aetna insurance

Does Your Policy Cover Rehab

Insurance is constantly changing, it feels difficult to always have a grasp on what your insurance does, and does not provide. Furthermore, when you are struggling with addiction, money should be the furthest thing from your mind. If you are here it most likely means you or a loved one is struggling with addiction and wants to begin the recovery journey. We are glad you’re here. We at Northbound Treatment feel that finding the resources to cover your treatment should be easy as you begin this journey, so we have a team that will help you determine what your insurance covers. Here particularly, we are discussing Aetna insurance.

Aetna Insurance for Drug and Alcohol Treatment

Aetna does provide coverage for treatment involving both drug and alcohol treatment. Aetna covers inpatient, residential, and detox in most cases. All of their facilities are taken of the utmost care, pre-screened, and are equipped to follow up with patients.


Aetna services almost 50 million people and is one of the nation’s largest insurance companies. They are available in all 50 states, has 34,000 employees, over 470,000 doctors, and its self-stated goal is to create a better health-care system which simple for patients, and transparent in motives.

Helping You Navigate Your Policy

Aetna has a very helpful navigator which is able to show you what you are covered for based on your plan. Dissimilar to other insurance companies; Aetna determines needs on an individual basis. Most inpatient, detox, and residential treatments are included, however, the length of stay varies from patient to patient. Aetna offers open-access plans, copay only plans, and high-deductible plans. Open-access plans allow you to choose your doctors; and they even have a section where you can find a doctor. They do not require a referral.. 

Addiction Prevention Tools With Your Policy

Aetna is committed to patient follow-up with their “Continuing Care” programs. This means that they value the ongoing community. They will host events to continue to care for “alumni” who have moved on in the recovery process. Sometimes this is a social event to celebrate a big step taken. The results from programs like these have momentous effects since they keep alumni connected. Along with this, Aetna has a customer service center that provides members with care and service all hours of the day.

Policy Coverage for Substance Abuse with Aetna

If you are wondering if Aetna covers substance abuse as well, you will be pleased to know that they do. Aetna partners with the CRC health group to cover opioid treatment as well. Policy plans mostly cover inpatient, outpatient, detox, and residential; however, it is important to know what your specific policy covers. It can sometimes cover everything, or only partially cover it based on your specific policy, plan, and location.

How Policies Work For Treatment Centers

As previously stated, if you have a policy with Aetna, you are likely to have access to the following.

  • Detoxification
  • Inpatient/residential rehabilitation
  • Partial hospital treatment
  • Intensive outpatient treatment
  • Continuing care programs (“alumni” programs)

Aetna determines need on an individual basis, so while you have access to all of these, your particular length of stay will vary based on your plan. This is why it is important to contact us to determine what you qualify for or head over to Aetna’s navigator which will help you know your coverage.

Does it Need to be In-Network?

Sometimes people want to opt for out-of-network treatment. While Aetna allows for this, the patient should be aware that out-of-network treatment can be significantly more expensive, and will often require you to may mostly, or completely out of pocket. Along with this, Aetna prides itself on the screening, care, and follow up of its facilities. Out-of-network treatment centers may not have been screened in the same way.

About Coverage for Detoxification

Many individuals will go through a medical detox as they begin the recovery process. Detox is the process of cleansing your body from harmful substances. Some individuals choose to do detox on their own, this is not recommended. The reason being is that detox is a very unpleasant experience, and depending on the severity of the addiction/substance; it can be a harmful process. That is why you should seek a medical detox where professionals are able to supervise you, focus on your needs, and help ease the process along. Aetna does provide coverage for medical detox, however, the length patients are allowed to stay in the facility varies patient to patient.

Covers Inpatient Insurance

For inpatient services, many of Aetna’s plans have 0 percent coinsurance. This is insurance that kicks in once you pay your full deductible. In regards to out-of-network, as previously stated if the patient wished to go out of network, it will oftentimes be much more expensive and sometimes be completely out of pocket. Aetna also covers residential treatment.

Costs and Services at Inpatient

Premium – This is a monthly payment made to a health insurance company by the policyholder to maintain coverage. Many times, individuals are fortunate enough to have employer-provided insurance, meaning that the company picks up all or part of the monthly premium cost.

Coinsurance – Coinsurance, like a copayment, is a form of cost-sharing for services involving healthcare and prescription medications. It is never a flat fee and is always a percentage of the cost for a health service or Rx paid by a member once they have reached their deductible.

Deductible – This is the amount you will need to pay before your health insurance starts to cover a larger portion of your bills. As an example, if your deductible is $1,000, you must pay $1,000 for your own care “out-of-pocket” before the insurance kicks in and pays a higher percentage of the costs- the deductible resets yearly.

Out-of-pocket Maximum – This is the most amount of money you may have to pay in one year out of your own pocket for healthcare services you receive before your coinsurance covers 100 percent of the bill

Coverage for Mental Health Treatment

For those who are struggling with mental illness, you are not alone. Ending the stigma is so important to us. Especially since mental illness and substance abuse so often intertwine. This is what is called a co-occurring disorder or a dual diagnosis. At Aetna, you will also be able to receive coverage for your mental health treatment. This is why it is imperative that you seek treatment for both substance abuse and mental health. 

Insurance providers are required to provide aid to both physical and mental health, therefore, policies will cover mental illness in the same way that they would have covered physical illnesses. This is why Aetna wants to help you know that is and isn’t covered. Treating the mind and the body is important to have a healthy recovery. The following are examples of mental illness.

  • Depression
  • Anxiety
  • Eating Disorders
  • Bipolar Disorders
  • Post-Traumatic Stress Disorders

Aetna does cover treatment for mental illness as well. With Aetna, you are given access to psychiatrists, psychologists, counselors, therapists, social workers, psychiatric nurse practitioners, and primary care doctors. They share the belief that substance abuse and mental illness go hand in hand, so treatment should do likewise.

Helping You Understand Your Benefits

Here are some other benefits to being a BCBS policyholder and enlisting the help of Northbound Addiction Treatment Services:

· We’ll thoroughly review your Aetna health insurance plan.

· We’ll help determine if you are covered for substance abuse treatment.

· We’ll help determine what kind of treatment and how much is covered.

· Aetna health insurance is accepted by almost every treatment center in the U.S., so we’ll identify which ones will work best with your policy.

The Northbound Addiction Treatment Services Promise

We won’t recommend a drug and alcohol rehab facility unless it meets or exceeds our own standards of what comprises an effective, comprehensive and client-centered program. At Northbound Addiction Treatment Services, we’ve been in your shoes and understand what you’re going through. Sometimes what you think you need for your recovery isn’t necessarily what’s going to work best.

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