Using Aetna Health Insurance for Addiction Treatment

Nearly 39 million people rely on Aetna — one of the nation’s leading health insurance companies— to provide them with coverage for their healthcare needs.^1,2 Acquired by CVS Health in 2018, Aetna offers a range of health plans and services including substance use disorder treatment.^2,3 Read on to learn more about how to use your Aetna coverage to pay for rehab.

Does Aetna Cover Substance Abuse Treatment and Detox?

Aetna plans will provide some degree of coverage for substance abuse treatment.⁴ Each Aetna plan will vary in terms of the extent of its coverage, but the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act ensures that plans that cover substance abuse treatment services do so at similar rates as they cover surgical and medical procedures.⁵

Aetna also offers 24/7 support to those looking for detox and substance abuse treatment.⁴ If you’re struggling, you can call the number on the back of your insurance card any time of day to speak with an Aetna customer service agent who can assign you to an Aetna Care Advocate.⁴

Your Care Advocate will walk you through the process, providing support along the way. They can answer any questions you have about substance use disorder treatment and detox, and help you find a rehab center that is within the Aetna network, such as Laguna Treatment Hospital. They will also talk with you about what your insurance plan covers in regards to treatment, what you can expect while in treatment, and supports that are available to you once you complete treatment.⁴

You can get help understanding your coverage by filling out the . Submit your details and we will reach out to you shortly with more information about your insurance coverage for addiction treatment.

What Types of Treatment Does Aetna Cover?

Aetna insurance may cover a number of different substance use disorder treatments, including:⁶

• Inpatient or outpatient detoxification to help you overcome physical drug or alcohol dependence.
• Inpatient or residential rehabilitation for intensive support and structure in a safe environment.
• Partial hospitalization programs (PHPs) where you attend outpatient treatment for most days of the week, many hours per day.
• Intensive outpatient programs (IOPs), are similar to PHPs but require fewer days of treatment per week and fewer treatment hours per day.

Each Aetna plan may differ when it comes to what services are covered, but the Affordable Care Act ensures that substance use disorder treatments are at least partially covered.⁵ Aetna will cover treatment that they deem medically necessary for the treatment of your substance use disorder or any other conditions.⁶

How Do I Use Aetna Insurance to Pay for Rehab?

Laguna Treatment Hospital in in-network Aetna and can provide individualized, evidence-based addiction treatment. Laguna Treatment Hospital offers hospital-based medical detoxification as well as inpatient and residential rehabilitation in a beautiful Southern California rehab facility. To learn more about how to use your coverage at Laguna Treatment Hospital or one of our sister treatment facilities, call to speak to an admissions navigator at .

Different types of Aetna plans have different rules about how to enroll in a substance abuse treatment program. Some plans require members to have their primary care provider refer them to specialty treatment, including detox or rehab.  Other plans allow you to seek out your own addiction treatment provider without a referral.⁷

If you’re unsure whether you need a referral before contacting an addiction treatment facility, you can call the number on your member ID card and ask.

You may need precertification from Aetna before beginning treatment for specialty services such as inpatient medical detox or inpatient rehab. Your treatment provider should request precertification from Aetna on your behalf.⁸

How Much Does Rehab Cost with Aetna Insurance Coverage?

Aetna will provide at least some coverage for addiction treatment, but you will likely have some out-of-pocket expenses with your insurance policy. Out-of-pocket expenses are those that you must cover yourself without the help of insurance coverage. These costs will vary. You may pay more for inpatient services, for example, than you would for outpatient therapy. Your costs will also differ based on the specific plan you have and the coverage details.

If you are uninsured, underinsured or are worried about out-of-pocket costs, staff at Laguna Treatment Hospital will work with you to explore financing, loans, and other payment options.

Benefits of Using Aetna Insurance for Addiction Treatment

Many people living in Orange County, California struggle with substance abuse. The county sees some 5,500 hospitalizations and nearly 700 deaths each year related to drugs and alcohol.^.9

Nearly 8% of Californians have a substance use disorder, but only 10% of them receive any kind of treatment.¹⁰ When you have Aetna insurance, you don’t have to fall into this unfortunate statistic. You can use your benefits to get the help you need. To begin the process now, simply input some basic details into the form below, including your name and insurance information and we’ll verify your benefits and reach out to you within minutes.