Aetna Insurance

Aetna Provider Overview

Based on membership, Aetna is the third-largest health insurance provider in the country. CVS bought the company several years ago, leading to more treatment options. In 2022, Aetna announced it would offer individual plans through Affordable Care Act exchanges.

Aetna Plans and Coverage Levels

The health insurance plans available through Aetna differ based on where you live, but they are usually divided into two policy types and three coverage tiers. 

• HMO: An HMO (health maintenance organization) has lower premiums and deductibles, and your copays are pre-set, but with these plans, you have to see in-network providers. If you want to see a specialist and have an Aetna HMO plan, your primary care doctor will likely have to provide a referral. 
• PPO: The preferred provider organization or PPO plan has higher premiums but lower copays. You can see specialists or receive out-of-network care without referrals.

The three tiers of PPO plans available from Aetna include:

• Bronze: These plans have lower premiums but the highest deductibles, and you are expected to pay around 30% of your out-of-pocket costs. Aetna covers about 70% of treatment costs after you meet your deductible.
• Silver: A silver plan has higher premiums and lower deductibles than the bronze plan, and Aetna pays around 80% of care costs after you meet your deductible.
• Gold: A gold plan from Aetna will have the highest premiums and lowest deductibles, with the insurer paying around 90% of care costs once you meet the deductible.

Aetna also provides Medicaid plans in many states and Medicare plans. These are federal government insurance plans for people who meet specific requirements.

Does Aetna Insurance Cover Drug and Alcohol Rehab?

Most insurance plans, including the ones available from Aetna, will cover the cost of drug and alcohol rehab. Because of the Affordable Care Act, it became a requirement that private insurers offer addiction treatment and behavioral health care as essential health benefits. That means they have to be covered similarly to physical health conditions. The levels of care that may be covered by Aetna insurance include:

• Medical detoxification
• Inpatient residential programs
• Partial hospitalization programs
• Intensive outpatient treatment
• Outpatient rehab

Aetna Mental Health Services Coverage

Mental health services are required under the ACA to be essential health benefits, as is true with rehab. Mental health services covered by Aetna might be available inpatient or outpatient. Depending on your plan and state, therapies may include: 

• Psychiatric care
• Medication management
• Talk therapy, such as cognitive-behavioral therapy
• Eye Movement Desensitization and Reprocessing (EMDR)
• Group therapy

It’s fairly common for someone with an addiction or substance use disorder to have a co-occurring mental health condition, like anxiety or depression. When addiction and psychiatric conditions are treated at the same time, it can improve recovery outcomes. This is known as dual diagnosis treatment and is usually included in Aetna’s rehab coverage.

Aetna and Medication-Assisted Treatment

Medication-assisted treatment (MAT) can be part of an addiction treatment program. MAT uses FDA-approved medications and behavioral therapies to ease withdrawal symptoms and drug cravings. Medication-assisted treatments that Aetna may cover for treating opioid use disorders are Suboxone, which is buprenorphine and naloxone and methadone. FDA-approved drugs may also help treat alcohol dependence.

Aetna Length of Treatment

Addiction treatment stays can be 30, 60 or 90 days or shorter or longer. The length of someone’s addiction treatment plan depends on their: 

• Needs
• Substance use history
• Co-occurring mental health disorders

Aetna will usually decide on an approved residential stay based on: 

• Your recovery plan
• Whether you previously sought treatment 
• The setting where you’re receiving treatment

Colorado Rehab That Accepts Aetna

The Recovery Village at Palmer Lake accepts Aetna rehab coverage and is an in-network provider. We can help you learn more about the services your Aetna insurance plan will cover for addiction treatment. You can also directly contact Aetna to learn more about the specifics of your plan and coverage. 

The Recovery Village at Palmer Lake also has a simple insurance checker tool to fill in insurance coverage information. The information is sent to a Recovery Advocate, who will contact you about your addiction treatment coverage and the next steps. You can also contact us today to learn more about our treatment programs and get started on the path to lasting sobriety.