Aetna Insurance Coverage for Drug Rehab in Las Vegas, NV

Aetna is a health insurance company that provides a variety of coverage (healthcare, pharmacy, and dental insurance) to people across the country.¹ Aetna helps approximately 39 million people navigate their health care.¹ What’s more, there are a wide variety of Aetna health plans that cover all of these people, ranging from private plans, employer-sponsored plans, Medicare, and Medicaid plans.^{1, 2} Many of these plans may be able to help you cover some or all of the cost of treatment in Nevada. While coverage and acceptance will depend on your plan and various other factors,  53 of the 66 Nevada facilities accepted Medicaid coverage, 53 accepted private insurance, and 47 accepted Medicare.^{3, Pg 117, 119}

What this means is that you may be able to use your Aetna health insurance plan at rehabs in Las Vegas, Nevada, to obtain partially or fully covered addiction treatment. Be sure to verify your plan coverage before seeking treatment whenever possible.

Does Aetna Cover Drug Rehab in Las Vegas, Nevada?

The Affordable Care Act (ACA) requires almost all health plans, including Aetna plans, to provide some level of coverage for what are deemed “essential health benefits.”⁴ Mental and behavioral health services are considered to be EHBs, which means that the following services must be covered in some capacity under your plan:⁴

• Treatment for substance use disorders (including rehab).
• Inpatient mental and behavioral health care services.
• Behavioral health services treatment.

Despite coverage being mandated in some capacity, your coverage may vary. Where you attend treatment, the intensity of your treatment, how long the treatment lasts, and what insurance plan you have will all effect whether Aetna covers rehab in Nevada. It’s important to reach out to your Aetna representative to determine the extent of your coverage before committing to treatment.

How To Check Aetna Rehab Coverage in Las Vegas

It’s recommended that you check your Aetna rehab coverage before seeking care whenever you can. This can help you avoid surprise medical bills or high out-of-pocket costs. There are a variety of ways you can go about checking your coverage. First, you can call the number on the back of your Aetna card to speak to a customer service representative who can help you verify your benefits. You may also be able to log in to your web portal and view your summary of benefits and coverage. Or, if you’d rather work with the rehab center directly, you can call and ask a representative to help you check your benefits and coverage. When you’re checking your coverage, be sure to ask whether the desired facility is an in-network provider under your Aetna plan to ensure the highest level of coverage possible and to avoid high medical costs.

 How To Use Aetna Insurance for Rehab in Las Vegas

Using your Aetna insurance plan for rehab in Nevada may be a cost-effective way for you to receive the care that you need. Most rehabs, upon admission, will ask for your insurance information. In most cases, they will then coordinate coverage and billing directly with the insurance company. Be sure to ask for itemized bills from the rehab center to compare the bills you receive from insurance in the mail. Most rehabs will have an insurance coordinator on their team to help you if you have questions. ⁷

Please keep in mind that just because you’re using insurance doesn’t mean you won’t have to pay anything. In many cases, you’ll have to pay your plan deductible before coverage will kick in, and you may owe other costs like copays or coinsurance. Plus, depending on your plan, you may need to obtain preauthorization for rehab (pre-approval from insurance) to avoid high care costs. Finally, whether your rehab center is an in-network provider will affect your care costs. Whenever possible, choose in-network providers to keep care costs as low as possible.⁷

Do Treatment Facilities in Nevada Need To Be In-Network?

While you don’t necessarily need to stay in-network with Aetna providers to receive rehab care in Las Vegas, receiving care at out-of-network facilities may have significantly less or even no coverage. In short, a network is a set of providers that have a contract with Aetna to provide their services at a certain rate, which is much lower than the out-of-pocket rate they may charge or what they may charge non-Aetna users. ⁸

If you go to someone out-of-network, they don’t have these contracts, which means they can charge whatever they want. What’s more, most Aetna plans don’t offer coverage for out-of-network providers (unless it’s an emergency), which may translate to high care costs for you. ⁸

Types of Aetna Insurance Plans

Aetna is a nationwide provider of health insurance plans and offers plans at many different levels. As a result, coverage for rehab in Nevada may vary greatly between plans. In addition to offering Medicare and Medicaid plans, Aetna also offers a few different types of managed care organization (MCO) plans, which include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and high deductible health plans (HDHPs).⁹ Click here to learn more about each of these types of Aetna plans.

Types of Treatment Covered by Aetna

There are many different types of treatment for addiction that may be covered by your Aetna plan. While coverage and need will vary, there are a few common types of treatment you may encounter in rehab:

• Medical Detox: Often regarded as the first step in rehab, medical detox is the process of ridding the body of substances (e.g., drugs or alcohol). Detox will typically be accompanied by withdrawal symptoms ranging from mild to severe and possibly life-threatening. As a result, many may seek medical detox in order to help manage the withdrawal symptoms.⁵
• Inpatient and residential treatment: With this type of treatment, the patient stays at a hospital or facility and receives care 24/7. Inpatient treatment is generally more intensive and can last a few days to a few weeks. Residential treatment tends to last longer, ranging anywhere from a few months to a year.⁶
• Outpatient care: Outpatient rehab is a program type that allows patients to live at home and attend school or work while still receiving addiction care. Any care that doesn’t involve an overnight stay is often considered to be outpatient care.⁶
• Aftercare: As the name suggests, aftercare involves treatment intended to help the patient stay the course and clean. In some cases, it may involve the patient living at a substance-free sober living facility.⁶

Whether your Aetna plan covers these treatments, and the extent to which they may be covered, will depend on your chosen plan, location, and cost-sharing requirements. Call the number on the back of your insurance card to learn more about your coverage.

Finding Las Vegas Rehab Centers That Accept Aetna Insurance

Finding a Nevada rehab that accepts Aetna insurance can be difficult, but there are ways to ease the process. One of your first stops for guidance may be your doctor. Medical professionals can help determine your treatment needs, and may be able to refer you to in-network facilities.

Another way that you can find a Nevada rehab that accepts Aetna plans is to call your Aetna insurance company at the number on the back of your card. You can also log in to your Aetna member portal online. You should be able to have customer service help you locate a covered facility near you. You may also be able to call the local facilities near you and ask staff members whether they take Aetna insurance.

You may also benefit from reaching out to an online directory or a helpline. These online resources can help answer questions and connect you with Nevada or Las Vegas rehabs. American Addiction Centers operates a 24/7 addiction helpline that can connect you with individuals that can answer questions about paying for rehab with Aetna insurance. AAC also operates Desert Hope, a Las Vegas rehab that works with Aetna insurance plans.