Aetna Health Insurance Coverage for Addiction Treatment

Detox can last up to two weeks, depending on the substance used and other factors. Aetna insurance does cover medical detox, but members may need to get pre-certification or authorization prior to starting the program. Most residential treatment plans last four to 12 weeks before stepping down to an outpatient program.

Alcohol use disorder

Please call us or see your Evidence of Coverage for more information, including the cost share for out‐of‐network services. Aetna is an insurance company that provides several products and services, including health insurance. This page will cover some necessary information for individuals looking to use Aetna health insurance to cover drug and alcohol rehab services. All Aetna insurance plans are required by law to cover some level of addiction treatment. There are rehab centers across the US that are in-network with Aetna health insurance, so finding a suitable placement close to home should be possible.

1. A PPO plan with an extended service area (ESA) gives you the flexibility to see any provider, in or out of network, at the same cost.
2. All Aetna insurance plans are required by law to cover some level of addiction treatment.
3. Listed below are some of the addictions that Aetna is required by law to cover under its insurance plans.
4. Once your doctor sends a request for prior authorization, Aetna reviews the request.
5. The extent of coverage for a rehab program will depend on the state, the healthcare plan, and whether the facility is considered in-network or out-of-network.

Does Aetna Cover Rehab?

Once your doctor sends a request for prior authorization, Aetna reviews the request. During our review, we look at the most recent and highest quality medical research and guidelines. We update your care provider throughout the review process to keep them informed on the status, and come to a decision within 14 days. Your doctor can keep you updated on the status of your requested prior authorizations. Point of service (POS) plans will typically require clients to get a referral to see a specialist. POS plans do have higher premiums than HMOs, but they do cover out-of-network doctors.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

I figured this might be the best place to post this since they are the same company. I have recently accepted an offer to work for Aetna on the insurance side. I’ve held off on smoking for a while and don’t mind holding off longer, but would love to celebrate with a nice bowl pack. I have a friend who works at a competing insurance agency; they said the same thing and he’s worked there for over a year without ever getting tested.

It has details about your coverage and how to make the most of your plan. In most cases, the drug does aetna drug test test is a urine test that is done through a private laboratory and paid for by Aetna. Naomi Carr is a qualified mental health nurse with several years of experience working with children and adults in the UK. We want to make sure you can access your benefits even during urgent situations – like a public health emergency or state of disaster. Review your Evidence of Coverage (EOC) to learn about comprehensive plan details, and your rights and responsibilities. We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.

For some services, your PCP is required to obtain prior authorization from Aetna Medicare. Generally, you must get your health care coverage from your primary care physician (PCP). You can also download the Aetna Health mobile app and manage your benefits from your phone, including the option to search for in-network rehab centers near you. Contacting an Aetna representative and asking about which nearby addiction treatment centers accept Aetna insurance is one of the easiest ways to find a facility.

Aetna insurance will cover behavioral therapy as well as medication therapy that can be effective in treating conditions such as depression. Each Aetna plan has its own different rules on whether a referral or prior authorization is needed. To be sure, check Chapters 3 and 4 of your Evidence of Coverage (EOC) to see your plan’s rules for prior authorization. People facing severe addiction will likely need to attend medical detox before they can transition into intensive therapy and counseling for substance abuse. Currently, Aetna is active in all 50 states and has nearly 6,000 medical centers that are classified as in-network.

In addition, Aetna reserves the right to drug test an employee at any time if substance use is suspected or if a workplace accident occurs. If a drug test is required and the result is positive, that can void any worker’s compensation claims and can result in disciplinary action up to and including termination. Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device. The Centers for Medicare & Medicaid Services periodically issues National Coverage Determinations.

Morgan is a mental health counselor who works alongside individuals of all backgrounds struggling with eating disorders. Morgan is freelance mental health and creative writer who regularly contributes to publications including, Psychology Today. If you get routine care from out‐of‐network providers, Medicare and Aetna Medicare won’t be responsible for the costs. Reaching out to the rehab center of your choice with your insurance information in hand can be a quick way to confirm whether Aetna is accepted.