Aetna Insurance Coverage

Aetna Insurance Coverage

Founded in 1850, Aetna Insurance coverage is now the third-largest health insurance provider in the U.S. by membership. Acquired by CVS in 2018, Aetna has since expanded treatment options, making care more accessible within CVS drugstores for those insured through Aetna. Aetna’s rehab coverage can help significantly reduce the costs of addiction treatment across various settings.

Questions Answered: About Aetna Insurance Coverage

Aetna Substance Abuse Treatment Options

Aetna is among several major insurance providers that cover addiction rehabilitation. Aetna’s substance abuse treatment coverage is available with both HMO and PPO plans. Depending on your policy, the following types of addiction treatments may be covered:

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

Aetna Substance Abuse Guidelines

Aetna’s guidelines for substance abuse treatment align with the American Society of Addiction Medicine (ASAM) criteria. During your initial consultation, an addiction specialist may ask:

  • How long have you been using the substance?
  • When was the last time you used drugs or alcohol?
  • Have you sought treatment previously?
  • Are you aiming for long-term recovery?

 

These questions help determine the appropriate type and level of care covered by your insurance.

Addictions Covered Under Aetna Insurance Policies

Under the Affordable Care Act (ACA), insurance providers, including Aetna, are required to cover behavioral health and substance abuse treatments. While coverage varies by policy, common addictions typically covered include:

  • Alcohol Abuse
  • Prescription Medication Abuse
  • Cocaine Addiction
  • Methamphetamine Addiction

Does Aetna cover mental health services?

Yes. The medical community now recognizes the link between addiction and mental health conditions, which often require concurrent treatment for long-term recovery. Aetna may cover treatments like Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Biofeedback, depending on your specific plan.

Aetna Coverage: Paying for Rehab

Substance abuse treatment is an essential health benefit under the ACA, though the level of coverage may vary by insurance plan. Higher-coverage plans generally come with a higher monthly premium, while lower-coverage plans may reduce monthly costs but offer less extensive coverage.

What states are covered by Aetna?

Aetna operates nationwide, offering coverage in all 50 states. However, specific plan availability and covered services can vary by state. It’s essential to review your state’s specific offerings to understand your coverage fully.

What length of treatment does Aetna cover?

The duration of treatment covered by Aetna depends on the individual’s recovery plan and treatment setting. Approved residential treatment centers typically cover 1-6 weeks, while approved outpatient centers may provide coverage for 4-12 weeks, based on medical necessity and policy details.

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