Aetna Insurance

Aetna Insurance

Aetna Insurance, Overview, Coverage, Addiction Resources, & FAQs

If you have Aetna insurance and are searching for a drug and alcohol treatment facility in NJ that is covered by your plan, We Level Up NJ can help.

Aetna Rehab Insurance for Addiction Treatment

You may be wondering if your Aetna health insurance plan covers substance abuse rehab. The answer is yes. Aetna insurance will cover at least some of your substance abuse recovery treatment. Based on your plan, your substance abuse treatment may be partially or fully covered.

As of 2008, the U.S. government enacted new laws that help you pay for quality rehab treatment at evidence-based treatment centers in New Jersey. The Mental Health Parity and Addiction Equity Act (MHPAEA), is one such law. It balances your mental and behavioral health care benefits with the quality of your medical or surgical health care benefits. In short, if you can expect a certain level of coverage for diabetes, asthma, or heart disease, you also can expect that same coverage for addiction treatment.

As part of the Affordable Care Act (ACA) [1], Aetna insurance provides marketplace insurance plans that cover some or all the costs of a substance abuse rehab program. If you have Aetna health insurance and are searching for a drug and alcohol treatment facility that is covered by your plan, We Level Up NJ is here to help.

Aetna Insurance
With the passing of the Affordable Care Act, all insurance providers were mandated to cover behavioral and substance abuse treatments.

What Is Aetna Rehab Insurance?

Founded in 1853 and active in all 50 states, Aetna’s network coverage includes 1.2 million healthcare professionals, almost 700,000 primary care doctors and specialists, and over 5,700 hospitals. The company has over 46 million members in its different health plans, including regular health insurance, dental insurance, and vision insurance.

Aetna insurance is a national plan with coverage across all 50 U.S. states. This means that you can seek treatment in a different location from where you’re insured. While out-of-state treatment is not ideal for everyone, it can be a chance to break out of the environment leading to addiction and help you reset.

If you have an Aetna insurance policy, you likely have Aetna insurance drug rehab coverage that New Jersey accepts. This is true whether you purchased your plan through your employment, another group program, or the individual market. However, multiple agencies regulate these different types of plans. This leads to greater confusion when trying to find out if your Aetna insurance drug rehab coverage in New Jersey pays for addiction rehab.

Does Aetna insurance cover mental health services?

The short answer is yes. The medical community has come a long way in recognizing that addiction often goes hand-in-hand with mental illness, needing treatment to encourage long-term sobriety. Aetna insurance may cover many popular therapies like Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, and even Biofeedback (depending on the plan).

Aetna Rehab Insurance Coverage For Inpatient Treatment 

Depending on your location and Aetna policy coverage, the costs associated with inpatient rehab programs may vary. If you’re seeking Aetna inpatient coverage at a rehab facility, there are several locations from which to choose. With range by Aetna, rehab facilities can help you down the road to recovery and live a life free of drugs and alcohol.

Aetna Insurance
Inpatient rehab is the highest level of care for substance abuse treatment

Inpatient Rehab Service And Costs 

For in-network inpatient services, some Aetna insurance plans have 0% coinsurance – insurance that kicks in once you pay your full deductible. Other plans may require a copay per admission for different services [2].

In regards to out-of-network providers, coverage varies based on location and the type of plan. Some plans may not cover any form of treatment that’s out-of-network; however, others have 30 to 50 percent coinsurance. Out-of-network programs frequently require a pre-certification. Otherwise, there will be a penalty per occurrence. Talk with your provider to determine the type of treatment your policy will cover.

Aetna Coverage For Outpatient Treatment

Outpatient rehab coverage through Aetna insurance is different for everyone. Various costs associated with rehab services are compiled below.

Outpatient Rehab Services And Costs

Certain Aetna insurance policies may not have an option for any outpatient services or may involve a fixed coinsurance percentage. Several other plans have a set copay per visit. The largest factors of coinsurance or copays are location and type of insurance coverage.

Aetna Healthcare Addiction Resources 

Aetna is committed to patient follow-up with their Continuing Care programs. Members meet weekly and offer support for the “alumni” of various treatment programs. Sometimes social events are organized to celebrate an achievement or recent recovery. The results from programs like these are significant – they keep individuals affiliated in their community with ongoing support.

Aetna Policy Coverage For Substance Abuse

To determine what your individual plan covers – including coinsurance, copays, and deductibles – you will need to contact your insurance provider.

With Aetna insurance, and Aetna Better Health NJ Providers, individuals may be covered for the following substance abuse treatments:

Detox Programs

Medical detox helps you withdraw safely from drugs and alcohol. Under 24/7 medical supervision, staff will work closely with you—and may prescribe medications to help ensure that you withdraw safely and that your symptoms are addressed as needed. 

Inpatient or Residential Treatment

With inpatient treatment, you receive treatment and live at the facility. Inpatient or residential addiction treatment typically involves group and/or individual therapy. It is often recommended for individuals with co-occurring or dual diagnosis mental health issues, limited outside support, home environments that don’t lend themselves to sobriety, and poor treatment outcomes in the past.

Partial Hospitalization Program (PHP)

These programs allow you to live at home throughout treatment and spend your days at the treatment facility. This is sometimes referred to as day treatment. 

Intensive Outpatient Programs (IOP)

These programs typically involve attending substance abuse treatment programs approximately 3 evenings a week. People in these programs can live at home and go to work during the day.

Outpatient Treatment

An outpatient facility lets you meet with doctors and therapists, and you can even attend group sessions and recovery meetings before heading back home at the end of the day. With a residential program, you get the chance to focus solely on your recovery without any daily tasks getting in your way or slowing down your progress.

When you decide to get treatment for a drug or alcohol addiction, you will need to decide what type of treatment is best for you.

Do Treatment Centers Need To Be In-Network?

Even though not all Aetna plans require service providers to be in-network, programs that are out-of-network may cost more. It’s also important to note that programs not in Aetna’s network have not been screened for treatment that is consistent with current standards of practice.

Aetna’s in-network programs are all screened for quality care and adherence to modern principles.

In some cases, pre-certification or authorization of a treatment program will be required. Such cases may include:

  • Inpatient admissions
  • Outpatient detoxification
  • Residential Treatment Center admissions
  • Intensive Outpatient Programs
  • Partial Hospitalization Programs

Pre-certification involves a review process to determine whether the requested service or program meets Aetna’s clinical criteria for coverage. Be sure to check with your insurance provider to see if your substance abuse treatment will require pre-certification before you begin the program.

Types of Aetna Health Insurance Plans

They offer open-access plans, copay-only plans, and high-deductible plans.

  • Open-access plans allow you to choose your doctors; they don’t require a referral, and they don’t need a primary care physician.
  • Copay-only plans will guarantee that your costs after paying your deductible are only copays, with primary care physician visits and generic drugs covered before you hit your deductible.
  • High-deductible plans offer preventative care services before the deductible is met, sometimes coverage through a primary care physician before the deductible is met (with a copay), and the option of a health savings account. To view your plan’s details, you can log into the member website.

Aetna insurance offers many local plans supported by the national network of providers to better support patients at the community level.

To learn more about your Aetna mental health coverage, an online program allows you to view your coverage details, make claims, search for providers, and much more. Simply logging in gives you access to a wide variety of resources for insurance users.

In many cases, mental health problems can co-occur with substance abuse. Therefore, it is important to address mental health concerns if you seek care for substance abuse and addiction.

Frequently Asked Questions About Aetna Providers Coverage for Rehab

Does Aetna insurance cover drug and alcohol rehab?

Insurance coverage for drug and alcohol rehab will vary from policy to policy, but most Aetna policies provide coverage for addiction treatment through a variety of in-network or out-of-network rehab centers. Depending on the details of your specific policy, Aetna may cover all or some of the cost of drug rehab at We Level Up NJ.

What should I do If Aetna won’t cover the total cost of rehab?

If your Aetna insurance policy does not cover the entire cost of rehab at We Level Up NJ, our admissions team will thoroughly discuss the details of your coverage with you and provide information about alternative payment options you may use to cover the remaining balance. 

At We Level Up NJ, we understand that paying for drug and alcohol rehab can be an obstacle for some clients, so we will do our best to help you identify and access applicable insurance benefits and alternative payment options.

How can I verify my Aetna health insurance benefits?

Verifying your Aetna health insurance NJ benefits is a quick and simple process at We Level Up NJ that only takes a few minutes. You may contact us to verify your insurance benefits over the phone now. Or, if you prefer to do so online, you may fill out the confidential form on this page. To confirm your medical insurance benefits, you will need to have the following information on hand:

  • The company name of your insurance provider
  • Your member ID number
  • Your date of birth
  • Your insurance provider’s telephone number (found on the back of your insurance card)

How much does it cost to verify my benefits and begin the admissions process at We Level Up NJ?

It’s completely free to verify your insurance benefits and start the admissions process at We Level Up NJ. We’re happy to confirm your coverage and begin the screening process at no cost to you.

Who else will be notified when I verify my Aetna health insurance NJ benefits?

The insurance verification process at We Level Up NJ is completely confidential, so no one else on your policy will be notified when we contact Aetna on your behalf. Additionally, any personal information you provide on the phone or online via our website will remain completely confidential unless you give us permission to share it.

Do I have to commit to treatment? 

No. There is no obligation to enroll in rehab at We Level Up NJ, even if we complete an insurance benefits verification for you.

We Level Up NJ Makes It Easy to Verify Your Aetna Insurance Benefits for Drug Rehab

We understand that combing through the coverage details of your Aetna insurance policy can be challenging, time-consuming, and frustrating. Fortunately, you don’t have to do it alone. At We Level Up NJ, our admissions staff works with many Aetna customers during the admissions process.

Once we determine the appropriate level of care for you or your loved one, we will quickly verify your insurance benefits and have an open and honest conversation with you about the cost of drug rehab and your Aetna coverage options.

Aetna Insurance
Aetna health insurance policies generally offer coverage for various addiction treatment and drug rehab services.
Sources:

[1] SAMHSA – https://www.samhsa.gov/about-us/who-we-are/laws-regulations

[2] Aetna – https://www.aetna.com/