Does Aetna Cover Drug and Alcohol Rehab?

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Serenity at Summit has Massachusetts and New Jersey facilities specializing in substance addiction rehab and mental health treatment. We are committed to helping you achieve lasting sobriety and enhancing your overall well-being. Our holistic approach integrates the latest clinical methods and evidence-based techniques for addiction and mental health recovery.

Serenity at Summit accepts health insurance and may take your Aetna policy for rehabilitation treatment. Contact us to determine the details of your insurance coverage levels, or call Aetna directly. You can also keep reading for more information on Aetna’s rehab insurance coverage.

Who is Aetna?

Established in 1853, Aetna, originally a provider of life insurance policies, has evolved into a prominent health insurance company offering a comprehensive array of healthcare products and services. Its offerings extend to individuals, employers, and government entities, encompassing health insurance, dental insurance, pharmacy benefit management, disability insurance, care management programs, and a broad spectrum of healthcare-related solutions.¹

Aetna has become one of the leading health insurance providers with a presence in all 50 states. The company’s headquarters are situated in Hartford, Connecticut. A vast network of over 1.2 million healthcare professionals, including 690,000 primary care doctors and specialists, supports Aetna’s mission.² In 2018, CVS Health, a prominent retail pharmacy and healthcare conglomerate, acquired Aetna.³

Some Aetna Brands, Products and Services

Aetna provides many health and wellness brands, products, and services. These offerings include health insurance plans, mental health services, pharmacy benefits, and innovative digital health solutions. With a vast network of providers and a commitment to enhancing healthcare, Aetna caters to a broad spectrum of needs, including, but not limited to, the following brands, products, and services:

  • Aetna Health Insurance: Health insurance plans for individuals, employers, and government entities, including medical, dental, and vision coverage
  • Aetna Medicare Plans: Medicare Advantage, Medicare Prescription Drug Plans, and Medicare Supplement plans to provide comprehensive coverage for seniors
  • Aetna Behavioral Health: Services focused on mental health and well-being, offering support and resources for mental health and substance abuse concerns4
  • Aetna Guardian Angel Program: A support initiative that offers personalized care and resources for individuals dealing with the opioid overdose crisis5
  • Aetna Pharmacy Benefits: Prescription drug benefits, ensuring access to medications and cost-effective solutions
  • Aetna International: Global health insurance and services for international travelers and expatriates6
  • Aetna Care Management: Services to help individuals with complex medical conditions navigate healthcare and receive support7
  • Aetna Health Connections: Wellness and prevention programs promoting a healthy lifestyle for members8
  • Aetna Provider Network: Healthcare providers, hospitals, clinics, and more, ensuring access to a wide range of medical services

Aetna Digital Health Solutions: Digital health solutions, such as The Aetna Health app℠ and online portals that enhance healthcare delivery and improve patient engagement9

What is Aetna Rehab Coverage?

Aetna’s coverage for rehabilitation services extends a helping hand to insured members seeking treatment for substance abuse and addiction. The extent of coverage can differ depending on your plan, residence, and other factors. Generally, Aetna’s rehab insurance encompasses in-network inpatient care, outpatient care, detoxification services, medication-assisted treatment (MAT), and more.

Furthermore, Aetna is committed to assisting individuals on their path to recovery by offering valuable resources like managed care, behavioral health services, and round-the-clock support hotlines. The company collaborates with a network of healthcare professionals and facilities to ensure customers can access top-tier, evidence-based treatment options.

Does Aetna Cover Rehab?

Aetna provides coverage for drug and alcohol rehab to its members who need treatment for substance abuse and addiction. Aetna alcohol rehab and Aetna drug rehab encompasses a wide range of services, including detoxification, inpatient and outpatient care, and medication-assisted treatment. Additionally, members may receive cognitive-behavioral therapy (CBT), motivational interviewing, counseling, and aftercare support services for relapse prevention.

Rehabilitation services and programs can vary from plan to plan according to several factors, including the terms and conditions of your policy and the treatment provider. For accurate, up-to-date details, call (844) 326-4514.

Check Your Insurance Coverage

Does Aetna Cover Medical Detox Treatment?

Aetna typically covers medical detox treatment as part of its services for substance abuse treatment. Coverage specifics can vary depending on your Aetna policy and other factors. For a clearer understanding of your coverage, including co-pays or deductibles and whether there are specific facilities you should use, review your summary of benefits documentation or check your insurance here.

Does Aetna Cover Residential Treatment?

Aetna health insurance may cover residential treatment for various medical and mental health conditions, including substance abuse and addiction. However, the extent of coverage can vary based on many factors. Contact Aetna directly to determine if your Aetna plan covers residential treatment and to understand your coverage details, such as any co-pays, deductibles, and network requirements.

Additionally, when seeking residential treatment, work closely with healthcare providers and rehab centers that take Aetna insurance, like us at Serenity at Summit. We can provide the most accurate, up-to-date information about your coverage options and help you access the appropriate care. Call (844) 326-4514.

Does Aetna Cover Mental Health Therapy Treatment?

Aetna’s mental health coverage encompasses a wide range of evidence-based services, such as inpatient and outpatient therapy, counseling, and psychiatric care. Beyond these, your Aetna mental health coverage might also extend to various other services, and here’s a partial listing10 of what it may include:

  • Access to a personal care advocate
  • Behavioral health evaluations and therapy
  • 24/7/365 Telehealth
  • Medication management
  • Prescription drug plans
  • Support groups
  • Wellness programs

It’s important to remember that depending on your plan and other variables, the particular coverage for mental health services may differ. You can verify insurance coverage for mental health therapy here or by calling (844) 326-4514.

Check Your Insurance by Phone

Call Now: (844) 326-4514

Does Aetna Cover EMDR Therapy?

Aetna may cover Eye Movement Desensitization and Reprocessing (EMDR) therapy, particularly when medically necessary for conditions like post-traumatic stress disorder (PTSD). However, the coverage specifics can vary based on your Aetna insurance plan, where you live, the treatment provider, and more.

To determine if your Aetna plan covers EMDR therapy and to understand the details of your coverage, such as any co-pays, deductibles, and network requirements, review your Aetna summary of benefits documentation, contact Aetna directly, or call (844) 326-4514. We can provide you with the most accurate, up-to-date information about your coverage options and help you access the appropriate therapy.

Other Rehab Treatment Programs Covered by Aetna

Aetna provides a range of rehabilitation treatment programs, extending beyond drug and alcohol rehab to address various and diverse health needs. Coverage specifics can vary based on your particular policy and other factors. Below, we’ll explore other rehab treatment programs that Aetna typically covers.

Coverage for Partial Hospitalization Programs

Aetna insurance plans typically offer coverage for Partial Hospitalization Programs (PHPs), which provide intensive outpatient treatment for individuals with mental health conditions or substance abuse issues. PHPs serve as a transitional step between inpatient care and standard outpatient services, enabling individuals to receive comprehensive treatment during the day and return home in the evening.

Aetna’s coverage for PHPs often includes services such as therapy, medication management, group counseling, individualized treatment plans, and aftercare. Access to PHPs can be a crucial step toward sobriety and managing and recovering from mental health or substance use disorders.

Coverage for Intensive Outpatient Program

Aetna insurance plans typically provide coverage for Intensive Outpatient Programs (IOPs), presenting a valuable option for individuals seeking treatment for mental health concerns or substance abuse challenges. IOPs deliver structured, intensive therapy and counseling sessions while allowing you to uphold your daily routines and responsibilities.

Aetna’s coverage for IOPs often includes a spectrum of services, such as one-on-one counseling, psychoeducational sessions, support groups, and comprehensive mental health assessments. Engaging in an IOP can represent a crucial step in preventing relapse, and Aetna is typically committed to supporting individuals requiring this level of care.

Coverage for Acute Treatment Programs

Aetna insurance plans frequently cover acute treatment programs tailored for individuals needing immediate, intensive psychiatric or behavioral health care, usually within hospital settings, providing 24/7 support to stabilize those facing acute mental health crises. The coverage for such programs typically encompasses inpatient care, psychiatric assessments, medication management, and therapeutic interventions, crucial for addressing severe mental health issues.

Coverage for Inpatient Rehab

Aetna commonly covers inpatient rehab programs, providing comprehensive care for mental health and substance abuse. These residential programs offer 24/7 care, including medical assessments, therapy, and medication management. Access to inpatient rehabilitation is vital for focused care, and Aetna is committed to supporting these needs.

Rehab Centers in Massachusetts That Take Aetna

We’re dedicated to guiding you from detox to outpatient care at Serenity at Summit, promoting overall well-being and genuine sobriety. Our modern facility offers a comfortable, private setting for recovery, utilizing a holistic approach that integrates cutting-edge clinical methods and evidence-based techniques. Call (844) 326-4514 or visit our nationally-recognized treatment center that accepts Aetna insurance:

Rehab Centers in New Jersey That Take Aetna

Our Union, New Jersey, facility offers a full spectrum of treatment options, spanning detoxification to outpatient care. We pride ourselves on personalized services with low staff-to-client ratios, a team of experienced master’s level therapists, and comprehensive drug detox and rehabilitation services that address the most critical substance addiction needs.

To learn more or inquire about our rehab center in New Jersey that accepts Aetna insurance, call (844) 326-4514 or visit our facility.

Check Your Insurance Coverage

How Much is Rehab with Aetna Insurance?

The expenses associated with rehabilitation under Aetna insurance can fluctuate due to multiple factors, including the unique features of your plan, your state of residence, and the specific treatment type and duration. Aetna insurance usually contributes to some of the rehab costs, but members may be accountable for co-payments, deductibles, and additional out-of-pocket expenditures.

Your rehab cost will depend on your treatment plan and its specifics. The length of your stay, the type of program you choose (inpatient or outpatient), and the services you receive are all factors that will also affect the cost. Some plans may have coverage limits on the duration of inpatient treatment or the number of visits, while others may not have any limits.

Typically, outpatient therapy costs, which involve receiving treatments without being admitted as a patient, can vary between $1,400 and $10,000 for 30 days.11 However, these are only estimates that vary according to many different factors.

How To Check Aetna Coverage Levels for Rehab Treatment

You can easily confirm your insurance coverage by completing our no-commitment, confidential online form. Our team of experienced professionals will promptly reach out to your health insurance provider to validate your eligibility for rehab treatment. We will then contact you at your earliest convenience to go over your policy details and discuss the next steps.

It’s essential to understand the specifics of your insurance policy and find rehab facilities that are in-network with Aetna. To assess your Aetna rehabilitation coverage, you may also call us at (844) 326-4514.

How To Get Aetna to Pay for Rehab Treatment

Begin by thoroughly reviewing your summary of benefits documentation to understand your coverage. Choose an in-network rehab center that meets your needs, and obtain a referral (if needed) from your primary care physician. If pre-authorization is necessary, provide Aetna with essential information about your diagnosis and treatment plan. Ensure that the rehab facility submits claims to Aetna on your behalf.

After completing your treatment, follow up with Aetna to confirm claim processing and receive any owed reimbursements or coverage benefits. Staying in-network with approved providers and following your treatment plan as advised can maximize the likelihood of Aetna covering your rehab treatment.

Check Your Insurance by Phone

Call Now: (844) 326-4514

How Many Times Will Aetna Pay for Rehab?

The frequency of Aetna’s coverage for rehab is contingent upon several factors, encompassing the type of rehabilitation program, the specific terms within the policy, and your medical prerequisites. Typically, Aetna provides coverage for rehab when deemed medically necessary, signifying that treatment is essential to address a particular condition or illness.

Periodic assessments to determine ongoing medical necessity and coverage may be required by Aetna, and exclusions or limitations on the duration of rehab programs they cover can apply, all of which are contingent on the policy’s terms, the nature of the rehabilitation program, and your medical requirements. In many cases, Aetna may provide coverage for rehab on multiple occasions.

Addiction Statistics in Massachusetts

  • Throughout 2022 in Massachusetts, the prevalent reasons for substance abuse treatment were consistent across all races, ethnicities, and genders, with heroin/fentanyl and alcohol at the forefront.12
  • In Massachusetts, 438 substance abuse treatment facilities served 66,912 clients on March 29, 2019, according to the 2019 N-SSATS report.13
  • Massachusetts had the fourth-highest number of fentanyl reports in the US in 2019, according to the 2020 National Drug Threat Assessment.14
  • Over 25% of Massachusetts residents have lost a friend or loved one to opioid overdose.15
  • According to state reports, the number of opioid-related deaths in Massachusetts has increased by 450% in the past 16 years.16

Addiction Statistics in New Jersey

  • In a 2019 Substance Abuse Treatment Admissions report for New Jersey, 42% of all treatment admissions involved heroin use, followed by alcohol (31%).17
  • Data from the 2019 New Jersey Substance Abuse Monitoring System reveals key demographics of treatment-seekers. They are primarily male (70%), predominantly aged 35 to 44 (24%), white and non-Hispanic (60%), not in the labor force (around 50%), living independently (75%), and not married (over 80%).
  • Over the past decade, overdose deaths have increased in New Jersey, with a peak in 2018 where 3,118 residents lost their lives.18
  • The primary reason for accidental deaths in New Jersey is drug overdoses.19
  • Between 2016 and 2021, an estimated 312,000 New Jersey residents sought substance abuse treatment.20

Sources

  1. “About Us and Company Information | Aetna.” Aetna, www.aetna.com/about-us.html. Accessed 25 Oct. 2023.
  2. “Our Corporate Profile.” Aetna International. www.aetnainternational.com/en/about-us/who-we-are/corporate-profile.html. Accessed 25 Oct. 2023.
  3. “Our History | Aetna.” Aetna, www.aetna.com/about-us/aetna-history.html. Accessed 25 Oct. 2023.
  4. “Mental Health Benefits for Members.” Aetna, www.aetna.com/individuals-families/health-insurance-through-work/health-insurance-information/behavioral-health.html. Accessed 25 Oct. 2023.
  5. “CVS Health Combines ‘Guardian Angel’ and Unite Us Programs to Support Opioid Overdose Victims in North Carolina.” CVS Health, 16 Mar. 2020, www.cvshealth.com/news/community/cvs-health-combines-guardian-angel-and-unite-us-programs-to.html.
  6. Aetna Inc. “International Medical Insurance.” Aetna International, www.aetnainternational.com. Accessed 25 Oct. 2023.
  7. “Care Management | Aetna.” Aetna, www.aetna.com/services/care-management.html. Accessed 25 Oct. 2023.
  8. “Workplace Wellness Programs for Employees | Aetna.” Aetna, www.aetna.com/insurance-producer/health-wellness/wellness-programs.html. Accessed 25 Oct. 2023.
  9. “Tools and Tech – Aetna.” Aetna, www.aetna.com/individuals-families/health-insurance-through-work/health-insurance-information/tools-and-tech.html. Accessed 25 Oct. 2023.
  10. “Behavioral Health.” Aetna, www.aetna.com/individuals-families/health-insurance-through-work/health-insurance-information/behavioral-health.html. Accessed 25 Oct. 2023.
  11. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  12. Commonwealth of Massachusetts. “Data on Enrollments in Substance Addiction Services.” Mass.gov, www.mass.gov/info-details/data-on-enrollments-in-substance-addiction-services. Accessed 20 Oct. 2023.
  13. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. “2019 State Profile — Massachusetts : National Survey of Substance Abuse Treatment Services (N-SSATS).” Substance Abuse and Mental Health Services Administration (SAMHSA), www.samhsa.gov/data/sites/default/files/quick_statistics/state_profiles/NSSATS-MA19.pdf. Accessed 25 Oct. 2023.
  14. U.S. Department of Justice. “2020 DEA National Drug Threat Assessment.” Drug Enforcement Administration, Mar. 2021, www.dea.gov/sites/default/files/2021-02/DIR-008-21%202020%20National%20Drug%20Threat%20Assessment_WEB.pdf.
  15. Crowe, Jack. “Poll: More Than One in Four Massachusetts Residents Have Lost Friend or Loved One to Opioid Overdose.” National Review, 12 Mar. 2018, www.nationalreview.com/2018/03/opioid-crisis-massachusetts-25-percent-overdose-victim.
  16. “Massachusetts State Health Assessment.” Mass.gov, www.mass.gov/doc/chapter-6-addiction/download. Accessed 25 Oct. 2023.
  17. “New Jersey Drug and Alcohol Abuse Treatment: Substance Abuse Overview 2019 Statewide.” New Jersey Department of Human Services, Oct. 2020, www.nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2019/Substance%20Abuse%20Overview%20Statewide%20Report%20-%20%202019.pdf.
  18. Stainton, Lilo H. “Overdose Deaths Rising and May Set Record.” NJ Spotlight News, 2 Sept. 2021, www.njspotlightnews.org/2021/09/nj-drug-overdose-deaths-rise-heroin-fentanyl-pandemic-isolation-stress.
  19.  NJTV. “New Jersey’s Drug Addiction Crisis – NJ PBS and the Drug Addiction Crisis.” New Jersey’s Drug Addiction Crisis, www.njpbs.org/addiction.
  20. “New Jersey Drug and Alcohol Abuse Treatment: Substance Abuse Overview 2021 Statewide.” New Jersey Department of Human Services, July 2022, www.nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2021/statewide.pdf.

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