Does Aetna Cover Addiction Treatment?

Yes, your Aetna health insurance plan will typically cover at least some of your addiction recovery treatment. Based on the plan you have, your treatment may be partially or fully covered.

Founded in 1853 and active in all 50 states, Aetna’s network coverage includes 1.2 million healthcare professionals, almost 700,000 primary care doctors and specialists and over 5,700 hospitals.¹ The company has over 46 million members in its various health plans, including health insurance, dental insurance, and vision insurance.²

The Affordable Care Act (ACA) requires that all insurance companies provide some type of coverage for alcohol and drug rehab treatment. The ACA requires that all health insurance plans cover behavioral health treatment (e.g., psychotherapy and counseling), mental health inpatient services, and substance use disorder (SUD) treatment.³

The financial responsibility you have for your addiction treatment will depend on the state you live in, the healthcare plan you have, the treatment coverage you need, and if you choose an in-network or out-of-network facility. Regardless of what drug and alcohol treatment facility you choose and what insurance policy you have, you will likely be responsible for paying some out-of-pocket costs.

What Rehab Centers Take Aetna Insurance?

There are various rehab treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. Use our free, nationwide rehab locator tool to filter for facilities that accept Aetna, levels of care, amenities, and more.

What Drug and Alcohol Rehab Services Are Covered by Aetna?

With most Aetna insurance plans covering at least some of the costs of recovery treatment for drug and alcohol addiction, the types of treatment can vary in intensity and frequency. Types of treatment may include:^4,5

Medical Detox Programs

Medical detox programs help you withdraw safely from drugs and alcohol. Under 24/7 medical supervision, staff will work closely with you—and may prescribe medications to help ensure that you withdraw safely and that your symptoms are addressed as needed. Read more: Medical Detox Centers Near Me.

Inpatient or Residential Rehab Treatment

With inpatient treatment, you receive treatment and live at the facility. Inpatient or residential rehab treatment typically involves group and/or individual therapy. It is often recommended for individuals with co-occurring or dual diagnosis mental health issues, limited outside support, home environments that don’t cater to sobriety, and poor treatment outcomes in the past. Read more: Inpatient/Residential Drug and Alcohol Rehab Centers.

Partial Hospitalization Program (PHP)

These programs allow you to live at home throughout treatment and spend your days at the treatment facility. This is sometimes referred to as day treatment. Read more: Partial Hospitalization Program.

Intensive Outpatient Programs (IOP)

These programs typically involve attending substance abuse treatment programs approximately 3 evenings a week. People in these programs can live at home and go to work during the day. Read more: Intensive Outpatient Programs and Rehabs.

Outpatient Treatment

An outpatient facility lets you meet with doctors and therapists and attend group sessions and recovery meetings before heading back home at the end of the day. With a residential program, you get the chance to focus solely on your recovery without any daily tasks getting in your way or slowing down your progress.

When you decide to get treatment for a drug or alcohol addiction, you and your healthcare provider will decide what type of treatment is best for you and your situation.

Check What Your Aetna Plan Covers

Before choosing the right rehab treatment center for you, check your Aetna policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket for you. You can call the phone number on the back of your insurance card or log in to your account on Aetna’s website to learn more about your health insurance coverage for addiction treatment.

Knowing exactly what your Aetna insurance plan covers can give you peace of mind while you or your loved one is in rehab for substance abuse. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles.

Which Aetna Insurance Plans Cover Addiction Treatment?

Aetna offers open-access insurance plans, copay only plans, and high-deductible plans that can help you pay for addiction treatment.⁶

Open-access plans allow you to choose your doctors; they don’t require a referral, and they don’t require a primary care physician.
Copay-only plans will guarantee that your costs after paying your deductible are only copays, with primary care physician visits and generic drugs covered before you hit your deductible.
High-deductible plans offer preventive care services before the deductible is met, sometimes coverage through a primary care physician before the deductible is met (with copay), and the option of a health savings account. To view your plan’s details, you can log into the member website.

Aetna offers many local plans supported by the national network of providers to better support patients at the community level.

Aetna, Medicare, and Medicaid

Aetna works with federal insurance programs like Medicare and Medicaid to supplement addiction rehab expenses just as they do other healthcare costs.

Aetna Medicare Advantage plans supplement your Medicare Part A and B with additional coverage and, many times, lower deductibles and copayments.⁷ Medicare Advantage plans are HMOs, HMO-POS plans, or PPOs which can be used for drug and alcohol rehab coverage.

Aetna provides Medicaid plans in 17 states.⁸ From California to New York, you might be able to access low-cost coverage through this insurer. The specific coverage you’ll receive will vary depending on which state you live in.

Will Aetna Cover Rehab at an Out-of-Network Facility?

In most cases, you will need to seek treatment at a rehab center that is in-network with Aetna to receive your full benefits. Even if you choose a substance abuse treatment facility that is in-network, you may still be responsible for some of the treatment costs.

If you choose a center that is out-of-network, you may be responsible for all the costs of your drug and alcohol treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the facility.

How to Pay for Rehab Without Insurance Coverage

If your Aetna insurance policy does not cover all your drug and alcohol rehab expenses, it’s important not to let that stop you from getting treatment for addiction. You don’t have to use insurance when you decide to check into rehab. There are many other ways to finance your treatment and get the help you need. Some ways to pay for rehab include:

Payment plans: You pay off rehab in affordable installments.
Sliding scale: The rehab decreases your cost to something you can reasonably afford—typically based on your income level.
Grants or scholarships: The Substance Abuse and Mental Health Services Administration (SAMHSA), as well as individual rehabs, offer grants and scholarships to pay for people who can’t afford treatment.
Purchase affordable insurance on the Healthcare Marketplace.
Open a healthcare credit card or take out a specialized healthcare loan.
Use your savings or a credit card.

Make sure to do thorough research when looking for rehab so that you can find one that meets your financial needs.

Here are additional resources that provide more information about other ways to pay for drug and alcohol rehab with or beyond what Aetna covers:

If you’re ready to find addiction treatment options for yourself or a loved one, get started with our free nationwide rehab search tool. Find addiction treatment facilities that take insurance, rehabs that allow pets, outpatient rehab programs, and more.

Sources

Aetna. (n.d.). Aetna Home Page.
Aetna. (n.d.). Aetna Facts.
Healthcare.gov. (2021). Mental Health and Substance Abuse Coverage.
National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide: Treatment Settings.
Aetna. (n.d.). Medical Insurance Plans for Individuals and Families.
Aetna. (2020). Medicare Advantage Plans.
Aetna Better Health. (2020). Medicaid plans.

Aetna Insurance Coverage for Addiction Treatment