Aetna Insurance 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:

• Medical Detoxification
• Inpatient/Residential Rehab
• Outpatient Rehab (PHP, IOP, and OP)
• Prescription Medications
• Behavioral Therapy

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:

• 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

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:

• Alcohol Abuse
• Prescription Medication Abuse
• Cocaine Addiction
• Methamphetamine Addiction
• Opiate Addiction

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:

• Cognitive Behavioral Therapy (CBT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Individual and Group Counseling

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.

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.