Does Aetna covers Opioid rehab or detox centers?

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If you have an Aetna insurance plan and are struggling with opioid addiction, you may be wondering whether you can use your Aetna coverage to help pay for rehab. Because Aetna is a large company that provides health insurance plans in various markets, including the ACA individual and family market, employer-sponsored health plan market, private market, student health plan market, Medicare, and international health plans, there is a wide variety of plans that may be offered.1 “Explore plans tab”

As such, it’s impossible to say exactly what may be covered under your specific plan, as no two plans are created equal. The best way to find out whether your plan covers opioid rehab is to call the number on the back of your Aetna insurance card and speak with a plan representative.

What Does Aetna Insurance Cover for Opioid Treatment?

Aetna is a large health insurance company providing various healthcare solutions, including medical, dental, pharmacy, and behavioral health benefits.2, para 2 Aetna plans are available in all 50 states, as well as across the globe, serving a total of 39 million people.3

Given the sheer number of customers and many different markets in which plans are available, there are many different plans and coverages afforded to the millions of members. As every plan is different, it’s best practice to call the number on the back of your insurance card to find out what may be covered under your plan in regard to opioid treatment.

Be sure to ask whether any of the following types of opioid treatment methods are covered under your Aetna plan:

  • Screenings, Many providers will recommend patients undergo screenings or interventions prior to being admitted to a program so that they can properly assess your opioid usage or misuse and determine whether you have an opioid addiction.4
  • Detox. A common component of treatment involves ridding your body of substances (i.e., opioids) in order to begin your path to sobriety, which is known as detoxification. Many providers do detox in a medically supervised setting to help manage the side effects of withdrawal, which can become life-threatening if not properly managed.5, para 2
  • Inpatient. In an inpatient program, patients live at the facility for the duration of their rehab stay, which could range from days to months, so that they can receive round-the-clock medically supervised care.6, (How are behavioral therapies used to treat drug addiction?)
  • Outpatient. In an outpatient program, patients travel to a facility 1 or 2 times per week to receive the care that they need. However, the main difference between inpatient and outpatient care is that no overnight stay is associated with outpatient programs.6, (How are behavioral therapies used to treat drug addiction?)
  • Behavioral therapies. At any point in your treatment, a provider may use behavioral therapies to help you stop or abstain from using opioids, as well as modify your attitudes, learn life skills, and find ways to cope with daily stressors without using opioids or other substances.7
  • Treatment for co-occurring disorders. If you have both a mental illness and substance use disorder, it’s referred to as a co-occurring disorder.8 Because mental illness and substance use disorder are said to be interconnected and influential toward the other, many mental health experts recommend treating each condition simultaneously while a patient is in rehab.8 “What should I do?”

Depending on your unique situation and your path toward recovery from opioid addiction, your mental health provider may recommend any or all of these treatment methods. However, this does not mean that they will absolutely be covered under your Aetna insurance. The best way to find out what may be covered under your plan is to call the number on the back of your insurance card.

What Aetna does not cover for Opioid Treatment?

Just like there are opioid treatments that your plan will cover, there may also be treatment methods that your plan will not cover. Every plan is different and varies in coverage details, so it’s best practice to verify your benefits with the rehab center directly or by calling and speaking to an Aetna plan representative. Here is a list of elements that may or not be covered under your plan:

  • Non-medical amenities
  • Holistic care services
  • Recreation programs
  • Food delivery
  • Private treatment services
  • Alternative therapies

How Much Does Opioid Rehab Cost?

There are a variety of factors that play a role in determining how much you may have to pay for opioid rehab. Depending on your Aetna health insurance plan, the extent of your coverage may be subject to the plan you have and the base plan details, as well as where you seek care, and that will have major effects on your overall cost of care. Additionally, depending on your plan, you may owe costs before coverage kicks in, which is known as your deductible, and you may also be responsible for other out-of-pocket costs such as a copay or coinsurance.

Other factors that can affect the overall costs of your opioid rehab stay include the type of treatment you need, how long your treatment lasts, amenities offered by your rehab facility, and whether your facility is standard or luxury. You can ask the rehab center you’re seeking to use whether they can give you an estimate of the cost of your treatment. Being a wise healthcare consumer and keeping your costs as low as possible involves being proactive and asking for costs ahead of time whenever possible.

Cost of Inpatient Opioid Rehab

The cost of inpatient opioid rehab will vary greatly depending on your Aetna healthcare plan. Whether the facility is within your health plan’s network and how long your inpatient stay is will also affect your overall costs of care.

While these factors are the primary drivers behind the cost of care, it’s important to note that, due to the more intensive nature of inpatient care and the round-the-clock care and lodging, costs for inpatient care may be higher than the costs for outpatient care. Be sure to work with an Aetna plan representative to learn more about coverage details for inpatient opioid rehab.

Cost of Outpatient Opioid Rehab

The costs of outpatient opioid rehab may have a wide range, as someone who only attends 1 session every other week may have lower costs than someone who attends 2 sessions a week. Other factors that contribute to the cost of outpatient rehab for opioid addiction include the specific plan you have and whether the facility or provider you see is an in-network provider under your Aetna health plan.

To find out whether a provider is within your plan’s network, you can call the number on the back of your plan’s card.

Cost of Opioid Partial Hospitalization Programs (PHP)

PHPs for opioid addiction combine elements of inpatient and outpatient care. How long you’re in a PHP, how long treatment lasts each day, and the frequency you attend the PHP will influence the overall costs of care. Additionally, whether your Aetna plan provides coverage for PHPs and your plan design will determine your out-of-pocket costs for care. You can work with the rehab center directly to get a quote for the cost of treatment.

Cost of Medication-Assisted Treatment (MAT)

The cost of MAT will depend on the types of prescription drugs that may be covered under your health plan. MAT is a type of treatment method in which a healthcare provider prescribes medications designed to help reduce or stop your substance use while helping you manage potential side effects of withdrawal, and it’s commonly used with opioid addiction.10 Calling the number on the back of your Aetna insurance card will put you in touch with a plan representative who can help you find out more about your prescription drug coverage.

Opioid Rehab vs. the Cost of Opioid Addiction

Opioid addiction in the United States is an epidemic. On an annual basis, according to the Centers for Disease Control and Prevention, untreated opioid addiction costs the country $78 billion.11 Even though this is already a staggering amount, untreated opioid addiction more alarmingly is correlated with a higher prevalence of incarceration, lost income, and health problems.11

So, although the upfront cost of treatment for opioid addiction may seem steep, whatever it may be, it is less expensive than taking the risk of health problems, incarceration, or losing a job. Choosing rehab and the path to recovery is always the wise decision, and pushing treatment down the road may become a more expensive choice than getting treatment today.

What Length of Opioid Rehab Does Aetna Cover?

When your mental healthcare provider puts together your treatment plan, they will recommend a length of time you should remain in treatment. While it is different for everyone, most providers agree that longer treatment times are generally considered the most effective. Specifically, treatment is suggested to last at least 90 days to improve overall outcomes and stop or reduce drug use.12, bullet 5 Please work with your personal doctor to determine how long you may need to be in treatment for your opioid addiction.

Regardless of how long it’s medically suggested that you stay in rehab, it’s important to note that your health plan through Aetna may not align in coverage length. Looking up the plan information on your insurance card or speaking with an Aetna plan representative to understand how long your plan may cover rehab can help you plan for the expenses that may be associated with opioid rehab. Call the number on the back of your plan today to begin learning more about your plan’s coverage details.

Choosing between Aetna Inpatient vs. Outpatient Opioid Rehab Centers

You may or may not have the choice between inpatient and outpatient opioid rehab centers. Making this choice is something that should be done carefully and with the assistance of your mental health care provider. When discussing your options for opioid rehab, you should ask your provider about the quality of care, level and prevalence of support groups, overall environment, and accountability expected at both inpatient and outpatient centers. From there, you and your provider can work together to figure out what is the best fit for you.

How to Use Aetna Insurance for Opioid Rehab?

Using your Aetna insurance plan for opioid rehab coverage generally begins by seeing a doctor who can help screen you for opioid addiction. From there, they can refer you to an appropriate opioid rehab center, which could be inpatient or outpatient.

Then, you or the rehab center can work with your Aetna health plan to determine coverage levels and any applicable out-of-pocket costs. If the rehab center accepts your plan, you generally do not have to do anything else besides make any applicable copayments and pay your bills as they are delivered to you.

How to Find Opioid Rehabs That Accept Aetna Insurance

American Addiction Centers, a leader in addiction care and treatment, is here to help you if you’re ready to overcome your opioid addiction. By calling our confidential helpline, you can speak with a trained professional who can verify your benefits while you’re on the phone. They can also check whether your Aetna plan is accepted at any of the top-notch addiction treatment centers across the country or help you locate a covered facility near you. Don’t wait any longer to get started on your path to recovery. Call us today.

What Rehab Centers Take Aetna Insurance?

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have an Aetna insurance plan, the following AAC facilities accept Aetna for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and telehealth.
  • Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with individualized treatment programs.
  • Recovery First Treatment Center: Located in Hollywood, Florida, Recovery First treats substance use disorders by combining evidence-based therapeutic modalities with top-level care. Recovery First provides a personalized continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth.
  • River Oaks Treatment Center: Located in Riverview, Florida, River Oaks treats substance use disorders through combining evidence-based therapies with world-class amenities. Provided care includes detox, residential treatment, behavioral disorder treatment, dual-diagnosis treatment, outpatient services, and telehealth, all with individualized treatment programs.
  • Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various rehab treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Aetna insurance.

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