Aetna Coverage
for Alcohol & Drug Rehab Addiction Treatment

Now that you’re considering treatment for a substance use disorder, whether it’s for you or your loved one, you may be concerned about how you’ll pay for it. The costs of drug rehab treatment can add up. Especially if you need to go to a residential facility where you live there 24/7 for the duration of the program, which may be as long as 90 days depending on your medical need. Fortunately, if you have healthcare coverage through Aetna, insurance may cover some or all of your expenses for alcohol rehab or drug rehab treatment near you.

What Is Aetna Insurance & How Does It Work for Drug Rehab?

Aetna provides a variety of healthcare services through different types of plans. In general, you’ll need to pay 100% of your costs up to your annual deductible. (Typically, the more you pay for your plan per month, the lower your deductible.) 

Once you’ve satisfied the deductible, you’ll pay a portion of the remainder of your costs. This could be through a copay, which is a specific dollar amount, or through coinsurance, where you pay a certain percentage of the cost. Each year, you have a maximum out-of-pocket limit, and if you reach this limit from copays, coinsurance, and deductible payments, Aetna covers the rest. It depends on the plan you choose as to how much you’ll pay for different services.

It also depends on whether you use a provider (doctor or facility) that’s in the Aetna network or not. If it’s in-network, the costs will generally be significantly lower than if you use one that’s out-of-network. Whether the provider is in or out of the network depends on your plan as well.

What are Aetna’s Types of Plans?

Aetna offers a variety of plans for individuals through the Affordable Care Act marketplace, plans through your employer, and Medicare as well. You may choose an HMO (health maintenance organization), PPO (preferred provider organization), or POS (point of service) plan.

Drug Rehab Facilities That May Accept Aetna Insurance 

If you live in Orange County, California, Resurgence Behavioral Health is an in-network facility with Aetna. That means you won’t pay the additional costs as you would with an out-of-network drug rehab insurance. To see if Resurgence is the right solution for you, either go to the website for Resurgence or give them a call at (855) 458-0050. There are other drug rehab centers near Orange County available that may take Aetna as well as an in-network provider.

Does Aetna Insurance Cover Drug Rehab Treatment?

Depending on your plan, your Aetna drug rehab insurance may cover some or all of the costs of alcohol rehab and/or drug rehab. If you have an HMO or PPO with them, substance use disorder treatment is paid for through your Aetna plan. The Affordable Care Act mandates that certain insurers cover addiction treatment, and Aetna is one of them.

What Does Aetna Insurance Cover?

Aetna covers a wide variety of health issues as well as preventative care and mental health and behavioral health issues. Depending on the type of plan you have, you may have access to coverage for the full continuum of care from detox to inpatient or residential treatment to outpatient care.

Does Aetna Insurance Cover Mental Health & Substance Abuse Treatment?

As part of its mission to promote health and wellness, Aetna pays for both mental health and substance abuse care. Your emotional and mental well-being is just as important when it comes to overall wellness as physical health is. Even though in the past the idea of mental illness including substance abuse was somewhat taboo, modern society recognizes the importance of treating the whole person, which includes the mind.

Does Aetna Insurance Cover Inpatient Drug Rehab?

Not everyone who needs treatment to get clean and sober needs to go to a residential facility. Inpatient drug rehab is a highly structured program where you live at a residential facility while you’re in treatment. Typically you will be in therapy in the mornings and afternoons. You’ll eat meals with the rest of the residents at specific times of the day. After dinner, you usually have the time to play games or engage in hobbies and fun activities. If inpatient drug rehab is considered medically necessary for you, Aetna will pay for at least some of it.

Does Aetna Insurance Cover Intensive Outpatient Drug Rehab?

Outpatient care still gives you access to therapy and life management classes. But when you’re in an intensive outpatient program (IOP), you’ll go home or to sober living at night instead of living at drug rehab. This type of outpatient treatment can be done while you’re at work or school since you usually attend for nine to ten hours a week on evenings and weekends. If it’s deemed medically necessary for you, then insurance will cover some portion of it depending on your plan.

Does Aetna Insurance Cover Partial Hospitalization?

Partial hospitalization programs (PHP) are also outpatient care, but they’re more intensive than IOPs. These generally run for 25-30 hours a week, so you may not be able to attend work or school while you’re in a PHP. You can expect to spend most of the days during the week at drug rehab in therapy and taking life skills classes. Aetna covers at least some part of it if it’s medically necessary for you.

How Long Will Aetna Insurance Cover Alcohol & Drug Rehab?

Treatment programs vary in length and depend on whether you need to attend all levels of care from inpatient to outpatient. Some people with substance use issues are able to start with outpatient treatment. Whatever the clinicians assess as being medically necessary, you’ll be covered for that length of time. An inpatient drug rehab program could run for one, two, or three months. Outpatient drug rehab insurance depends on the treatment, and sometimes you may need to spend months in this kind of care.

Aetna Insurance May Offer Treatment Coverage for the Following Addictions: 

In the modern world, many people get hooked on drugs that have been prescribed for them for some other issue. Yet the popular image of someone with a drug or alcohol addiction is a man sleeping in an alley, despite what happens in reality. Not all addictive drugs are illegal, and it’s easy to develop an addiction to the powerful medicines that get synthesized in a lab. That makes it critical for your provider to be able to help you with a variety of substances whether they’re illicit or not.

• Stimulants
  • Adderall, Dexedrine, Ritalin, and similar drugs
• Opioids
  • Oxycodone
  • Morphine
  • Hydrocodone (brand name Vicodin or Lortab/Lorcet)
  • Lomotil
  • Demerol
  • Codeine
  • Fentanyl
  • Dilaudid
  • Darvon
  • Methadone
• Depressants
  • Benzodiazepines (“benzos”) such as Valium, Xanax, Halcyon
  • Sleep aids like Lunesta, Ambien, and Sonata
  • Barbiturates such as Nembutal, Mebaral, Luminal Sodium
• Alcohol

What are the Options if Aetna Insurance Does Not Cover the Cost of Drug Rehab?

Depending on the Aetna plan you’ve chosen and whether the drug rehab is in or out of network, you may not have the whole cost of alcohol rehab or drug rehab covered by your drug rehab insurance. Fortunately, in that case, you do have several options. It’s critical to get help if you have a substance use disorder, so don’t let financial issues get in the way.

• Payment plans

Many recovery centers offer payment plans. That way, instead of having to pay the whole amount upfront, you can pay a reasonable amount over time.

• Loans

There are a number of other loan providers that can help you in addition to banks and similar financial institutions. Some (such as CareCredit) lend money to people who need it for healthcare purposes. You might try crowdfunding and peer-to-peer lending sites too.

• Scholarships or grants

Depending on where you live and some other factors, you could qualify for a scholarship or grant to get sober and change your life. These are good options because you normally don’t have to pay them back once you transition out of treatment.

Verify Your Insurance for Drug Rehab with Us 

We’ve made it easy for you to check your drug rehab insurance coverage with Resurgence Behavioral Health if you’re considering us to help you recover from your substance use disorder. The form on our website is quick and simple for you to fill out. Or give us a call at (855) 458-0050. We’re dedicated to recovery so we’ll do our best to work with you to make sure you can afford to attend drug rehab with us.

Next Steps with Insurance Coverage for Alcohol & Drug Rehab Treatment with Resurgence Behavioral Health 

Ready to go to alcohol or drug rehab? Verified your insurance? Now it’s time to prep for your admission to Resurgence so you can feel comfortable about your recovery path. 

Here are a few tips to help you prepare for the first step on your journey to sobriety.

• Let your friends and family know where you’re going
• Tie up any loose ends in terms of financial or legal obligations, as well as anything at work or school
• Pack according to what you’ll need – no need to overpack
• Consider writing a letter or shooting a video to your future sober self
• Know that you can do it and the life you want and deserve is waiting for you to heal and recover

Our caring staff is on your side to help you recover mentally and emotionally as well as physically. You don’t have to spend the rest of your life being controlled by drugs and alcohol.