Aetna Insurance: Addiction Treatment Coverage

Aetna Insurance is a top-rated insurance company that provides coverage for health care, including addiction treatment coverage.  Aetna’s licensed clinical staff works with treatment providers through their Aetna 360 Behavioral Health program to secure the high-quality individualized care a client with SUD needs.  

Design for Change Recovery is one of many treatment facilities that are in-network with Aetna Insurance.  To qualify as an in-network treatment provider, we must consistently meet Aetna’s high standards of client care and safety.  As a result, you’ll receive effective, evidence-based treatment that promotes healing and long-term recovery.  

If you have Aetna Insurance and need addiction treatment, here are the answers to some of the questions you may be asking about Aetna’s addiction treatment coverage.

Addiction Treatment Coverage Provided by Aetna

Unlike many insurance providers, Aetna does not have a predetermined limit on addiction treatment.  The amount of coverage you’ll receive is dependent on the type of plan you have, and your unique situation and needs.  

More than 21 million people have some type of addiction, but only 19% of them get the treatment they need, according to SAMHSA’s National Survey on Drug Use and Health (NSDUH).  Aetna strives to make a difference by helping people get affordable treatment through accredited, full continuum-of-care programs like Design for Change Recovery.  

Our program qualifies for in-network status with Aetna because we provide the following evidence-based practices:

Aetna Insurance offers addiction treatment coverage regardless of the level of care needed.  You can learn more about their coverage options by contacting your Aetna Care Advocate.  You may also speak to our insurance specialists at Design for Change to assess your treatment options.

Does Aetna Addiction Treatment Coverage Include Inpatient Rehab?

Aetna Insurance provides addiction treatment coverage for inpatient rehab.  The programs they cover may vary depending on your location and the insurance plan you have.  Some Aetna plans have zero coinsurance requirements for in-network services whereas other plans require a copay per admission for various services.

Depending on your specific needs and the severity of your addiction, an inpatient rehab program may be the best choice.  An inpatient or residential program provides a secure, supportive environment that facilitates healing.  Short-term or long-term inpatient programs at Design for Change last for 30, 60, or 90 days, or longer if needed.  

Inpatient rehab is recommended for people with co-occurring mental health and substance use disorders.  Aetna provides full or partial coverage for this level of treatment, depending on your Aetna plan.  To find out what Aetna covers for inpatient rehab contact us or your Aetna advisor.

Does Aetna Insurance Cover Intensive Outpatient Rehab?

The scope of Aetna’s addiction treatment coverage for outpatient rehab is determined by several factors.  For instance, the specific plan you have and whether your treatment provider is in-network with Aetna will affect the coverage provided.  

Intensive outpatient treatment is a more intensive form of outpatient rehab.  Clients live at home while attending treatment during weekdays or weekends.  At Design for Change Recovery, our IOP includes evidence-based therapies administered by skilled, compassionate professionals.  To find out whether you will have any financial responsibility for IOP, contact Design for Change or your Aetna advisor.

Which Aetna Plans Provide Addiction Treatment Coverage?

Aetna Insurance offers various insurance plans to help people get the level of treatment they need.  

  • Open-Access Plans – Allows you to choose your doctor without a referral and doesn’t require a primary care physician.
  • Copay-Only Plans – Guarantees that your after-deductible costs are copays only with generic drugs and primary care physician visits covered before you meet your deductible.
  • High-Deductible Plans – Provides preventative care services before the deductible has been met.

Aetna also works with Medicaid and Medicare to supplement addiction treatment coverage.

Does Aetna Insurance Cover Suboxone Treatment?

Medication-assisted treatment (MAT) may be fully or partially covered by Aetna. Although Aetna removed brand-name Suboxone from its list of approved medications, it does cover the use of generic Suboxone treatment.  

Suboxone is typically used to treat opioid use disorders (OUDs).  The FDA approves generic Suboxone as an effective medication for MAT.  Aetna will cover MAT medications such as Naloxone, Methadone, and Naltrexone as alternate forms of treatment.

Design for Change offers MAT for people with OUD to help minimize withdrawal symptoms and reduce cravings.  We will verify your insurance to determine the MAT coverage provided by your Aetna plan.  You may also check our FAQ page to learn more about insurance coverage for addiction treatment.

Aetna Addiction Treatment Coverage at Design for Change Recovery

Design for Change Recovery seeks to provide affordable addiction treatment by working in-network with most major insurance providers.  Our full continuum of care will help you gain the confidence, life skills, and motivation to remain substance-free long after treatment.  

Reach out to a treatment advisor by contacting our Lancaster, CA facility by phone, email, or online.  We will check your Aetna Insurance plan and advocate for you to get the highest level of treatment possible.  

Sources:

https://www.aetna.com/individuals-families/using-your-aetna-benefits/network-out-of-network-care.html
abcnews.go.com/ – Nearly 21 Million in US Have Substance Use Disorder: Surgeon General’s Report

aetna.com/ – If You’re Struggling with Drugs or Alcohol, Aetna Can Help

aetna.com/ – Alcohol Screening, Intervention & Referral Program