While most insurance providers set limitations on substance abuse treatments, a small number of insurers base their policies on one’s individual needs. Aetna is one of those companies as it recognizes that different individuals have different treatment needs.
What makes Aetna unique?
Aetna’s Continuing Care programs are committed to helping patients follow up on their treatments with weekly meet-ups and social events that offer support for those who completed their treatments. Programs such as these keep individuals in touch with their community, who helps them with their recovery to continual support.
Aetna policy coverage
Aetna policy holders may be covered for detoxification, inpatient rehabilitation, residential rehabilitation, partial hospital treatment, intensive outpatient treatment, and continuing care programs.
To determine the specifics of your individual plan, it is a good idea to check with a representative of your insurance provider.
Do treatment centers need to be in-network?
Yes, but they likely will cost you more. Not all Aetna programs require service networks to be in-network, but keep in mind that these treatments have not been screened for consistency with current practice standards.
What is pre-certification?
Pre-certification refers to a review process performed to find out if a requested service or program meets Aetna’s criteria for coverage. Some substance abuse treatment programs require pre-certification before you are allowed to begin.
Cases where pre-certification is required for inpatient admissions, outpatient detoxifications, residential treatment center admissions, intensive outpatient programs, partial hospitalization programs, and Aetna coverage for inpatient treatment.
Depending on your location and Aetna policy coverage, the costs associated with inpatient rehab programs may vary.
What is the cost of inpatient rehab services?
Some Aetna plans have 0% coinsurance, or insurance that kicks in once you pay your full deductible, for inpatient services within its network. Other plans, however, may require a copay arrangement per admission for different services.
Coverage for out-of-network providers will vary on location and the type of plan. While some plans may not cover treatments outside the network, some offer 30-50% coinsurance. Keep in mind though that out-of-network programs often require pre-certification.
What is Aetna’s coverage for outpatient treatment?
Aetna’s coverage for outpatient rehab varies from person to person. A number of Aetna policies may not have an option for outpatient services or involve a fixed range for coinsurance, while others have copay arrangements. Coinsurance and copay arrangements will depend on location and type of insurance coverage.
I have more questions about Aetna. Whom can I talk to?
We at Resurgence know that addictions can be effectively treated, as we help families to recover every single day in our facility. We offer inpatient and outpatient care for addiction and our aftercare approach ensures that you have the tools you need to maintain sobriety when formal treatment is through.
If you need help with your treatment, call us at 888-700-5053 so we can check with your Aetna policy and determine the right treatment for you.