Will Aetna cover 90 days of rehab?

When people make the decision to stop using drugs and get help, it’s quite normal for their financial reserves to be depleted. That’s one of the reasons some people have second thoughts about getting treatment. They simply feel they cannot afford it.

What a lot of people don’t realize is their healthcare insurance will cover a good portion of addiction treatment. Of course, that is only applicable to people who have healthcare insurance as an individual or through an employer’s group policy. How do we know someone’s healthcare insurance provider will pay for a good portion of treatment? The Affordable Care Act of 2009 says so.

The ACA, as it is referred to, mandates that substance abuse treatment must be covered by healthcare insurance providers to the same degree that traditional medical treatments are covered by an applicable plan. To be clear, that’s the law. What the ACA does not dictate is the extent of coverage from a percentage standpoint. Each insured individual gets the same level of coverage as they would if they went to the hospital for a broken arm.

Of course, insurance companies are not required to pay for stays in luxury rehabs. The ACA goes so far as to dictate what treatment options insurance companies have to cover. The law did that to make sure insurance companies would not take advantage of customers. Here are the treatment options insurance companies must cover:

  • Medically monitored detox programs
  • Prescription drugs directly related to treatment (suboxone, methadone, etc.)
  • Standard residential treatment up to 90 days (no luxury rehabs or alternative types of therapy)
  • Outpatient treatment programs

It’s worth pointing out that a lot of insurance companies will offer to pay 100% of outpatient care. They are motivated to do this because outpatient treatment is significantly less than residential treatment. If a customer will agree to outpatient treatment, the insurance company saves money.

One other point needs to be made about the ACA. The ACA took away the ability of insurance companies to discriminate against people with preexisting conditions. That’s a ploy insurance companies used to use, but they cant get away with it anymore.

Will Aetna cover 90 days of rehab?

If you have Aetna as your insurance provider, it would benefit you to know exactly what rehab costs they will pay and to what extent. Keeping in mind health insurance policies will vary by state and premium amount, we can offer you some general guidelines about what Aetna will pay. Here are some general guidelines based on policy type:

  • Their Bronze plans will cover 60 percent of costs
  • Their Silver plans will cover 70 percent of costs
  • Their Gold plans cover 80 percent of costs
  • Their Platinum plans will cover 90 percent of costs

At this point, all you need to know is what kind of a plan you have. If you are not sure, you have one of three ways you can get that information. You can start by reading the summary page of your policy details. If you don’t have them, you can request them from your employer or the insurance company.

If you want to talk to someone about your coverage, you can contact your insurance company’s customer service department. They should have direct access to your policy information through their in-house computer system.

If drugs or alcohol have diminished your ability to read and comprehend, there is another way. You can speak with an administrator who works at a rehab you have under consideration. They can call the insurance company on your behalf and ask what treatment options are covered and to what extent. The fact is rehab administrators usually have good relationships with insurance company customer service departments. That would especially be true of a major insurance company like Aetna.

To answer the titled question, there is a high degree of likelihood Aetna would cover a good portion of your addiction treatment costs for up to 90 days.

If you have insurance, money should not be an obstacle for you getting treatment. Without that obstacle, we would like to encourage you to contact our facility right now at 833-820-2922. When you reach one of our staff members, they can answer all of your questions related to our facility, the services we offer, and to what extent your insurance company will help. As a convenience, our great staff is available to answer your call 24/7, 365 days a year.