(Please note: Rehabs.com strives to provide you with the most updated information on each carriers' addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by Aetna.)
"Aetna covers heroin addiction treatment under its behavioral health plans, which include substance abuse treatment." Heroin addiction is a debilitating and progressive condition. Heroin is highly physically addictive, with the ability to render an “experimental” user into an addict in a disarmingly short period of time. According to the Substance Abuse and Mental Health Services Administration, the number of heroin users in the United States nearly doubled between 2007 and 2012. Heroin addiction is a growing problem, with the World Health Organization estimating that there are 9.2 million heroin users worldwide.
Does Aetna Insurance Cover Treatment for Heroin Addiction?
Aetna covers heroin addiction treatment under its behavioral health plans, which include substance abuse treatment. Coverage varies from state to state and from plan to plan, so check your individual policy for specifics with regard to substance abuse treatment coverage.
What Kind of Coverage Does Aetna Insurance Offer for Heroin Addiction Treatment?
Aetna covers a variety of heroin addiction treatment options. Traditional rehab centers, luxury treatment centers, outpatient therapy, and even medication maintenance therapies (such as methadone, buprenorphine and naltrexone maintenance) that are relatively unique to specifically treating heroin addiction. Insurance coverage may be full or partial depending on the plan you have subscribed to and where you live.
Types of Rehabs Aetna Will Pay For
Aetna will pay either in part or in full for a variety of rehab and addiction treatment types, from luxury treatment centers to outpatient therapy sessions. Options include inpatient hospitalization, residential treatment facilities, and outpatient treatment (either one-on-one therapy or group sessions).
How Much of the Cost of Rehab Is Covered by Aetna?
The amount that Aetna covers for rehabilitation stays varies regionally and between plans. With some plans, the cost of rehab may be completely covered if you have already met your deductible and annual out-of-pocket maximum for the year. Check your policy to see what coverage you are eligible for.
Can I Pay Above What My Insurance Will Provide to Receive Treatment?
You have the option of paying above and beyond what your insurance will cover in order to receive the treatment you need. If your insurance only offers partial coverage due to high deductibles that haven’t been met or for other reasons, you have the freedom to pay out-of-pocket for the treatment of your choice, and many treatment options offer payment plans for those who cannot pay a lump sum for their addiction treatment.
Inpatient Addiction Treatment vs. Outpatient Therapy
Aetna generally offers full coverage for inpatient hospitalization treatments, such as those used for initial detoxification from chemicals like heroin. Inpatient treatment is a good option for people who wish to detoxify under the care of experienced medical professionals. Withdrawal symptoms can be more than just uncomfortable — they can also negatively impact your health. You may wish to go through withdrawals in an inpatient setting in order to ensure that you have access to the medical care you need during the detox process.
Outpatient therapy is also available and is often covered in part through Aetna’s behavioral health plan. You may wish to engage in outpatient therapy, which involves meeting regularly with addiction specialists, if you’re unable to dedicate time to being in an inpatient setting due to job demands.
Should I Choose a Residential Rehab Center?
A residential rehab center may be perfect for you if you wish to have solidarity with others who are going struggling with the same addiction as you. Residential rehab is an excellent option for people who wish to be around others who understand them while being monitored and treated by drug addiction professionals around the clock.
Will Aetna Pay For Local Rehab and Out-of-State Treatment?
Several of Aetna’s insurance coverage plans will cover out-of-state treatment as well as local treatment, provided that the treating facility is in network for the plan. If you need addiction treatment and you are currently outside you home state, you may wish to review the policy you are insured under to see if out-of-area coverage is provided to you. Another option is checking with the facility you intend to seek treatment at to see if they accept your insurance.
Does Aetna Pay for Private or Luxury Treatment?
Aetna does cover costs of private and luxury treatment centers in many cases. However, some luxury or private treatment centers don’t accept any insurance at all and demand cash payment instead. Even in these cases, though, the facilities often offer payment plans so you can get the kind of treatment you want and need without having to pay an outrageous lump sum for services.
What Does Executive Treatment Offer Over Other Rehabs?
In traditional rehab settings, you are somewhat kept away from the outside world to discourage your ability to go out and relapse into addictive behavior. Traditional rehab means close monitoring and strict limitations on the types of interactions you can have with people outside the facility.
With centers that offer executive rehab as an option, there is far more flexibility for clients who need to stay on top of commitments in the outside world. Executive treatment was created for people whose careers demand that they be available for work projects, such as corporate leaders and managers. Executive treatment allows you to continue to uphold your work-related responsibilities while getting the addiction treatment you need.
What Treatment Lengths Will Aetna Pay For?
Aetna will cover various programs with varying lengths of treatment, such as:
- 28-30 Day Residential Programs
- 60 Day Residential Programs
- 90 Day Residential Programs
Depending on the plan, Aetna may also cover rehab stays of six months, nine months, or one year. This ensures that you can afford to get the level of care that is right for you, so that you can get back on track with living your life free from addiction.
What If I Have No Insurance?
If you are uninsured, you will not be turned away from the treatment you need. There are scholarships available at many treatment facilities, and hospitals and other treatment centers frequently offer payment plans for people that are uninsured and meet certain income guidelines. There are also options that cost no money at all in the community, such as 12-step groups and other addiction support groups.
Using Our Helpline to Determine Your Options for Heroin Addiction Rehab with Aetna Insurance
If you find yourself in need of addiction treatment but feel confused about what your options are when it comes to what Aetna will pay for, help is available. Call your insurance company and speak to an operator about what options you have for getting your life back on the sober track.
Aetna may cover multiple stays in a rehabilitation facility. Coverage will vary from state to state and from policy to policy, so review your plan in order to find out what level of coverage your insurance offers for stays in rehab.
Aetna offers coverage, in part or whole, for aftercare. Outpatient therapy and medication maintenance therapy, for example, are generally covered by your insurance.
Your stay at a rehabilitation facility is not likely to create a higher insurance premium by itself. Several things factor into a raise in premiums, and these variables tend to be on a larger scale than one filed claim.
The Affordable Care Act has widened availability for substance abuse and mental health services for many Americans who were previously unable to receive the treatment they need. By enforcing mental health and addiction treatment coverage by insurance companies, the Affordable Care Act has been a boon to individuals who are struggling with addiction.
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