What Is Aetna Insurance and How Does It Work?

Aetna Insurance is a US-based insurance company that offers various healthcare services that cover various health-related costs, including medical services and mental health treatment. It is often provided as part of a benefits package for employees and has over 46 million members across America.

To use Aetna insurance, you will need to pay all costs of medical care until you reach your deductible. The deductible amount is decided on ahead of time and will typically be lower the more you pay for your plan per month. Once the deductible is met, your insurance will kick in and begin to cover a portion of your cost. Every year, an out-of-pocket limit includes all copays, coinsurance, and deductible payments. Once you have paid that amount, Aetna will cover the rest. Using an in-network doctor or facility will lower your costs more than choosing a provider that is out of network.

What Are Aetna’s Types of Plans?

Aetna provides several types of plans that are all offered through the Affordable Care Act marketplace, Medicare, Medicaid, and plans through employers. You choose options from health maintenance organization (HMO) plans, preferred provider organizations (PPO), or point of service (POS) plans. Each has its pros and cons, and reviewing the monthly costs and benefits each type of insurance provides is worthwhile before deciding which is best for you and your family.

Drug and Alcohol Rehab Facilities That May Accept Aetna Insurance

Muse Treatment Center is a California-based facility that may accept your Aetna Insurance plan. Muse has a wide range of customizable programs, including medical detox programs, medication-assisted treatment (MAT), inpatient (residential) rehab, partial hospitalization plans (PHPs), intensive outpatient programs (IOPs), and aftercare options. Substance use disorders are serious medical issues that require comprehensive programs tailored to each individual’s needs. Muse integrates a wide variety of therapies and holistic treatment options for a whole-patient approach to healing that incorporates the body, mind, and spirit, with relapse prevention programming, community support, and long-term aftercare programs that will ensure patients are never alone in their recovery. Choosing Muse is choosing a network of care that will lead you through all the steps of addiction recovery at your own pace, so you can heal and overcome the underlying causes of addiction in a safe, supportive environment. If you are ready to begin your recovery journey now, please call Muse at 800-426-1818 to speak with an expert sober living specialist.

Does Aetna Insurance Cover Alcohol and Drug Rehab Treatment?

The Affordable Care Act has deemed mental illness and addiction as health disorders that must be covered by health insurance, so Aetna will likely cover at least a percentage of the costs associated with drug rehab and alcohol rehab. The amount covered will depend on the type of HMO or PPO you have and the types of addiction treatment that you choose. It will also depend on the state you live in, and whether you choose a provider who is in-network or out-of-network with Aetna. Clients may even qualify for screening coverage that will help pay for their diagnosis to help them be placed in the right level of care for their needs.

How to Check Your Aetna Insurance Coverage

If you are considering rehab or addiction counseling of any kind and want to check whether your treatments will be covered by Aetna Insurance, all you need to do is give them a call and a knowledgeable insurance representative will help you understand your coverage. You can also opt to log into their website and check your plan on your own.

Calling Muse is another option, as our addiction experts have plenty of experience with all types of insurance plans. Even if you are not ready to commit to rehabilitation just yet, we can answer any questions you have or verify the types of treatment your insurance will cover. We are here to help you and will do all we can to keep it simple and ensure you understand your options before you decide on anything.

What Does Aetna Insurance Cover?

Aetna is a large insurance company that covers various health-care-related treatments, preventative care, dental care, disability plans, long-term care, mental health treatments, and behavioral health therapies. You may also have access to coverage for the full continuum of addiction programming. For a full summary of your benefits and coverage, you may wish to ask for a copy of your SBC from your insurance company. This document will explain everything in great detail, with easy-to-understand examples of out-of-pocket payments and more.

Does Aetna Insurance Cover Mental Health and Substance Abuse Treatment?

Yes, Aetna offers coverage for mental health and substance abuse treatments, as these aspects are recognized as a large part of a person’s overall wellness in today’s modern society. Aetna offers a 360 Behavioral Health program that looks at patients from all angles, including physical health, mental health, housing, financial issues, family dynamics, and substance use disorder. This comprehensive coverage helps individuals heal from all angles, reducing the likelihood of relapse over time.

Does Aetna Insurance Cover Inpatient Drug and Alcohol Rehab?

Inpatient rehab is offered as a full-time treatment program that occurs as the patient lives inside the rehab center 24/7. Typically, therapy, educational programs, and support groups will be provided in the mornings and afternoons, with healthy meals provided. Evenings are usually free-time, with games, movies, and other activities offered. If this type of treatment is deemed essential by your doctor, and if Aetna determines the program to be cost-effective and necessary, at least some of the cost will be covered by insurance.

Does Aetna Insurance Cover Intensive Outpatient Alcohol and Drug Rehab?

Intensive outpatient programs for alcohol rehab and drug rehab are offered as part-time treatment plans that can be organized around your work schedule and other responsibilities you may have. You will likely live at home or in a sober living home at night, coming in for treatments on a set schedule, which can range from every day for several hours per day to a few hours a week. If outpatient rehab is deemed medically necessary for you, insurance will cover some or all of the costs associated with your IOP.

Does Aetna Insurance Cover Partial Hospitalization?

Partial hospitalization programs (PHPs) are one type of intensive outpatient care. They are also known as day programs, as they are 25-30 hours per week, running in the daytime. Going to a PHP requires the same commitment as a full-time job or school, which is often a person’s main commitment. At this level of care, patients receive similar programming as a person in inpatient rehab does, with days filled with therapy, counseling, groups, and educational programs. Aetna will cover at least some of the costs associated with partial hospitalization programs as long as they are deemed medically necessary to you.

How Long Will Aetna Insurance Cover Alcohol and Drug Rehab?

Everybody is unique in how much time they need to spend in rehab. This is not only determined by the type of substance you were using and the length of time it was used. It is also based on social, psychological, and medical factors. If you need to attend all levels of care including inpatient rehab and outpatient treatments, you may be in some form of rehab for up to a year, while others may only need a few weeks of therapy and counseling. Medical professionals and addiction specialists will better be able to answer these types of questions after you have had a thorough medical and mental health assessment.

Aetna Insurance May Offer Treatment Coverage for the Following Addictions:

Your Aetna insurance policy may cover treatment for addictions like:

  • Opioids – opioid drugs are a highly addictive class of drugs that include prescription pain medication and illegal substances like heroin
  • Benzodiazepines – these include prescription medications like Ativan, Xanax, and Valium that are often prescribed short-term for anxiety and panic disorders, seizure disorders, and sleep issues
  • Alcohol – one of the most common addictions in the US is alcohol use disorder, with 29.5 million American adults reportedly having an alcohol addiction in 2021
  • Amphetamines – these stimulant drugs speed up the nervous system and are often abused as they produce feelings of energy and short-term euphoria
  • Prescription medications – addiction to prescription medications can arise if they are abused, and some people may even develop a dependence when they are used as prescribed by a doctor


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What Are the Options if Aetna Insurance Does Not Cover the Cost of Drug and Alcohol Rehab?

Addiction is a treatable chronic disease. The sooner you get help, the easier it will be to heal your body and recover from the short- and long-term issues caused by substance abuse. It is important to get help for a substance use disorder, as it will not resolve on its own. If your Aetna plan does not cover the full cost of your drug and alcohol rehab program, you have several options to choose from to help you pay for treatment. These include:

  • Payment plans – many recovery centers offer payment plans allowing you to pay in installments instead of the entire amount up front. Some also offer sliding-scale fee programs for those in financial need
  • Loans – loan providers, banks, and similar financial institutions like CareCredit exist to loan money to people who need it. Some people also utilize peer-to-peer lending sites or crowdfunding sites
  • Grants and scholarships – there are certain institutions that provide scholarships and grants to people who are working to get sober and change their life. These are not the same as loans, as they do not need to be paid back, but you may need to put work in to find, apply, and compete for these types of awards

Verify Your Insurance With Us

Muse makes checking your insurance coverage for detox and rehab programs easy. If you are ready to get started and are considering our services, please give us a call at 800-426-1818. We will be happy to help you understand your coverage and your treatment options so you can make an informed decision moving forward. It is always a good idea to verify your coverage before making a commitment, so you can plan your out-of-pocket payments and understand the time and work needed within the program of your choice.

Next Steps With Insurance Coverage for Alcohol & Drug Rehab Treatment With Muse Treatment

Once you have decided that you are ready to start the process of addiction treatment, all you have to do is call us at 800-426-1818. Our team will let you know exactly what to expect from the process. The first thing that will happen is you will have a professional evaluation that is done by a physician, often accompanied by a psychologist or psychiatrist. This is important, as it is when our team will learn all about your history of substance abuse and your current health concerns, and we will also be able to determine whether you need a dual diagnosis program that also deals with mental health issues. After this assessment, we will have all the information we need to work with you and create a customized treatment program to help you.

Ensuring all loose ends are tied up is a good idea as you prepare to enter rehab. That means letting friends and family know where you will be, taking time off work, arranging your schedule appropriately, ensuring bills will be paid when you are away, and making sure that your kids, pets, plants, and anything else you are responsible for will be taken care of. That way, you can enter rehab with a clear head, able to focus on yourself, your healing, and your future. Our team is here to help you get started now. Please call the Muse treatment center today at 800-426-1818 if you have any further questions or if you would like to learn more about the types of treatment we offer. We are here to help.

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