Aetna Rehab Coverage Information

insurance aetna

Aetna Insurance Coverage with Surfside Recovery in Huntington Beach, CA

Aetna was founded in 1850 and has become the third-largest health insurance provider. The national insurer was acquired by CVS in 2018, expanding treatment options within the drugstore for those insured through Aetna. Aetna rehab coverage helps reduce the cost of addiction treatment in various settings.

Aetna Substance Abuse Treatment Options

Aetna is one of many national insurance providers to cover addiction rehab specifically. Aetna’s substance abuse treatment is included in its HMO and PPO plans. You can expect to see the following types of addiction treatment covered to some extent: 

  • Detox
  • Inpatient/Residential Rehab
  • Outpatient Rehab
  • Prescription Medications
  • Behavioral Therapy

Aetna Substance Abuse Guidelines

Aetna’s substance abuse guidelines follow the American Society of Addiction Medicine’s criteria for diagnosing alcohol and substance use disorders. While this is not an exhaustive list, you can expect your initial discussions with an addiction specialist to include the following questions, which help them determine what type of care your insurance may qualify you for:
  • How long have you been using the substance?
  • When was the last time you drank or used drugs?
  • Have you sought treatment previously?
  • Are you looking for long-term sobriety/recovery?

Addictions Covered Under Aetna Insurance Policies

With the passing of the Affordable Care Act, all insurance providers were mandated to cover behavioral and substance abuse treatments. While each patient’s policy is unique, you can expect to see the most common addictions covered under your Aetna policy:
  • Alcohol Abuse 
  • Prescription Medication Abuse 
  • Cocaine Addiction
  • Methamphetamine Addiction
  • Opiate Addiction
  • And more

Does Aetna Cover Mental Health Services?

The medical community has come a long way in recognizing addiction and mental illness. Both needing treatment to encourage long-term sobriety. Aetna may cover many popular treatments such as Cognitive Behavioral Therapy, Eye Movement Desensitization, and Reprocessing.

Aetna Medication-Assisted Treatment

While medication-assisted treatment (MAT) is not necessary for all clients, many, especially those struggling with opioid addiction, can find lasting recovery with a combination of prescription medications and behavioral therapy. Your specific plan will determine the exact medications Aetna covers. So long as you know your plan name and year, you can search for the particular medication coverage on their site.

Aetna Coverage: Paying for Rehab

While substance abuse treatment is deemed an essential service under the Affordable Care Act, the level of coverage offered by insurance companies will differ. Typically, you can elect for a higher coverage plan at an increased monthly cost or select a lower coverage plan at a reduced monthly cost.

What Length of Treatment Does Aetna Cover?

The length of treatment covered depends on the client’s personalized recovery plan and the setting in which they are receiving treatment. Approved Aetna residential treatment centers typically cover between 1-6 weeks of treatment, while approved Aetna outpatient treatment centers generally are covered for 4-12 weeks.

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