Aetna Insurance Coverage
✔ PHP · ✔ IOP · ✔ Outpatient · ✔ Virtual IOP
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Insurance Coverage
Using Your Aetna Plan for Addiction Treatment
Aetna was founded in 1850 and has become the third-largest health insurance provider. The national insurer was acquired by CVS in 2018, expanding treatment options within the drugstore for those insured through Aetna. Aetna rehab coverage helps reduce the cost of addiction treatment in various settings.
What You Need to Know
Understanding Your Aetna Coverage
Aetna Substance Abuse Treatment Options
Aetna is one of the leading national insurance providers to cover addiction rehab specifically. Aetna substance abuse treatment is included with both their HMO and PPO plans. You can expect to see the following types of addiction treatment covered to some extent:
Aetna Substance Abuse Guidelines
Aetna’s substance abuse guidelines follow the American Society of Addiction Medicine’s (ASAM) criteria for diagnosing alcohol and substance use disorders. During your initial discussion with an addiction specialist, you can expect questions designed to determine the appropriate level of care, such as:
Addictions Covered Under Aetna Insurance Policies
Under the Affordable Care Act, Aetna is mandated to cover behavioral and substance abuse treatments. While each patient’s policy is unique, Aetna typically provides coverage for the following addictions:
Aetna Mental Health and Dual Diagnosis Coverage
The medical community recognizes that long-term sobriety often requires treating both addiction and mental illness simultaneously. Aetna may cover evidence-based mental health services and dual diagnosis treatments, including:
Aetna Medication-Assisted Treatment (MAT)
For many clients, especially those struggling with opioid addiction, lasting recovery is found through a combination of prescription medications and behavioral therapy. Your specific plan determines the exact medications Aetna covers. If you know your plan name and year, you can search for particular medication coverage directly on the Aetna website.
Aetna Coverage Levels: Paying for Rehab
While substance abuse treatment is an essential service, the level of coverage differs by plan. Typically, you can elect a higher coverage plan at an increased monthly cost or select a lower coverage plan with a reduced monthly premium but higher out-of-pocket costs.
Coverage Details
More About Aetna and Addiction Treatment
Every plan is different. Tap a topic to learn more, or call us and we will check your specific benefits.
Aetna Substance Abuse Treatment Options
- Medical Detoxification
- Inpatient/Residential Rehab
- Outpatient Rehab (PHP, IOP, and OP)
- Prescription Medications
- Behavioral Therapy
Aetna Substance Abuse Guidelines
- How long have you been using the substance?
- When was the last time you drank or used drugs?
- Have you sought treatment previously?
- Are you looking for long-term sobriety and recovery?
Addictions Covered Under Aetna Insurance Policies
- Alcohol Abuse
- Prescription Medication Abuse
- Cocaine Addiction
- Methamphetamine Addiction
- Opiate Addiction
Aetna Mental Health and Dual Diagnosis Coverage
- Cognitive Behavioral Therapy (CBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Individual and Group Counseling
Aetna Coverage Levels: Paying for Rehab
What length of treatment does Aetna cover?
The length of treatment depends on your personalized recovery plan and the clinical setting. Approved Aetna residential treatment centers typically cover between 1–6 weeks of treatment, while approved Aetna outpatient treatment centers generally cover 4–12 weeks.
Simple & Confidential
How We Verify Your Aetna Benefits
1. Share Your Plan Details
Call us or send the secure form with your member ID. It only takes a few minutes.
2. We Contact Aetna
Our admissions team checks your benefits for PHP, IOP, outpatient, and virtual care.
3. Get a Clear Answer
We walk you through what is covered, any out-of-pocket costs, and your next steps.
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