Similar to other states, substance use and substance use disorders (SUDs) are prevalent in Texas. From 2018 to 2019, 1,360,000 Texans over the age of 18 had an SUD in the past year.4 Specifically, within that same age group, 1,877,000 reported past-month illicit drug use, and 456,000 reported a past-year illicit drug use disorder, while 5,551,000 reported past-month binge alcohol use and 1,038,000 reported past-year alcohol use disorder (AUD).4 And, in terms of opioid addiction and opioid misuse, four of the nation’s top 25 cities—Texarkana, Amarillo, Odessa, and Longview—for opioid misuse are in Texas.5
What these stats indicate is that if you or a loved one is struggling with an SUD or addiction, you’re not alone. Overcoming addiction is possible and generally involves rehab, which can come at a cost. Fortunately, with the help of health insurance plans like Aetna Texas plans, you may be able to use your plan to cover at least some of the cost of detox treatment, inpatient or outpatient rehab, or more long-term residential treatment programs.
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With the form below you can quickly and privately check your insurance benefits to see if you're covered for addiction treatment services. We'll be able to tell you if your policy is in-network at an American Addiction Centers location.
How to Check My Aetna Coverage for Rehab in Texas
Finding a treatment facility can feel overwhelming but knowing in advance what your Aetna insurance will cover can give you peace of mind. The good news is, checking your coverage is easy. To learn about your specific coverage, contact one of our admissions navigators at , click here, or fill out the form above.
What Is Aetna Texas?
Aetna Texas isn’t a specific type of health plan, but rather it refers to the variety of Aetna health plans offered throughout Texas. Aetna itself is a well-known health insurance provider that provides plans in every market across the country.6 Specifically, Aetna provides medical, pharmacy, and dental plans, Medicare plans, Medicaid services, behavioral health programs, and medical management plans.6
Since 1853, Aetna has been providing insurance solutions to people, when it began as a life insurance annuity fund.7 Almost half a century later, in 1899, Aetna offered its first health insurance policy.7 Fast-forward hundreds of years to the present day, and Aetna is merged with CVS Health, another big name in the healthcare industry, and the two provide services in the open healthcare model to about 39 million people across all states.6,7
Does Aetna Cover Rehab Treatment in Texas?
Most insurance companies, including Aetna, are required by federal healthcare law (the Affordable Care Act (ACA)) to provide coverage for 10 services known as essential health benefits.8 One of the 10 essential health benefits (EHBs) for which coverage is mandated are mental and behavioral health services, including treatment for SUDs.9 This means that Aetna plans must provide some level of coverage for rehab treatment in Texas.
Because exact plan coverage details will vary depending on the plan you have and where you seek care, it’s recommended to check your insurance by calling the number on the back of your card. Or, sometimes, you can call the rehab facility directly and speak to a staff member to help verify your benefits and coverage. One such example of a nearby rehab facility that you can call directly to check whether your insurance is accepted there is the Greenhouse Treatment Center in Grand Prairie, Texas. Greenhouse Treatment Center is an American Addiction Centers (AAC) facility, and AAC works with a variety of insurers, including Aetna, which means they may be able to accept Aetna Texas insurance.
What Substance Addiction Does Rehab Treatment Cover?
Because there are so many different types of Aetna Texas plans, it’s not possible to know what substance addiction types may be covered across all health plans. Despite this, most plans are mandated by the ACA to provide some level of coverage for SUDs. Your Aetna Texas plan may be able to cover at least some of the cost of addiction treatment for substances such as alcohol, marijuana, opioids, heroin, cocaine, crystal meth, and prescription drugs. Call the number on the back of your insurance card or sign into your Aetna Texas plan portal online to verify your benefits and coverage.
What Rehab Programs does Aetna Texas Cover?
Every person’s path to recovery is different, and what type of rehab program is best suited for you will be decided by you and your healthcare provider. Similar to how there’s not a one-size-fits-all approach to treatment methods for SUDs or addiction, there’s not a standardized coverage approach across all Aetna Texas plans. That’s why it’s so important that you check your insurance prior to seeking care, when possible, to see what your coverage limits or amounts may be for the following common rehab programs:10-12
- Medical detox: Generally, the first step to recovery is to rid the body of substances like drugs or alcohol. This is typically done in a medically supervised setting to manage life-threatening withdrawal symptoms if they occur and is known as medical detox. This type of program generally involves a patient staying overnight for days, weeks, or months at a facility to receive round-the-clock care. Inpatient programs are generally recommended for those who need structure, round-the-clock medical supervision, and may be recommended for those who are just beginning their path to recovery.
- Inpatient programs: This type of program, which is comprised of a patient staying in a facility overnight for a set amount of time (i.e., days, weeks, or months), may be recommended for those who need structure or round-the-clock medical supervision.
- Outpatient programs: Generally recommended for those who have less severe substance use disorders or are stable and ongoing care is needed for management, outpatient programs take place in a variety of settings (e.g., offices, clinics, primary care offices, or school-based clinics). This type of program generally involves a patient visiting a facility one or two times per week to receive care, and then returning home. Services rendered in such programs may include individual and/or group counseling, family therapy, medication-assisted treatment, psychotherapy, and occupational/recreational therapy.
- Intensive Outpatient Programs (IOPs): This type of program provides a bit more support than a standard outpatient program, where a patient receives a minimum number of hours of care each week at an outpatient facility (e.g., no overnight stay is required). Therapies offered in IOPs can include the same services offered in outpatient programs, including psychotherapy, counseling (group and individual), family therapy, and medication-assisted treatment (MAT).
- Partial Hospitalization Programs (PHPs): This type of rehab program is often referred to as a day program, in that a patient spends their day at a facility, usually for 4-8 hours per day, multiple days a week, receiving structured care for their SUD or co-occurring disorder. It is generally recommended for those who would benefit from daily monitoring and support in a structured outpatient (e.g., no overnight stay) setting.
- Aftercare: Once rehab is completed, a patient may enter into an aftercare program, which refers to any type of ongoing or follow-up care (e.g., sober living).
Does Aetna in TX Cover Mental Health & Dual Diagnosis Treatment?
Under the ACA’s mandate, your Aetna Texas plan should provide coverage in some capacity for mental health and dual diagnosis treatment. Though it may sound like a complicated type of treatment, dual diagnosis treatment refers to treating a patient with a diagnosis of two or more co-occurring disorders.13 Essentially, with dual diagnosis treatment, this means that each disorder is addressed and treated concurrently.
For those with a co-occurring disorder—those who experience a mental health disorder (e.g., anxiety, depression, post-traumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, or trauma) and SUD simultaneously—treating both conditions at once is generally recommended.13 This is because researchers estimate that 50% of those who experience an SUD in their lifetime will also experience a mental health disorder and vice versa.13 Treating only one diagnosis but not the other may lead to relapse or further issues down the road.
Which Rehab Centers in Texas Take Aetna Insurance?
AAC has a variety of rehab facilities across the country that provide high-quality drug and alcohol addiction treatment. What’s more, AAC works with a variety of insurers, including Aetna, which means that certain facilities may be in-network under your Aetna Texas health plan. As always, please call the number on the back of your insurance card or call the confidential AAC helpline and speak to an admissions navigator to check whether your plan is accepted at any of the following AAC centers:
- AdCare Rhode Island: The AAC Rhode Island facility comprises four campuses, three of which offer outpatient services (Warwick, Greenville, and South Kingstown) and one of which offers inpatient services (North Kingstown). The North Kingstown location is set on 30 acres of serene, wooded land, and is one of two nonhospital treatment facilities to provide medical detox services. Across all the locations, patients will be looked after by board-certified physicians, nurses and nurse practitioners, certified counselors and therapists, case managers, therapists, yoga instructors, and recreational therapists.
- Greenhouse Treatment Center: The Greenhouse Treatment Center, located in Dallas, TX, provides medical detox, residential, outpatient and aftercare rehab services. The treatment center boasts 130 beds and is housed within a former spa. The facility also offers spa services, an indoor and outdoor pool, hot tub, and fitness center.
- Laguna Treatment Hospital: Located near Hollywood (Los Angeles) in California, the Laguna Treatment Hospital is one of the few in California that provides medical detox services. What’s more, the 93-bed residential treatment facility is set among the San Joaquin Hills, which provides a serene setting for patients on the road to recovery.
- Oxford Treatment Center: Located in Mississippi, alongside a remote lake, the Etta-based facility provides medical detox and residential treatment services. Another facility in Oxford, MS, which is facilitated by AAC, provides PHP, IOP, outpatient, and aftercare planning programs.
- Recovery First Treatment Center: This Florida facility, located in Hollywood, FL, provides IOP and aftercare planning services. It’s located about 10 miles from the beach, providing a serene setting for those in recovery.
- River Oaks Treatment Center: This facility is another one of AAC’s Florida locations. This Riverview location offers retreat-like accommodations, where patients can take a holistic approach to their recovery and receive three levels of residential and outpatient programs, as well as on-site medical detox.
- Sunrise House Treatment Center: This New Jersey location is set in the mountains on a 22-acre campus. Here, patients can undergo medical detox, residential, IOP, and outpatient programs.
There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs.
Rehab Centers in Texas That Take Insurance
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- United States Census Bureau. (2021). Quick facts, Texas.
- Texas Realtors. (2021). 2021 Texas relocation report.
- United States Census Bureau. (2021). City and town population totals: 2010-2019.
- Substance Abuse and Mental Health Services Administration. (n.d.). TEXAS – national survey on drug use and health: 2018-2019 state-specific tables.
- Texas Targeted Opioid Response. (n.d.). Understanding the opioid crisis in Texas.
- Aetna. (n.d.). Aetna facts.
- Aetna. (n.d.). Our history.
- Healthcare.gov. (n.d.). Essential health benefits.
- Healthcare.gov. (n.d.). Mental health & substance abuse coverage.
- Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
- Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment?
- Medicaid.gov. (2017). Overview of substance use disorder (SUD) care clinical guidelines: a resource for states developing SUD delivery system reforms.
- Substance Abuse and Mental Health Services Administration. (2020). Mental health and substance use disorders.