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Updated on October 18, 2023
6 min read

Aetna Insurance For Addiction Treatment

Vince Ayaga
Dr P. E. Pancoast, MD
Written by 
8 Sources Cited
Vince Ayaga
Written by 
8 Sources Cited

Does Aetna Insurance Cover Drug and Alcohol Rehab?

Under the Affordable Care Act (ACA), health insurance companies such as Aetna must provide coverage for drug and alcohol rehab. This includes treatment for alcohol use disorder (AUD).

It can also help cover other substance abuse and related mental health problems. However, there’s no guarantee Aetna will fully cover treatment.

Factors that can affect your coverage include:

  • The type of treatment
  • The state you live in
  • Whether the program is in or out-of-network
  • Your Aetna plan
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What is Aetna?

Aetna is one of the largest health insurance providers in the U.S. and a subsidiary of CVS Health. They’re active in all 50 states and provide various health plans, including:

  • Regular health insurance
  • Dental insurance
  • Vision insurance

Aetna Health Plans

Aetna offers three types of health insurance plans:

  1. Open-access plans: Allows you to see any doctor they choose without a referral from their regular provider
  2. Co-pay-only plans: Guarantees your out-of-pocket expenses, after paying your deductible, are only co-pays; it also covers primary care physicians and generic drugs
  3. High-deductible plans: Offer screenings, check-ups, and counseling before you meet your deductible

High-deductible plans can sometimes cover general practitioner visits. They also offer health savings accounts (HSAs).

Even if you avail of Aetna’s policies, you will likely have to pay for some of your medical costs out-of-pocket. You must check your plan in detail to know how much you’ll be responsible for your treatment cost.

How to Check Your Aetna Coverage

To find out the details of your Aetna alcohol rehab coverage, call the number on the back of your insurance card or log into your Aetna account. The number for Aetna Behavioral Health is 1-888-632-386.

Before progressing with treatment, knowing the extent of your Aetna cost coverage is essential. If you don't want to be surprised by an unexpected bill, knowing how much your insurance company is responsible for covering is essential before seeking medical treatment.

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What Is the Cost of Alcohol Rehab?

The cost of alcohol addiction treatment will depend on two factors:

1. Type of Facility

Rehab for alcohol addiction at a basic facility is more affordable and costs around $5,700 per month.4 Insurance is likely to cover treatment at these facilities.

While insurance companies may shoulder part of the expenses, you may still need to pay some of the cost yourself. This may increase the overall cost if the facility is outside your health insurance network. Smaller programs also tend to be more expensive.

Unlike privately owned treatment facilities, a non-profit rehab program only offers basic amenities. These include:

  • A bed
  • Bathroom
  • Storage

2. Type of Treatment

The treatment type you sign up for can have a significant impact on cost:5

  • Outpatient treatment can cost $1,400 to $10,000 over 30 days
  • Inpatient treatment can cost around $5,000 to $20,000 over 30 days

Inpatient treatment tends to cost more. It involves 24/7 professional care in a hospital-type setting with beds, meals, and medical care.

Any treatment involving medication will also be more expensive. For example, medication-assisted treatment (MAT) with naltrexone might cost up to $14,000 per year.7

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Does Aetna Cover Privately Owned Rehab Facilities?

An insurance company like Aetna is unlikely to cover privately-owned facilities. Treatment at privately owned alcohol rehab facilities will cost more than non-profit facility stays.

A for-profit facility may cost up to $17,500 per month.4 This is because they tend to have more amenities than non-profit sites and market themselves to wealthier clients.

Remember that treatment success is not dependent on whether you attend a ‘luxury’ or less expensive facility. Both options are effective, depending on how you respond to treatment.

Which Substance Abuse Treatments Does Aetna Cover?

Aetna covers a variety of treatments for alcohol addiction and other substance abuse issues, including:

Detoxification

The first step toward sobriety for someone with an alcohol addiction is detoxification. During detox, the person stops drinking, allowing alcohol to completely leave the body.

A medical detox can also help minimize or manage alcohol withdrawal symptoms. Alcohol withdrawal happens when you suddenly stop using alcohol when you’ve become dependent on it. This can result in:

  • Brain and body malfunctions
  • Fluid balance upset
  • Seizures
  • Death

Withdrawal symptoms can be painful or even deadly. Because of this, they often require medical attention at an inpatient facility.

Inpatient Treatment

Inpatient or residential treatment involves around-the-clock medical care and support. This addiction treatment is often used for more severe cases of alcohol abuse.

Inpatient facilities provide a safe and controlled environment where you can recover from substance use disorders (SUDs). They also address co-occurring mental health conditions and other behavioral problems.

Outpatient Treatment

During outpatient treatment, a person keeps their routine while accommodating on-site treatment schedules. Program attendance is usually for several hours per day for a few days a week, and then they go home afterward.

People with severe addictions often start with inpatient care and then move to outpatient treatment, which is generally for less severe cases. Aetna also covers intensive outpatient care and partial hospitalization.

However, certain Aetna policies may not have an option for outpatient services or involve a fixed coinsurance percentage. Check your Aetna insurance plan for more details.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) uses medications to manage withdrawal symptoms and cravings. It's often used in conjunction with mental health counseling and inpatient treatment.

Common medications used for alcohol rehab include:

  • Acamprosate (Campral)
  • Disulfiram (Antabuse)
  • Naltrexone (Vivitrol)

All three of these drugs are FDA-approved for MAT to treat alcohol addiction. However, you must consult your doctor to confirm any drug interactions with these drugs.

Mental Health Treatments

Integrated treatment combines mental health counseling with a mix of both psychiatric and addiction medications. Some mental health treatment approaches for alcohol addiction include:

Mental health problems can often occur alongside SUD, known as co-occurring disorders or dual diagnosis. Because of this, it’s crucial to treat substance abuse and mental health simultaneously.

Mental health disorders linked to alcohol addiction include:

Will Aetna Cover Out-of-Network Treatment Centers?

You must seek treatment at an in-network facility to benefit from your Aetna health insurance. However, you may still need to pay for some treatment costs for it.

If you choose an out-of-network rehab, you may be responsible for all the costs of drug and alcohol treatment. However, you may be able to discuss financing options the facility offers, such as payment plans or scholarships.

How to Find an In-Network Physician

If you’re looking for an in-network primary care physician (PCP) you can find one on the Aetna website. All you need to do is log in and use their provider search tool.

A PCP can help keep you healthy and provide advanced care when needed. They may also offer lower medical costs.

Summary

Aetna is a health insurance provider that offers insurance coverage for dental work, vision, and addiction treatment. Aetna has three payment plans available, each offering different services and coverage.

Although your Aetna insurance coverage will pay for your treatment, you may still have to pay for some costs out of pocket. The cost of your treatment will depend on factors like the treatment facility, the type of treatment, and your Aetna health plan.

Aetna provides coverage for various treatment options like inpatient and outpatient rehab. However, it won’t cover the cost of privately owned rehab facilities and out-of-network treatment centers. It’s important to review your plan to confirm how much you’ll be spending.

Updated on October 18, 2023
8 sources cited
Updated on October 18, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. ACA health insurance plan coverage.” Aetna.
  2. Alcohol and Drug Treatment.” Aetna.
  3. Better health outcomes for substance use disorders.” Aetna.
  4. Beetham, T. “Admission Practices And Cost Of Care For Opioid Use Disorder At Residential Addiction Treatment Programs In The US.” Health Affairs, 2021.
  5. Average Cost of Drug Rehab.” National Center for Drug Abuse Statistics. 2022.
  6. Mental health & substance abuse coverage.” HealthCare.gov.
  7. Kaskutas et al. “Costs of day hospital and community residential chemical dependency treatment.”The Journal of Mental Health Policy and Economics, National Library of Medicine, 2008.
  8. How much does opioid treatment cost?” National Institute on Drug Abuse, 2021.
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