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Aetna Insurance Coverage for Eating Disorders
(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.)
Eating disorders stem from various sources — stress, depression, distorted body image — but they are all hazardous to your long-term health. According to the National Association of Anorexia Nervosa and Associated Disorders, as many as 24 million people in the United States, both male and female, struggle with eating disorders. Dr. Walter Kaye, director of the Eating Disorder Research and Treatment Program at University of California, San Diego, found that there is a heightened risk of mortality among people with eating disorders such as anorexia and bulimia, including an elevated risk of suicide.
Does Aetna Insurance Cover Treatment for Eating Disorders?
If you’re struggling with an eating disorder, be it anorexia, bulimia, binge eating or an eating disorder not otherwise specified, know that there’s help out there to get you back on the road to health and wellness. Aetna insurance covers treatment for eating disorders, as long as the provider of the treatment is “in-network” for Aetna.
What Kind of Coverage Does Aetna Insurance Offer for Eating Disorder Treatment?
The type of coverage you can receive from Aetna for treatment of your eating disorder depends on several factors, including your plan and the type of eating disorder you have. For example, different treatments are considered medically necessary for individuals with anorexia than for people with binge eating disorder.
Types of Rehabs Aetna Will Pay For
Aetna covers a variety of eating disorder rehab types, either fully or in part, including inpatient hospitalization, residential treatment programs and outpatient services like counseling and therapy. The amount of coverage provided for these services depends upon your policy.
How Much of the Cost of Rehab Is Covered by Aetna?
Aetna will cover all or part of your rehab costs, depending on which plan you have subscribed to, your deductible amount and out-of-pocket maximum, and the type of rehabilitation you undergo. Different facilities have different policies with regard to accepting insurance, so be sure to check with the facility you are considering undergoing treatment at to see if Aetna is accepted there.
Can I Pay Above What My Insurance Will Provide to Receive Treatment?
If your insurance plan with Aetna dictates that only partial payment will be provided for your eating disorder treatment, you are able to pay above what is provided by insurance to receive the care you need in order to get back to a healthy lifestyle. You may pay the remainder of the bill with a credit card or by setting up a payment plan with your treatment provider at the time of service.
Inpatient Treatment vs. Outpatient Therapy
Inpatient treatment, including hospitalization or living in a residential treatment center, is helpful for people who have struggled with an eating disorder for a long time. In an inpatient setting, you get the level of care and supervision you need to ensure that your road to recovery is off to a good start. If you need help with overcoming your eating disorder but are not interested in an inpatient setting, you can still seek treatment in the form of outpatient therapy, including short-term interventions and longer-term one-on-one or group therapy sessions. Whichever road you choose, Aetna may cover part or all of the cost for the services you use.
Should I Choose a Residential Rehab Center?
Residential rehab centers are a good choice for people who want close supervision to prevent relapse into disordered eating behaviors. They are also effective for those who wish to be around others who share a common struggle. The support of peers and professionals is readily available in a residential rehab facility, and a sense of community can aid the healing process.
Will Aetna Pay For Local Rehab and Out-of-State Treatment?
Aetna will generally pay for treatment received at facilities that are not local; however, the facilities must be in Aetna’s network in order to be covered. Find out if the facility you are considering accepts Aetna insurance, and review your benefits information to see if out-of-area coverage is provided to you.
Does Aetna Pay for Private or Luxury Treatment?
Depending on whether a treatment center accepts Aetna insurance, your policy may cover services you receive in a luxury facility. Luxury treatment offers an experience that is similar to a spa or retreat, with pools and hot tubs to help you relax and center yourself while receiving the treatment you need. Check with the facility to see if your insurance is accepted, and read your policy to see if the facility is in your Aetna network of care providers to ensure that you get the coverage you need.
What Does Executive Treatment Offer Over Other Rehabs?
Executive treatment is a unique form of treatment for eating disorders which gives you the help you need without interfering with your busy life. Executive treatment was created with the executive professional in mind, so you can get intensive treatment without your career suffering. With executive treatment, you can still be on-the-go with regard to your career while still being held accountable by eating disorder specialists for traveling the road to healthy eating habits.
What Treatment Lengths Will Aetna Pay For?
When it comes to treatment of eating disorders, Aetna will cover any treatment that is deemed a medical necessity. However, the actual lengths of treatment that will be covered by insurance vary from case to case. Aetna may cover, partially or totally, costs associated with one-month, two-month or three-month residential programs, depending on certain factors like severity of symptoms and whether outpatient treatment measures have failed you in the past.
What If I Have No Insurance?
If you don’t have health insurance, there is still hope for help. Many hospitals and eating disorder treatment facilities offer payment plans for fees associated with treatment, and some even offer grants to income-qualified individuals who are in need of a helping hand. Contact the facility you are interested in receiving treatment at for details about options available for those who are uninsured.
Using Our Helpline to Determine Your Options for Eating Disorder Rehab with Aetna Insurance
If you’re struggling with an eating disorder and want help overcoming it, but you’re unsure about where to turn for assistance with sorting out what’s covered by your insurance plan, there are people waiting to help you. Call 1-888-716-9806 and speak with an operator who can assist you with determining your options for eating disorder rehab under your insurance carrier.
In some cases, Aetna will cover multiple stays in a rehab facility for people who are seeking to recover from an eating disorder. For example, if a prior attempt at seeking treatment has failed, Aetna may cover part or whole of the cost of the next attempt at treating the illness.
Aetna will pay for aftercare that is deemed necessary to treat your eating disorder, such as group or individual therapy and medications associated with treatment and aftercare.
This is a common fear among people who are interested in seeking rehab. The answer is, “it’s unlikely.” Generally speaking, the reasons for a jump in insurance premium costs are related to trends among groups of people, rather than being due to the filing of a single claim.
Although some people were concerned that their insurance coverage would decrease due to “Obamacare,” the Affordable Care Act has caused mental health and eating disorder treatment services to expand rather than contract. Insurance carriers who provide mental health benefits are, under the ACA’s new federal parity rule, now providing extended services to those in need of help.