Substance use disorder is a serious mental illness that requires the utmost professional care. However, getting the right care in an affordable manner is quite the uptaking; it’s not easy finding good treatment that also doesn’t break the bank. This is why insurance is imperative in the rehab journey. Luckily, Aetna insurance provides a plethora of options.
What Is Aetna Insurance?
Aetna is a health insurance company dedicated to providing affordable and quality health care coverage. It offers a variety of plans to meet individual needs, including employer-sponsored benefits, Medicare Advantage, Medicare Supplement Insurance, Medicaid managed care, dental insurance, and vision plans. Aetna also provides access to medical practitioners and facilities across the United States.
It strives to provide members with access to quality health care and preventive services, as well as health education and wellness programs. Aetna works closely with providers to ensure customers receive the best care possible. It also provides a 24/7 helpline for members who need help navigating the healthcare system. Additionally, Aetna offers online tools to help members make informed decisions about their health and wellness.
How Does Aetna Insurance Work?
Aetna Insurance works by providing coverage for medical expenses, such as doctor visits and hospital stays. The company also offers a range of insurance plans to meet the needs of its customers, including HMOs, PPOs, and other types of managed care plans. Aetna works with hospitals and doctors to provide affordable healthcare services to its customers.
When a customer first signs up for coverage with Aetna, they will receive an insurance card that provides access to the network of hospitals and doctors in their plan. This card is then used when receiving medical services from any provider within the Aetna network. With managed care plans, the provider must be approved by Aetna in order to receive payments from the customer.
Aetna Insurance Plans for Substance Use Disorder
Aetna offers a variety of plans to help individuals with substance abuse treatment. Aetna’s behavioral health services include treatment for alcohol, drug addiction, and other substance use disorders. The most comprehensive plan is the Aetna Total Health Plan. This plan covers inpatient or outpatient mental health or substance abuse treatment, including detoxification and rehabilitation services. It also covers mental health counseling, family therapy, and other forms of drug addiction treatment.
Aetna’s Substance Use Disorder Plan is another option for those seeking substance abuse treatment services. This plan offers coverage for inpatient or outpatient treatment as well as medication-assisted treatment (MAT). MAT includes medications approved by the FDA to help with opioid addiction, such as buprenorphine and naltrexone.
Additionally, Aetna’s plan covers behavioral therapy, supportive counseling, and family-involved treatment for those who have a substance use disorder. It also provides coverage for relapse prevention and aftercare services, which are important for maintaining long-term sobriety.
Do Treatment Centers Need to Be in Network?
Whether or not a treatment center needs to be in-network for Aetna depends on the type of treatment center you are seeking. Generally, in-network providers have agreed to charge lower rates for their services as part of a contractual agreement with Aetna, so it is usually recommended that members use an in-network provider. However, out-of-network providers may be used if a member prefers their services or cannot find an in-network provider.
In many cases, out-of-network treatment centers will accept Aetna coverage and allow members to use their benefits as long as the provider is willing to bill Aetna directly for services. It is best to contact your provider directly to confirm their agreement with Aetna and any other related information before beginning treatment. It is also important for members to understand that out-of-network benefits are usually limited and may require additional cost-sharing with the member.
In addition, Aetna’s coverage limits the number of sessions allowed at an out-of-network provider, so members should confirm their coverage limits before beginning treatment. In some cases, members may need to obtain prior authorization from Aetna in order to receive out-of-network benefits.
Inpatient Rehab Services and Cost
Aetna offers inpatient rehab services for individuals looking to get the help they need. Aetna’s inpatient rehab services provide a variety of treatment options for substance abuse, mental health, and life skills development. The cost of these programs varies depending on the type and length of the program required as well as any special services that may be necessary. In general, Aetna insurance will cover some or all of the costs associated with inpatient rehab services.
Inpatient rehabilitation typically lasts for about a month and focuses on providing intensive treatment for substance use disorders, mental health issues, and other conditions. Treatment includes a combination of therapies such as counseling, group therapy, motivation enhancement therapy, relapse prevention, and 12-step programs. During inpatient rehab, patients stay in a secure facility where they can focus on their recovery without distractions or triggers from the outside world.
Outpatient Rehab Services and Cost
Outpatient rehab services are a great way to get the treatment you need while still being able to maintain your everyday life. Aetna Insurance offers a variety of options when it comes to outpatient rehab services and costs. Depending on your plan, you may be able to access different types of treatment such as individual counseling, group therapy, medication management, and 12-step programs, and some plans may even cover the cost of detoxification.
When it comes to cost, there are several factors that will determine the amount you can expect to pay for outpatient rehab services covered by Aetna Insurance. This includes the type of plan you have, the duration of treatment if additional services are needed, and whether your plan has any coverage limitations.
What Is SBIRT?
Substance Use and Behavioral Health Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use of substances such as alcohol and drugs. SBIRT utilizes a public health approach focusing on the early identification, prevention, and treatment of risky substance use and mental health disorders. It is conducted in a variety of settings including primary care, emergency departments, and mental health and substance use treatment programs.
SBIRT involves three main components: screening, brief intervention (BI), and referral to treatment (RT). Screening is the process of asking individuals questions about their substance use behaviors to determine if there is a need for further evaluation and/or intervention. The questions can range from how much and how often the person uses substances to how it affects their functioning in everyday life.
How Can You Pay the Costs That Aren’t Covered by Aetna?
There are several ways to cover the costs of substance use disorder treatment not covered by Aetna. Many states offer assistance for addiction and mental health services through their state-funded Medicaid programs. In addition, organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA) provide low-cost or free treatment programs.
If you are uninsured or have inadequate insurance coverage, there are nonprofit organizations that may provide financial assistance for substance use disorder treatment. Organizations such as the National Institute on Drug Abuse (NIDA) and the National Alliance on Mental Illness (NAMI) offer grant opportunities for individuals in need of treatment.
Get the Help You Need Today
Regardless of what insurance you have, treatment for substance use disorder is imperative for long-term recovery success. If you or a loved one would like to find out more, you can contact us here.