Aetna Insurance Coverage for Drug & Alcohol Rehab

Aetna is a subsidiary of CVS Health Corporation with an estimated 22.1 million medical members and 1.2 million health care professionals in their network.¹ If you have Aetna, you may be able to use it to cover rehab. This article will help you understand Aetna’s benefits and how to use them to pay for addiction treatment.

Does Aetna Cover Substance Abuse Treatment?

Yes, Aetna does cover addiction treatment, and the Affordable Care Act and Mental Health Parity and Addiction Equity Act ensure plans provide coverage for mental health and substance use at equivalent levels that they do for primary health services.²

However, the level of insurance coverage depends the specific plan. Generally, plans with higher monthly premiums have lower out-of-pocket costs for treatment.

To keep costs low, it’s crucial to find a rehab facility within the Aetna network, as facilities outside the network may not be covered or the benefits may be drastically reduced.

Use the to find out if your insurance plan covers treatment at AdCare facilities.

Types of Addiction Treatment Aetna Covers

Your Aetna plan may cover the following forms of treatment provided at AdCare, which include:

• Medical detox.
• Inpatient rehab.
• Outpatient addiction treatment.

Aetna provides health care coverage for members in 16 states across the country, including all New England states except New Hampshire.³

How Do I Use Aetna Insurance to Pay for Rehab?

The first step in getting Aetna insurance to cover rehab is to find a treatment facility that is within the Aetna network. For AdCare, you can confirm your treatment is covered in a matter of minutes by using the . This will require your:

• Name.
• Phone number.
• Email address.
• Insurance carrier (Aetna).
• Insurance policy number.

You can obtain more detailed information about your coverage as it applies to AdCare, and also learn about your options for treatment and the admissions process by calling an admissions navigator at .

Cost of Rehab with Aetna

There are many different variables that factor into the out-of-pocket costs when you use Aetna insurance for rehab. This includes:

• The specific treatment facility and its costs.
• The level of care (i.e., inpatient treatment is usually more expensive than outpatient care, and coverage will likely apply differently in either instance).⁴
• The specific Aetna insurance policy. Each plan is different and may cover the addiction treatment in different levels and in varying ways. For example, certain plans may charge a co-payment amount for each visit to an outpatient clinic, while others may charge a flat co-insurance rate for the total cost of outpatient care.

It can be helpful to look at the Summary of Benefits and Coverage for your specific plan. Understanding the following terms should give you a better idea of your treatment costs:

• Co-payment. This is an out-of-pocket fee paid in certain instances (e.g., to fill a prescription, at a doctor visit, etc.). ⁵
• Deductible. This is the yearly amount you must pay before insurance begins covering costs (does not include monthly premiums). ⁶
• Co-insurance rate. This is the percentage of the cost of a covered service you’ll pay after you’ve met the deductible until you reach the out-of-pocket maximum.⁷
• Out-of-pocket maximum. This is the total amount you can be charged for health services within a year (excepting monthly premiums). Once you’ve paid this amount, your Aetna insurance will cover 100% of the remaining healthcare costs.⁸

Why Use Aetna To Pay for Substance Abuse Treatment?

If you have Aetna health insurance, using it to cover addiction treatment will make the cost of treatment much more affordable. The Aetna network includes top-notch rehab facilities such as AdCare Treatment Center, which can not only help you detox from substances safely, but help you build the skills needed to achieve long-term recovery.

AdCare has both inpatient and outpatient care options in Massachusetts and Rhode Island and provides such services as:

• Treatment for co-occurring disorders, which affect approximately half of people that suffer from substance use disorder (SUD).⁹
• A program for veterans and first responders.
• Treatment specialized for trauma survivors.
• Medication-assisted treatment (MAT) for those that need it.
• Evidence-based and alternative therapy methods.
• 12-step and secular recovery programs.
• Aftercare facilitation.

Despite recent improvements in the percentage of insured Americans and in the way they can use their health insurance to pay for mental health services, cost remains a significant barrier to addiction treatment for many people.¹⁰ In these situations, it may be helpful to review other payment options to help handle the cost of rehab, such as loans or flexible payment plans.

If you or a loved one is struggling with addiction, it’s not too late to get help. Please reach out to an admissions navigator at to learn more and discuss treatment and payment options at AdCare or verify your benefits online in our easy and confidential form below.