Aetna Drug and Alcohol Rehab FAQs
How Does Aetna Decide My Claim?
Aetna makes decisions about their rehab coverage based on your health plan. They comply with all Federal guidelines, and each decision is typically a case by case basis. Aetna will review many of the services you use based upon national guidelines and then determine if it is covered. Services can include things like drug rehab, alcohol rehab, blood-tests, surgeries, or hospital stays.
If Aetna does not consider the rehab service to be needed, they will not pay for it.
If they will not pay, your claim is denied and they will send you a notice. You DO have the right to appeal. If you use up all your appeals, it is then possible to have an independent doctor review your denied claim in a process called an “external review.”
Does Aetna Cover Rehab?
Quick answer – yes, Aetna does cover rehab. The extent of it varies on a case by case basis though. They sometimes cover partial treatment. In other cases, they cover full treatment and 100% of the cost.
Most Aetna plans have coverage for the following:
|Intensive Outpatient Programs (IOP)|
|Mental Health Programs|
|Behavioral Health Programs|
To manage your Aetna Health Plan, or learn more about it, you can visit Aetna’s Website and use their online tool.
Verify Benefits / 100% Confidential
How Long Will Aetna Cover My Addiction Treatment?
Aetna does not set a specific limit on the number of days for addiction treatment. They base their alcohol and drug rehab coverage on a case-by-case basis.
Out-of-Network providers may incur additional costs.
Contact Aetna to confirm your level of coverage, if any, for out-of-network providers.
Does Aetna Allow for Treatment at Luxury Rehab Facilities?
Aetna has insurance programs that allow for certain, luxury rehabilitation centers. Some examples where they are located are South Dakota, California and Texas. Luxury drug rehabs are often where wealthy people and celebrities will go to detox. Luxury Rehabs are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges.
Inpatient Addiction Treatment vs. Outpatient Treatment
This is one of the biggest choices a patient or their family will make when looking for addiction help. Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.
An outpatient facility is usually a local option. They give you the chance to meet with medical professionals like doctors, alcohol and drug counselors or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards.
Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program.
Do I Need Insurance to go to Rehab?
You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.
Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.
Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.
What Else Does Aetna Rehab Provide?
Aetna offers members 24/7 support, a variety of plans for any phase of your life, a lot of online tools, the ability to manage and adjust your plan, more.
Anything that you say to them is kept confidential, so you don’t have to worry about everyone knowing you may have trouble with alcohol or drugs.
Get Approved for Aetna Rehab Coverage
Verifying what insurance will cover can be a time-consuming process.
This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.
NOTICE: Step One Rehab works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID ready to confirm your particular coverage or submit our free verification form to verify benefits.
Give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494