Addiction to drugs and alcohol can be a major obstacle to overcome, therefore, individuals need the right resources, support, and care to be able to fully recover from this deadly disease, to maintain a healthy and sober lifestyle. 

Unfortunately, millions of people throughout the United States are deterred from receiving the appropriate treatment for their substance use disorders (SUD), for various reasons including not being able to find the help that fits their needs, denial, and one of the most common ones, having financial burden. 

As medical services, especially for addiction and mental health, tend to be expensive, people don’t believe that they can afford treatment or have alternative options, and therefore, forego help altogether, which is extremely detrimental to one’s overall wellbeing.

At Ken Seeley Rehab, we understand that addiction treatment is expensive, but also that it is an investment that is imperative for a chance to have any chance of recovery and having a quality life. That is why we pride ourselves in providing payment options for those who need it most. Our rehab facility located in Palm Springs, CA, accepts most insurance plans, including Aetna. 

About Aetna Insurance 

Established in 1850, Aetna has been a provider of insurance to over 40 million residents throughout the United States. This includes coverage and benefits for dental, vision, preventative healthcare,  emergency medical services, and most importantly, addiction treatment and recovery. 

The goal of Aetna health insurance has always been to help individuals and their loved ones find the appropriate financial means to afford treatment for substance abuse. Aetna prides itself on making healthcare more accessible, which is why they work with 1.2 million health care professionals, including addiction specialists, primary care doctors, and over 5,700 hospitals. 

With the help of insurance coverage and its range of benefits, individuals will bridge the gap between the need for treatment and receiving it. As a result, as one the first commercial insurance companies to have peer support coverage for their members, Aetna provides its clients with tools to help them make better and informed decisions about their health and financial situations, so they can move forward with their recovery and lead healthy and productive lives.  

Can Aetna Insurance Cover Treatment for My Drug and Alcohol Dependence?

Before it was made a mandatory law that commercial insurance companies have to cover all or partial treatment costs for mental illness and addiction treatment, these types of treatment services were inaccessible for millions of Americans. 

However, that all changed when Congress passed and enacted the Affordable Care Act (ACA) in March 2010, marking the start of beneficial and significant changes made to federal programs and tax policies regarding health care. 

Today, by law, addiction treatment has to be covered under insurance. Thanks to the ACA, people can now worry less about the financial burden, as costs have lowered, making coverage more affordable and accessible to uninsured American families. Most importantly, no one can be denied coverage for any pre-existing conditions such as mental illness (depression, anxiety).

What Types of Addiction Treatment Does Aetna Insurance Cover? 

Getting addiction treatment is much easier thanks to the establishment of healthcare policies and mandates. Aetna Insurance will cover at least a portion of your addiction treatment costs, minimizing your financial stress and obligations. 

 

There are two different types of clinics Aetna focuses on, in-network clinics and out-of-network clinics. Addiction treatment services are at in-network rehab facilities that are provided usually at lower costs than out-of-network. It is recommended to check with your provider to see what your particular plan will cover. 

In-Network 

In-network means the healthcare providers in your area, accept the insurance you have. The cost of the services provided by medical professionals will be approved by Aetna, which in return saves you money. On your insurance claim and explanation of benefits statement, you’ll see these savings listed as a discount. In-network clinics are more affordable and carefully pre-screened by Aetna to ensure they are of quality. 

Out-of-Network

Rehab facilities who provide addiction treatment services with specialists out-of-network means, that they don’t accept your insurance plan. This means the medical provider or clinic does not accept Aetna’s pre-approved amount for their services. You may be told that there is a co-pay, which means you will have to pay money out-of-pocket if you choose to do so for the services provided.  

Aetna provides coverage for a variety of services used to treat people with substance abuse. These include the following: 

Detox

Detoxification also known as medically-assisted detox (MAT), in a professional and safe environment, the body is rid of toxins from the use of drugs and/or alcohol before official treatment and recovery can begin within the rehab facility. As it is very dangerous due to the onset of unpleasant withdrawal symptoms, self-detoxing on your own at home is not advised. 

Inpatient Treatment 

Inpatient treatment also known as residential treatment is covered under Aetna’s insurance policies for a certain number of days based on what plan you have. Patients live in the rehab facility while receiving around-the-clock treatment and monitoring. The length of stay depends on a variety of factors and varies from person-to-person. 

Partial Hospitalization Program (PHP)

After residential treatment, a person usually transitions into outpatient treatment or a partial hospitalization program (PHP). It is less restrictive than an inpatient program, but still holds patients accountable to help them learn and manage how to have a routine in place and maintain a healthy schedule. Aetna’s plans all provide a certain number of days that people have to remain in the program. 

Intensive Outpatient Program (IOP)

Intensive outpatient programs have patients attend significant hours of treatment and addiction therapy, but instead of staying at the facility, they can go home and maintain independence while attending work or school. This is usually an alternative for PHP. IOP plans through Aetna depend on the cost of treatment. 

Aftercare

An aftercare program helps people continue on a successful path of recovery. Relapse prevention techniques along with coping and life skill are taught to help avoid relapsing and how to maintain sobriety after treatment. Many rehabilitation facilities offer aftercare programs through Aetna.      

Peer Support

Being addicted to substances hinders many aspects of one’s life, including goal-setting.  Therefore, during or after treatment, everyone needs continued encouragement or help to avoid relapse and maintain sobriety. This is called peer support. As mentioned before, Aetna is one of the first major commercial insurance companies to offer this important service. 

Peer support is an evidence-based service provided in the behavioral health field to help people use the tools and skills that they were taught to help achieve the short-term and long-term goals that they set during their treatment programs.

Dual Diagnosis Treatment 

Addiction and mental illness often occur simultaneously. This is called dual diagnosis or co-occurring disorders. People with pre-existing mental illness tend to use drugs and alcohol as a means to cope with their symptoms and problems. The most common mental disorders covered under Aetna insurance plans include: 

 

• Depression
• Post-Traumatic Stress Disorder (PTSD)
• Obsessive-Compulsive Disorder (OCD)
• Bipolar Disorder
• Anxiety
• Schizophrenia

Vice Versa, individuals who use substances and are dependent on them, tend to have underlying mental issues. Without treatment, both conditions are made worse, and further complications and even death can occur. 

What motivated someone to engage in addictive behavior such as binge drinking, often leads to the development of the mental illnesses mentioned above, if they already do not pre-exist. For example, if you treat someone for alcoholism who has depression or anxiety, and the mental disorder is left untreated, relapse is inevitable. 

Dual diagnosis treatment helps detect any underlying mental illness, as well as, treating both conditions at the same time to ensure all needs are met. Aetna insurance plans cover all or partial costs for the treatment of mental illness and addiction. 

Frequently Asked Questions (FAQs): Aetna Insurance

Sometimes understanding all the ins and outs regarding insurance can be extremely difficult and frustrating. As receiving addiction treatment is a necessity, our insurance verification specialists and health care professionals at Ken Seeley Rehab will help you through the process, ensuring you get the best care possible. 

Here are some frequently asked questions that you may want to ask your Aetna insurance provider for further clarity on how to pay for rehab. 

• Is my psychological evaluation during the intake process fully covered? 

• How many days of detox treatment does Aetna provide?
• Is the rehab program I have with Aetna in-network or out-of-network?
• Will both outpatient and inpatient drug rehab programs be covered by Aetna?
• Will my insurance cover all of my programs and the whole length of my stay?

Verify Your Insurance Coverage And Get The Help You Need

Addiction treatment and recovery is a huge investment, but a life-changing one for those with drug and alcohol addictions. In the long run, nothing is more important than your health, quality of life, and maintaining relationships and support with loved ones.   

Paying for addiction treatment is stressful and can feel overwhelming. However, know you are not alone! At Ken Seeley Rehab, we are here to help. 

Our experienced team will help determine your insurance benefits. Our admissions and insurance verification specialists partner with a variety of providers to help you finance your recovery from addiction. 

Aetna healthcare insurance clients may find that their insurance plan is designed to help cover some of the costs associated, that they have once thought to be cost-prohibitive. 

Contact us here or call Ken Seeley Rehab in Palm Springs, CA today, and a member of our admissions team will be happy to assist you in answering any questions, and discuss all available payment options and verify your insurance plan and benefits that they cover. 

References

https://www.naatp.org/resources/clinical/affordable-care-act

https://www.addicted.org/aetna-drug-rehab-centers.html