitments.

Unlike inpatient programs, an IOP does not have food or housing costs attached to it. This cuts down on the costs drastically. For this reason, insurance companies like Aetna generally tend to pay a little bit more toward treatment. As a result, the client will pay less out of pocket.

IOPs are very beneficial to the client in many ways, and cutting down on costs is just one of them. Research has shown that they are just as effective as inpatient care too. That is another reason why so many people choose them.

Day Treatment Centers

Day treatment is very similar to IOP, except that it takes place during the daytime instead of in the evenings. These programs are tailored to the needs of the client, which means they can take any length of time that is deemed necessary. Some people may need to be there for only two hours, but others may need eight or even more.

The cost for day treatment programs is variable, depending on the duration of it. If the client will be in need of a meal, it can be more expensive. Insurance companies like Aetna may not pay as much for them for this reason. This leaves more of the cost to the client to cover.

Even so, clients are still able to live at home while they go to day treatment. This does cut down on the overall cost of rehab for them. Therefore, the insurance payout for this type of program should be higher than it is for an inpatient rehab.

Outpatient Rehab (Continuing Care)

Although getting into rehab is important, continuing your care on an outpatient basis is also a critical part of recovery. This goes back to the fact that addiction (or alcoholism) is a disease. Just like other diseases, it needs continual care. When people receive the treatment they need, their odds of recovery increase immensely.

An outpatient rehab is much less restrictive than an inpatient program, or even an IOP. By the time an individual reaches the place where they are ready for it, they do not need as much care. They will typically only come to appointments once a week at first, and then they will see their therapist less frequently as they improve. The therapist may also recommend for them to attend Narcotics Anonymous or Alcoholics Anonymous as well.

Many health insurance companies like Aetna cover outpatient rehab in full. This is to encourage people to continue to get the treatment they need.

What is the Affordable Care Act and How Does it Protect You?

The Patient Protection and Affordable Care Act was signed into law by President Obama on March 23, 2010. It is sometimes referred to as the ACA or simply Obamacare. This law represents the most significant regulatory overhaul for healthcare in the United States since Medicaid and Medicare were passed in 1965.

Most people think of the Affordable Care Act as being the law that required them to get health insurance. Citizens of the U.S. who did not get insured prior to a certain date were penalized through their taxes. Unfortunately, this fact has enabled people to paint the ACA in a negative light. It really is so much more than that.

One of the biggest benefits of the Affordable Care Act is the fact that it also requires health insurance companies to offer addiction treatment benefits. Many people do not realize that they now have this type of coverage because they never had it prior to 2010. In the United States, if you have health insurance, you also have coverage for drug or alcohol rehab.

There are other advantages to the ACA as well. Insurance companies can no longer deny coverage to people for pre-existing conditions. The law also provides subsidies to individuals, which makes health care much more affordable. There is also a major emphasis on preventative care, which is so important for people with addictions.

What Other Forms of Treatment Will Aetna Cover?

When you are in need of addiction treatment, there is so much involved with that. It is not as simple as going to a facility to talk with a therapist. Many other forms of treatment are often required. We have listed some of them below to give you an example of what type of benefits Aetna offers.

Drug Detoxification Programs

Sometimes when a drug addict stop using, they need to go through a period of drug detoxification. This is the very first step in the recovery process. There are some types of drugs that require detox, and they include:

Any of these drugs can cause severe withdrawal symptoms. In some cases, the complications that can arise from withdrawals can even become life threatening.

Most people need to go through an inpatient drug detox program prior to starting rehab if they use any of these drugs. This usually involves a medicated detox as well as holistic withdrawal treatments. The combination of these two methods has proven to be very effective at helping people get past this initial stage.

At Aetna, they know that detoxing is a very important part of recovery. That is why their coverage extends to this service as well.

Alcohol Detox Programs

Alcohol detox is also necessary for anyone who has been diagnosed an alcoholic. Contrary to popular belief, alcohol is a drug, and it is a very dangerous one at that. Stopping its use abruptly can result in serious complications from withdrawal.

About 5% of people who go through alcohol withdrawal will experience a condition called delirium tremens. This is a potentially fatal condition if treatment is not received right away. Detoxing can decrease a person’s chance of DTs significantly.

Aetna will also provide benefits to people to help cover the cost of alcohol detox. It is considered an essential part of the recovery process.

Treatment for Co-Occurring Disorders

For many people, mental health conditions often accompany their addictions. When someone has some type of mental illness, and they are addicted to drugs or alcohol, they have a co-occurring disorder. It is absolutely essential for the treatment program to offer help for that condition as well.

Not every drug or alcohol rehab will provide treatment for co-occurring disorders; although today, more of them do than ever before. The reality is that when they are not treated at the same time, the individual is very likely to relapse.

Aetna understands the need for dual diagnosis treatment for co-occurring disorders. That is why they offer benefits for this type of care to everyone who needs it.

Other Questions People Ask About Aetna’s Coverage for Rehab

There are additional questions that people often ask about Aetna’s coverage for drug and alcohol treatment. We have included some of them below.

Will Aetna Pay for Suboxone or Other ORTs?

Aetna has stated that they are striving to be a part of the solution for our country’s opioid epidemic. They are committed to helping their members get treatment for opioid use disorder. That includes providing them with:

  • Coverage for opioid detox
  • Substance use assessments
  • Appropriate tools
  • Strategies to fight this problem
  • Strategies to reduce harm

Opioid replacement therapy has become a major part of treating this type of addiction. That is why they do offer coverage for medications like Suboxone, Buprenorphine and Methadone.

In addition, a new medication called Vivitrol has also been able to help many people recover from opioid addiction. Aetna will also provide their members with benefits to help cover the cost of this drug.

How Long Will They Pay for Addiction Treatment?

The length of time that a person may need to be in rehab differs from person to person. Some people do well with treatment for only a few months. Others may need a few years before they are ready to stop.

Aetna understands that everyone is different, and people recover at different rates. They are committed to work closely with doctors and other addiction treatment professionals. That will allow them to provide benefits to people for the type of treatment they need, for as long as they need it.

Does Aetna Have Any Other Benefits That Can Help You?

One of the reasons people often put off going to rehab is that they are afraid they will lose their jobs. If you are an Aetna member, you have nothing to fear, thanks to their Employee Assistance Program coverage. Their EAP will ensure that you will not lose your job just because you need to get treatment for an addiction. This comes as such a relief to those with this concern.

You will find that Aetna is very flexible and member-friendly. They offer both Android and iPhone apps that will help you stay on track of all of your bills and claims. You can even pay bills through the app, and get information on your coverage.

One of the best parts of having Aetna as your insurance provider is the support you will receive. They will encourage you to attend 12-Step meetings and get additional types of support as well.

What is the Best Way to Get Started With Drug Rehab as an Aetna Member?

If you think you may need to go to rehab, there are a few steps that you should take. First, you might want to take an addiction quiz. This will help you understand what type of treatment might be best for you.

Once you do that, you should take the following steps next.

Fill Out an Insurance Verification Form

Many drug and alcohol rehabs allow you to fill out an insurance verification form on their websites. You’ll need your Aetna member information to ensure that it is done correctly. Once that is done, you can submit it, and it will be processed. This is the best way to get information about your benefits and coverage.

Talk With a Professional About Your Treatment

You can also talk with a professional about your plans to enter rehab. They will ask you questions about your addiction and help you decide what type of treatment you need. After you know that, you can move forward with them to verify your benefits. This free addiction assessment gives a lot of people peace of mind so they know they are making the right decision.

What to Look for in Drug or Alcohol Rehab

If you have never gone to rehab before, you may wonder what types of characteristics you should be looking for. There are several that can indicate that you have chosen the best rehab. They include:

  • Being an accredited facility through The Joint Commission.
  • Providing either detox services or a referral for detox.
  • Offering a program with proven, therapeutic methods.
  • Believing that aftercare is an important part of the recovery process, and ensuring that clients receive the appropriate referrals.
  • Providing clients with relapse prevention plans.

Taking the Next Step to Get Help With Your Addiction as an Aetna Member

At AspenRidge Recovery, we want you to know that your recovery is important to us. We would like to be of assistance to you as you seek to get help for your addiction. Please contact us and let us know how we can help.