Aetna Insurance Coverage for Addiction Treatment

Aetna Insurance was founded in 1853 in Connecticut, and now serves members throughout the country, including in Florida. Along with traditional healthcare plans, Aetna also offers Medicare and Medicaid coverage.¹

Aetna coverage for addiction treatment will vary depending on your plan, but you will have some assistance. This page will help you understand more about using Aetna for addiction treatment.

Does Aetna Cover Drug & Alcohol Rehab?

With the passage of the Affordable Care Act (ACA), all long-term health insurance plans provide at least some coverage for substance abuse treatment, as it’s considered an essential benefit.²

But Aetna drug rehab coverage will vary depending on your health insurance plan. You’ll want to check with your insurance provider to ensure you have all the details to understand how you can move forward with treatment.

You can learn about your insurance’s coverage and verify your benefits for treatment by filling out the form below.

There are several common types of health insurance, and each one will have different requirements when it comes to Aetna coverage for addiction treatment.

If you have a health maintenance organization (HMO) plan, you’ll need a designated primary care provider (PCP). You might need a referral from your PCP to get specialty treatment, including drug rehab. Then you will be able to choose among Aetna in network inpatient rehab facilities, for example.

A preferred provider organization (PPO) allows you to use any provider, including those outside the Aetna substance abuse rehab network. However, you’ll have much higher out-of-pocket costs for care outside of the network. You don’t need a referral for treatment, but it’s still a good idea to check with the insurance company before you begin treatment to ensure you didn’t miss any requirements.

Other types of insurance will have different restrictions on whether you have to use in-network providers or need a referral from your primary doctor. Be sure you fully understand your plan before you move forward.

What Types of Addiction Treatment Does Aetna Cover at River Oaks?

There are a variety of treatment types available when you use Aetna substance abuse coverage.

Most alcohol and drug treatment begins with detoxification. Sometimes, you can safely detox in an outpatient treatment program, but other times you’ll need to be admitted as an inpatient. The decision is based on the type of substance used, how long you’ve used it, and your overall mental and physical health.³

Aetna may cover a variety of rehabilitation programs at River Oaks, including:

• Detox.
• Inpatient treatment.
• Partial hospitalization programs.
• Intensive outpatient treatment.
• Outpatient treatment.

What are the different types of treatment? Inpatient treatment involves living at the rehab facility full-time while medical staff care for you around the clock. Outpatient treatment involves attending therapy several times per week. A PHP generally involves attending treatment at the facility for 4-8 hours each day but returning home in the evenings.⁴

After you graduate from your rehabilitation program, it’s important to have continuing care. Aetna recognizes the need for aftercare and River Oaks provides continuing care, 12-step and other support meetings, and alumni programs.

Cost of Substance Abuse Treatment with Aetna Insurance

The amount you’ll have to pay to attend a rehab program using Aetna insurance will vary depending on your specific plan. Most insurance plans have a specific deductible that you pay before insurance kicks in. In general, you’ll need to pay any deductible you have remaining for the year when enrolling in rehab. There may also be additional out-of-pocket costs, such as a copayment or coinsurance.

Help is available to cover out-of-pocket costs. If you use Aetna for substance abuse treatment, you can take advantage of our payment options, which include payment plans.

How to Use Insurance to Pay for Rehab at River Oaks

There are a few steps you need to take to get the Aetna addiction treatment help you need. First, call the number on your Aetna member ID card. They are available to help you 24/7.⁵

You’ll work with both your healthcare provider and the Aetna care team to set goals and create a plan to reach them. This includes reviewing treatment options, such as care at River Oaks. Once you decide on a program, you’ll start moving toward a sober life with a variety of tools and resources ready for you to use.

Reaching sobriety isn’t easy, and it’s important to have a support team to rely on. The staff here at River Oaks is on your side, and we’re happy to help with any questions you have. You don’t have to navigate the process alone. Contact us at for more information today.