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If you or a loved one is struggling with substance use and have Aetna Insurance, you may be eligible for addiction treatment services in rehab.
South Coast Behavioral Health’s specialty program for veterans and first responders offers an innovative approach to substance use disorder treatment.
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When you or your loved one is struggling with substance abuse, it can be confusing, frightening, and harmful. Along with the uncertainties of addiction, one of the scariest parts can be not knowing how to pay for treatment. In reality, professional treatment is the only way to find lasting relief from a substance abuse disorder (SUD). Many people go without rehab because of the cost. Using Aetna insurance for rehab is one way that people cover the costs of treatment. Aetna is a nationwide health insurance provider offering coverage for rehab. While most Aetna plans cover at least some of the cost of recovery, understanding your plan can be confusing. South Coast Behavioral Health is here to help you navigate the complicated world of using Aetna insurance to pay for rehab.
Aetna is a nationwide CVS Health insurance company with wide-ranging policy offerings. It was founded in 1853 and has since grown to provide coverage to 17 states and parts of Canada. Aetna insurance provides a many unique plans for members to choose from, ranging from basic to comprehensive coverage. Aetna prioritizes health equity, which is shown through its inclusive insurance policies, health and wellness resources, and customer service. As part of their commitment to providing for members, Aetna insurance offers coverage for substance abuse and mental health treatment.
Understanding Aetna policies is the first step in using this valuable resource for addiction and mental health treatment. Aetna provides many choices when it comes to insurance plans, including:
Medicaid plans help low-income individuals and families, but Aetna also has policies for families and individuals who don’t qualify. Aeta offers many employer-sponsored policies that may include healthcare, dental, vision, and pharmacy services.
In California, Aetna offers the following policy types:
Like most insurance companies, Aetna’s plans are separated into tiers:
To clarify, the different tiers do not affect the quality of treatment you receive. Rather, they allow you to determine what you want your fee breakdown to look like by month and by service.
To find out what your Aetna plan covers, you can login to the Aetna website and see the details of your plan. A consultation with the admissions team at South Coast can also offer more information about what kinds of treatment are available via your coverage.
If Aetna is your insurance provider, you’re probably wondering if they can help pay for rehab. Does Aetna provide addiction treatment coverage? Yes, many Aetna plans include coverage for addiction rehab services, including inpatient, outpatient, mental health care, and prescriptions. Your plan can provide you with specifics.
You may have bought your Aetna policy through the public health insurance marketplace. In this case, under the Affordable Care Act (ACA) you are guaranteed some coverage for addiction treatment. This is because the ACA mandates that substance abuse rehab is an essential service. If your Aetna plan is sponsored by your employer, you also likely have addiction treatment coverage. If you have an off-exchange policy through Cigna, your SUD rehab coverage may vary.
Make sure you determine the details of your plan prior to purchasing it so there are no surprises when it comes time to use Aetna insurance for addiction treatment. This includes your co-pay for services, deductible, co-insurance, and precertification requirements, which will depend on your policy. Your co-pay is the fixed out-of-pocket amount you pay before the percentage your insurance covers is fulfilled. In general, higher tiers like gold and platinum have lower co-pays because they have more comprehensive coverage. Yet, you can expect your co-pay to be reasonable on most plans, whether you’re seeing doctors, therapists, or addiction specialists at rehab centers. Your deductible is the amount you pay before insurance contributes. Co-insurance is the additional percentage you pay for services, split with your provider.
These terms can be confusing. Please reach out if you’d like us to break your policy down regarding treatment.
Your Aetna plan may require you to have a referral from your practitioner to be admitted to substance use disorders treatment. Referrals keep the flow of healthcare operating smoothly so those who need a specialist can access one. It’s always good to plan so when you’re ready to begin treatment there aren’t roadblocks. You can call us today to help you explore your plan. We’ll then help you navigate through the process of obtaining a referral where it’s required.
Preauthorization is when a medical professional gives a certification that an individual requires certain treatment, services, or prescriptions. Many Aetna insurance policies mandate preauthorization for aspects of substance abuse rehab before they will fund them. Understandably, this helps ensure only the right treatments and medication are administered for each unique individual. It’s best to look over your plan to learn of any preauthorization. Then, you can take the necessary steps to gain authorization from your doctor before using insurance for treatment.
Looking for quality substance abuse treatment that’s also affordable? South Coast accepts most major insurance providers. Get a free insurance benefits check now.
Check Your CoverageIn general, inpatient treatment is more expensive than outpatient treatment. This is because clients are admitted into a facility for around-the-clock care. Fortunately, many Aetna insurance policies provide coverage for inpatient treatment, as it’s a valuable and often necessary step of addiction and mental health rehab. Outpatient treatment can also be billed to insurance in the same way visits with primary care physicians are, making costs lower than inpatient care.
Many clients move through the levels of care to complete comprehensive addiction treatment. It’s common for clients to begin with detox, spend a few weeks in inpatient treatment, and move into outpatient care. Whether they enter partial hospitalization (PHP), intensive outpatient (IOP), outpatient (OP), or move through each, it is recommended outpatient rehab follow inpatient. Aetna insurance understands that levels of care are essential steps toward sobriety, so they provide many types of coverage for services.
Detox is a necessary first step in the recovery process for many. It involves ending substance abuse and removing all drugs and alcohol from the body. It can involve uncomfortable withdrawal symptoms, but working with a team of detox specialists can make the process easier. Using medication-assisted treatment and around-the-clock monitoring, specialized detox centers like those operated by South Coast Behavioral Health can help anyone get through detox and withdrawal safely. Aetna insurance plans often include coverage for detox, so check with our admissions team and see if your coverage includes detox.
Residential inpatient treatment provides comprehensive rehabilitation in a supervised setting during the crucial early stages of addiction recovery. Here, individuals delve into their substance use issues while benefiting from round-the-clock medical support. A significant number of Aetna plans offer coverage for residential inpatient care. Your co-pay determines your daily treatment costs or the duration of coverage for inpatient care under your insurance. From there, many make the transition to the appropriate level of outpatient care.
Aetna provides coverage for partial hospitalization (PHP) in many of its insurance plans for addiction treatment. This is an intensive stage of outpatient care that offers more flexibility than residential inpatient, but still very structured. Clients attend daytime sessions and return home at night. On average, PHP treatment spans five to seven hours a day, five days a week.
Intensive outpatient programming (IOP) is a continuing level of care for those looking for more flexible recovery options. Clients attend sessions in-center for between three to four hours a day. IOP can follow PHP or act as a standalone treatment. Those in IOP can maintain family and work obligations by commuting between treatment and home. Aetna provides outpatient benefits for IOP in many of its substance abuse insurance policies.
Medication-assisted treatment (MAT) is an approach to treating substance use disorders that combines the use of medications with counseling and behavioral therapies. MAT is primarily used for opioid use disorder (OUD) and alcohol use disorder (AUD), although it can also be employed for other substance use disorders.
Approved medication by the FDA for the treatment of alcohol disorders include:
Approved medication by the FDA for the treatment of opioid use disorders include:
Aetna insurance policies include coverage for prescriptions, both for addiction and mental illness. You may need preauthorization before you can be covered. Also, you may have to contribute a co-pay for prescription refills. Fortunately, coverage for medications can be quite extensive when using Aetna insurance to pay for addiction treatment.
Many Aetna plans incorporate mental health treatment, as it is an essential service for living a happy and healthy life. Aetna’s individual and family plans include coverage for mental health care. The same is true for their employer-sponsored plans, Medicaid plans, and Medicare plans. Aetna’s mental health services are accessible via virtual and in-person care options and benefits towards therapy, counseling, and prescriptions. The Aetna Better Health of California Medicaid plan provides a range of mental health options for low-income members. These include:
Your Aetna policy likely has mental health care coverage in some capacity. The main question is to what extent? South Coast is here to help you answer that question when you’re ready.
South Coast Behavioral Health is proudly an in-network provider of substance abuse and dual diagnosis treatment services for BlueCross BlueShield Anthem, Aetna, and Cigna health insurance plan members.
If you are ready to recover, please reach out to speak with one of our admission coordinators.
It’s important to note that seeking help for addiction and mental health issues is not a sign of failure. It takes bravery and strength to recognize when one needs help and take steps towards getting better. With Aetna covering mental health treatment, there’s no reason to suffer or feel bad about your situation.
If you or a family member is struggling with substance abuse, it’s important to seek help from a qualified and approved provider of Aetna rehab services. With Aetna, you have access to affordable and effective treatment options that can help you on your journey toward recovery today. We encourage you to reach out to our team by calling 866-881-1184 for more information on our treatment services and locations in your area.
If you don’t know what your Aetna insurance covers, we can help. To get started, simply fill out the insurance verification form available on our website. This form is your initial step toward peace of mind, as it allows us to gather the necessary information to verify your insurance coverage for addiction treatment services.
By providing details such as your full name, date of birth, Aetna member number, and contact information, you enable our dedicated team to conduct a thorough review of your coverage and get back to you with a clear understanding of the benefits available to you for substance abuse treatment.
South Coast Behavioral Health is an Aetna insurance addiction treatment provider located in Orange County, California. We are proud to offer evidence-based treatment programs for substance abuse and mental health disorders specifically tailored to meet the needs of military service members, veterans, and their families.
South Coast is honored to provide specialized treatment for veterans and first responders within each of our drug and alcohol rehabs in Orange County, CA. Our Valor Program provides personalized treatment founded on trauma-informed care.
At South Coast’s Aetna-approved rehab facilities, our clinicians understand the unique challenges faced by those who serve our country. Throughout our addiction treatment programming, we provide compassionate care and support throughout the recovery process.
During treatment, veterans gain access to a variety of vital addiction treatment services such as medication management, behavioral therapy, and addiction counseling.
In addition to traditional therapies, we also offer expressive arts therapy which allows clients to explore their feelings through creative outlets. This can be especially beneficial for veterans who have difficulty verbalizing their emotions.
We also provide dual diagnosis treatment for co-occurring mental health and substance abuse disorders, and medication-assisted treatment (MAT) for those struggling with addiction.
Remember, recovering from addiction is a journey that needs support from different places. Understanding how to use your Aetna insurance for addiction treatment is a big step toward taking control of your life again.
At South Coast, we’re here for you every step of the way. We offer caring support and know-how to help you through it all. If you want to know more about paying for rehab with Aetna insurance coverage, just give us a call at (866) 881-1184.
If you or someone you know is struggling with addiction, please don’t hesitate to reach out to us.
We are here to help because we’ve been there.
