Aetna Health Insurance for Substance Abuse Treatment
Discover how Aetna covers addiction treatment, mental health, and more. Learn about plan options, verify coverage, and find support for your health journey.
Aetna Health Insurance for Substance Abuse Treatment
Discover how Aetna covers addiction treatment, mental health, and more. Learn about plan options, verify coverage, and find support for your health journey.
Aetna was formed in the 1800s with a name inspired by an 11,000 foot volcano in Sicily, Italy. In the 1960s, they were the first to write individual life insurance policies to protect American astronauts in the early days of the space program and paid the first Medicare claim in the country.
Today, Aetna is a leader in addressing health disparities; they recently hired their first woman president in the company’s history.
Aetna provides a variety of health-related insurance plans and is today one of the oldest and largest health insurers in the U.S.
In 2018, Aetna was acquired by CVS Health in a move that merged health insurance offerings with an extensive network of pharmacies and services. The company is known for a broad network of providers and a focus on giving members resources to maintain and improve their health.
Does Aetna Cover Drug and Alcohol Addiction Treatment?
Yes, most Aetna policies offer coverage for drug and alcohol rehab and are regulated by two federal laws: the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act.
However, there are exceptions to these laws, which is why you must verify your insurance coverage before beginning treatment. Benefits may be limited or require prior authorization and documentation.
Coverage typically includes a range of treatment options depending on your policy and medical needs. These services can include medical detox to manage withdrawal symptoms, residential or inpatient treatment, outpatient programs, medication assisted treatment, or aftercare and support services. Not all policies cover all types of these services.
This is an ad and Avenues Recovery Center at Lake Ariel is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
This place has changed my life. I have never been to a rehab like this. From the counselors to the staff, everyone has been welcoming and so helpful. I have learned a lot and will put it to good use on the outside. So happy i came here and highly recommend it to anyone seriously looking for recovery from this hell that wants to overtake our lives.
Monika Egan
2 weeks ago
Avenues did the job for me! As this was my first time in Rehab it was the best choice to go for recovery journey. The Staff (EVERYONE OF THEM) was AMAZING, caring and supportive.. The Community was nothing but the best and very welcoming..
Amanda Kovaleski
2 weeks ago
I went in just to look good for court and had no plans to stay sober and I left with the passion and motivation for my recovery and sobriety
Very professional, great counselors, and a very good learning experience. Gave me structure and coping skills. Additionally, the psychiatric counseling was top notch.
Gregory Gheen
2 months ago
When it came to the realization I needed help to overcome my addiction, I ended up choosing to go to Sobermans. I couldn't have been more grateful for this choice and the experience. I can't say enough about the accommodations, setting, and food. However those things mean nothing without the proper staff. The best thing about Sobermans is their people. The care I received from each and every member of staff there was overwhelming. I've since returned for some aftercare and Alumni events, and upon my return, it feels like home. I would highly recommend Sobermans for any man that needs help with addiction or getting your mind cleared. I promise, if you put in the effort that their staff does, you will leave different person!
backfortyhunter Rose
3 months ago
Soberman’s estate saved my life and the staff was tremendously amazing. I deeply appreciate their commitment to assisting individuals battling with depression and other addictions. Thank you Brady, Trish, Janice, Jody, Allen and the entire staff.
I AM SO THANKFUL FOR SYMETRIA AND THE GREAT STAFF.
They are very helpful with any questions or concerns you may have about the program They make you feel at easeThey don't judge you it's a really great and safe place to began recovery. I highly recommend symyetria
To all staff : thanks so much. N.B
Nolan Brown
6 months ago
Symetria saved my life in more than one way. Each member of this team deeply cares about the patient without judgement. Vannah is such an incredible Clinician who truly listens, is an advocate for her patients, and is helping me work through my trauma to heal in a healthy way. I am forever grateful for this entire team: Samantha, Vannah, Dr. Son, the wonderful nurses. Thank you for saving my life and helping me heal.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionMental Health
Adult ProgramLGBTQ ProgramYoung Adult ProgramMilitary Program
Self-Pay OptionsMonthlyPrivate Insurance
STR and its staff has truly played a pivotal role in guiding me through life struggles past and present.
Vincent DAngelo
2 weeks ago
STR has been a very special experience. Normally I’m very uncomfortable being in groups while talking about personal issues, but this place has made it very easy to open up!
Matthew Reilly
3 weeks ago
STR has an amazing community from staff to clients!
This is an ad and Boca Recovery Center – New Jersey Drug & Alcohol Rehab is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
I learned so much from my program at elevate. They gave me an opportunity to change my life for the better. I would recommend elevate to anyone struggling with addiction.
Ariana Kramer
2 weeks ago
Elevate has changed my life. I have learned how to cope with intense emotions without substances. The full program has not only made me look forward to sobriety, but has made me look forward to living my life
confidently and well-balanced.
Aaron (ATST77)
2 weeks ago
This program really helped my daughter get sober by giving her the tools she needed to figure out that she was only harming herself. My daughter recently graduated from Elevate and has roughly past her 100th day sober and it’s been a big turn around and we are so grateful for the program and happy to have our daughter back home she’s much happier and interacts with the family more unlike before. I can’t thank all of the staff at Elevate for all the patience, understanding, and guidance they gave her.
This whole team was extremely supportive when my loved one was in crisis. They walk you through every step of the way with care. I highly recommend if you have anyone struggling with drug or alcohol addiction.
Jennifer Luppens
1 month ago
This place is god sent. I have been in several trauma centers in Florida and they are the only ones that seem to get it! Great snacks, fashionable donations (including shoes), and even better Techs.
Ive been clean since the holidays due to their new beginnings of sobriety excitement and impressive alumni support system +Nikki. Thanks, Boca 😀.
Beach Beauty
3 months ago
Boca is an amazing place. The staff is absolutely amazing. I was fortunate enough to be able to work with Misty and Sondra. From day 1 until the day I left was a complete 180. Misty helped set me up for my next steps, and truly cares and checked in on me to make sure it was the right fit. She got to know understood me as a person and truly knew the right next steps for me to be set up for success. Highly recommend Boca.
For anyone wondering whether or not they need to seek treatment, if you’re asking yourself that question then you likely do. Legacy will help you through every step of the process including getting you a ride to detox or the airport if you need it. They will set up your flights. They will check in on you through every step of the way and when you arrive you are in good hands. Don’t be afraid to ask for help, I was five years sober without seeking help and I still picked the bottle back up. You’ll learn to open up here and the weight that comes off your shoulders can’t be put into words. The houses you stay in truly are like a family. You won’t be judged for who you are.
Quentin Reintjes
2 weeks ago
Legacy has provided a great experience thus far and has me on track and pointed in the right direction for continued prolonged success. The staff have all been fantastic. They are understanding, relatable, and passionate about their work and the successful futures of everyone that walks through their doors.
Robert J. Yudt
2 weeks ago
Clinical help is professional and very helpful. I have 50 years of addiction and this is my first ever PHP experience. I am grateful.
This was my second tine in DFC outpatient treatment, the reason I chose DFC was their teaching, there, client, and the friendly environment. I have been to many treatment centers in my past when I knew in my heart I was serious about recovering from drugs and alcohol. There was no other place that I wanted to go other than Design For Change. They give group and individual counseling tailored for the individual which helped me tremendously. They help me find out what I want and how to go about getting it in the group setting they don’t allow disturbances. They make sure everyone is focused. An attentive, which makes it easy to learn. DFC, my wife says thank you for giving her her husband back.
Steven Jackson
2 weeks ago
I have attended the Family Workshop many times. It is so amazing and has helped me so much. Dealing with addicted loved ones is so hard. You must have a support system to help you navigate all of the scary, stressful heartbreaking realities of this disease. The Design For Change staff have become like family to me. I know I can call on them when I need advice, someone to listen or just a shoulder to weep on. They understand and are always willing to help. I feel so very blessed to have found them. I wish every suffering addict and their family members would come to DFC for support and help. I am stronger and definitely more educated in dealing with my addicted loved ones one. If you are suffering from addiction or have a family member or loved one who is an addict, there is hope and help at DFC!
Regina Linton
1 month ago
Design for Change is great. Very helpful, staff is supportive and real. Consuelo is the best! They really care about their clients. I went there, and received good advice, and outstanding treatment. Thank God for DFC
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance AbuseMental Health
Adult ProgramProgram For Men
Private InsuranceSelf-Pay Options
Coming to Jaywalker was a pivotal turning point in my journey to recovery from substance abuse. I admitted to this program reluctant and broken, not knowing if treatment could help me live a life of fulfillment and freedom from addiction. Jaywalker taught me that community and connection could free me from the desperate cycle of addiction that I felt trapped in. The program focuses on a community based approach to recovery. During the program, I went on activity expeditions, played golf on beautiful courses in the area, competed in pickleball tournaments, and hiked a 14er. The Jaywalker Counselors and Staff are there with you and by your side 24/7 to work with you in all facets of your life. The friends I’ve made at Jaywalker are friends I’ll have the rest of my life. I’m proud to say that I just celebrated my 1st year of Sobriety, and I’m forever grateful what Jaywalker has done for me to help me get there.
Ryan Ceccarelli
4 weeks ago
I am an interventionist and consultant who helps families find appropriate treatment options for their loved ones. All of the clients I have placed at Jaywalker have had an excellent experience and have grown significantly throughout their time there. Their treatment approach is clinically sophisticated, and also acknowledges that treatment is only a small piece of the puzzle in regards to a lifetime of recovery. That is why they focus so much attention on community integration, which research indicates is what really results in long term change.
Carbondale offers a rich recovery community, and Jaywalker is very much at the heart of that community. If your loved one is in need of great clinical work, meaningful experiences in recovery, and a strong and supportive community. Jaywalker would be an excellent option.
Henry Maxwell
1 month ago
This place saved my life. Coming in I was a broken man with no idea how to live a functioning and meaningful life. With the guidance of my peers and the staff here they let me regain a part of my soul I lost a long time ago. The town of Carbondale has an amazing recovery community with people that really care. Coming here was the best decision I’ve ever made and I’m forever grateful that I did.
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Frequently Asked Questions
Does Aetna Cover Suboxone & Methadone (MAT)?
Medication assisted treatment (MAT) is a specific type of addiction treatment. It is often an outpatient treatment program that uses FDA approved medications to treat opioid and/or alcohol misuse alongside counseling and recovery treatment. Suboxone and Methadone are two of the most commonly prescribed medications for MAT. MAT is covered by most Aetna plans if medically necessary. Some may cover a generic form of Suboxone instead of the brand name, and you may need to cover co pays for the prescriptions.
Does Aetna Cover Other Mental Healthcare?
Aetna’s behavioral health benefits generally include treatment for substance use disorders and mental health disorders. For those struggling with mental health concerns such as anxiety or depression, most Aetna medical plans provide resources and support. Resources include crisis support, preventive care, and treatment. Aetna members can visit the Aetna website or call the customer care number to find mental and behavioral health resources near them and learn which providers are in network and covered by their insurance plan.
Where Does Aetna Offer Coverage?
Aetna offers health insurance in every state of the U.S. and some international locations. While they offer all products in all 50 states and Washington D.C., the details, plan types, and network providers vary by state. Medicaid plans are limited to 16 states.
The availability and specifics depend on state partnerships and regulations. International coverage is provided for individuals and employers with members who live or work abroad. These plans access a global network of providers and facilities. They typically include coverage for emergency care, routine care, and other health services.
What Are Aetna Plans?
Aetna offers individual and family plans on four levels determined by the Affordable Care Act: bronze, silver, gold, and platinum. The metal levels are based on the level of coverage and costs.
Bronze plans typically have the lower premiums with higher out of pocket costs if you need care, while Platinum plans have the highest premiums with the lowest out of pocket costs for care. Aetna also offers high deductible health plans often paired with health savings accounts for those who want lower premiums and need to save up for the high deductible when care is needed.
Aetna offers Medicare Advantage plans, also called Medicare Part C. These plans coordinate care for Medicare Parts A and B and often offer additional benefits like vision, dental, and hearing.However, Advantage plans do require you to use the provider’s network for care, so be sure that your providers are included before choosing a plan.
For those with Original Medicare, Aetna offers Supplement Plans and Medicare Part D plans. Medicare Supplement Plans, called Medigap, help cover out of pocket costs like copayments and deductibles. Medicare Part D covers the cost of prescription medications, typically including medication assisted treatment for opioid addiction.
Medicaid plans are provided in 16 states, mostly on the East Coast, to help coordinate coverage for low-income individuals and families. These plans include comprehensive benefits and access to a wide network of providers. Benefits vary by state, but some level of mental health and substance use treatment will be covered in accordance with the Affordable Care Act.
Aetna offers several employer sponsored plans that include preferred provider organizations, health maintenance organizations, exclusive provider organizations, and point of service plans. Each has different rules that govern who you’re allowed to see, whether you need a referral to see a specialist, and whether out of network care is covered. If you have an Aetna plan through your employer, talk to your company’s benefits specialist to get all the details of your coverage.
Aetna’s specialty plans help cover dental, and vision services. Some plans also have a cash payout so you can handle expenses quickly. Each plan has different rules and offers various benefits. It’s important to verify your coverage before receiving care.
How to Verify Coverage With Aetna
Since benefits vary between policies, you must verify your coverage before beginning treatment. There are several ways to do this. For instance, when you purchase your plan, you receive documentation of the benefits for your policy.
Aetna maintains a member services phone number where you can call and ask questions about your coverage and limitations. You can also log in to your account online to look for in network providers or coverage information.
However, the easiest and often most efficient way is to work with the addiction treatment center. They can verify your coverage and answer questions about therapy. They can also do an initial assessment and help estimate your potential out of pocket costs.
What Kinds of Inpatient Addiction Treatment Does Aetna Cover?
Residential rehab is one type of treatment that Aetna may cover based on your needs. It’s the most well known type of inpatient addiction treatment. Residential rehab pairs intensive exposure to therapy with a stable and sober living environment. It may be a good option if you need to make major changes to your lifestyle to support your recovery.
Another treatment Aetna may cover based on your needs is medical detox. Medical detox also has you staying overnight in a facility. It tends to be shorter than residential rehab, lasting three to ten days on average. The focus is on getting you through withdrawal safely.
In either of these settings you may receive medications to help you with or even prevent you from experiencing withdrawal. You may hear people refer to this as medication assisted treatment (MAT). Qualified clinicians may treat you with MAT in any inpatient or outpatient setting.
With any of these treatments, it’s important to match the intensity of the treatment to the severity of the disease. That’s why a clinician will usually evaluate your situation to determine what treatment your condition warrants. Aetna uses the information from these assessments to inform their decisions about medically needed coverage.
What Kinds of Outpatient Addiction Treatment Does Aetna Cover?
Depending on your treatment needs Aetna may cover services like partial hospitalization and intensive outpatient treatment. These services have you spending time in treatment each day in a treatment center but going home at night. In a partial hospitalization program, you might need to be there all day for five days a week. In an intensive outpatient program you might be there for part of the day, two to three days a week. Either of these options can give you intensive support while you start to practice your new skills and mindsets.
The next step down from intensive outpatient treatment is standard outpatient. Aetna has many outpatient therapists in their network. In standard outpatient treatment you can expect to see an addiction counselor at regular intervals. Appointments can be weekly or monthly or you might agree on another schedule. You may also have appointments with someone to manage your medication if that’s appropriate for you.
MAT might be used together with any of these treatments or separately. Medications can help you manage cravings during treatment so you are able to focus on recovery and avoid relapse.
Again, a number of considerations go into determining what the right treatment is for you at the right time. As with inpatient, Aetna uses information about your clinical condition to inform their coverage decisions.
How Much Does Addiction Treatment Cost With Aetna?
This will vary widely based on what type of plan you have and the type of care you need. You can estimate your costs by knowing your plan’s deductible and copay or coinsurance amounts. You can also look at the out of pocket maximum.
Do take note that these figures might all be higher if you try to get treatment from outside Aetna’s provider network. Some Aetna plans may not cover out of network treatment at all.
How Long is Rehab When I Use Aetna Insurance?
The length of treatment varies from person to person. In general residential rehab can last from two weeks to three months. Partial hospitalization and intensive outpatient programs also can last a few weeks to a few months. Standard outpatient and MAT can continue indefinitely. You should always check ahead with Aetna to verify your coverage for a specific program.
What’s important is that you fully complete your treatment plan. This will give you the highest chance of long term recovery and help you avoid having to go through rehab again in the future.
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By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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