Aetna Drug Rehab Coverage
Does Aetna cover drug and alcohol rehab? Yes! Addiction treatment is covered under Aetna health plans.
Is 1st Step Behavioral Health in-network with Aetna?
Yes! Our South Florida rehab is proudly in-network with Aetna.
Aetna offers several plans, and most cover some form of addiction treatment for drug and alcohol abuse. We’ve outlined some details below, but the best way to find out for sure what your plan covers is to call the treatment facility for verification of benefits.
In our last review with Aetna, we received a 100% score on our annual report card! Here’s how Aetna’s market readmission rate compares to 1st Step’s rates:
- 30-day readmission rate for Aetna’s market is 53.83% versus our rate of 18.75%
- 60-day readmission rate for Aetna’s market is 57.35% versus our rate of 21.88%
- 90-day readmission rate for Aetna’s market is 59.89% versus our rate of 25%
Have a question? Call us at (855) 425-4846 or contact us to answer all questions and confirm your Aetna insurance policy for treatment at 1st Step. We’re here to help you get your life back on track by giving you the treatment you need in a family-like atmosphere.
Aetna Coverage for Substance Abuse Treatment
Although most Aetna health insurance plans cover drug and alcohol rehab, the coverage level and length of treatment they will cover may vary. Each insurance plan defines which services are covered and if the coverage is subject to caps or other limits.
An important thing to note is that all behavioral health services, including treatment for substance abuse and addiction, require pre-certification or authorization to ensure the treatment program meets the company’s criteria for coverage. Treatment decisions are made on a case-by-case basis according to your individual needs.
Screening, Brief Intervention, and Referral to Treatment (SBIF)
Aetna relies on SBIF (Screening, Brief Intervention, and Referral to Treatment), an evidence-based program that helps healthcare providers identify substance abuse problems and determine the appropriate level of treatment. The program allows for up to five covered counseling sessions if intervention is needed. Referrals are provided for patients who require more in-depth treatment.
Aetna also uses tools and guidelines established by ASAM (American Society on Addiction Medicine), Applied Behavior Analysis (ABA), Clinical Policy Bulletins, Medicare and Medicaid Services Coverage Determinations, the Agency for Healthcare Research and Quality (AHRQ), and Aetna’s Level of Care assessment tool to determine coverage.
Your Aetna substance abuse insurance coverage may include:
- Residential rehab (Inpatient treatment)
- Intensive outpatient treatment
- Partial hospitalization (PHP)
- Detoxification, including inpatient and medically administered detox
- Dual diagnosis treatment
- Psychological testing
- Mindfulness programs
- Continuing care and relapse prevention
If you’re not sure what program is right for you or if your Aetna insurance policy covers treatment, give 1st Step a call at (855) 425-4846 or contact us online to speak with an admissions counselor who will answer any questions you have and help you through the process.
Aetna Insurance and Drug Rehab: Important Terms You Should Know
There are several factors to consider and terms to be aware of while navigating your Aetna health plan coverage. These include:
- Deductible – The deductible is the amount you pay out-of-pocket before your insurance coverage kicks in. Your deductible will vary depending on your plan, but a lower monthly payment generally means you’ll pay a higher deductible, and vice versa.
- Coinsurance – This is the percentage you will pay for treatment, beginning after you meet your deductible. Many insurance plans have an 80/20 share, which means Aetna will pay 80 percent, and you will be responsible for paying 20 percent.
- Co-pay – Your copay is a flat, predetermined fee that you will pay for treatment or other healthcare services. The amount of your co-pay will depend on the type of treatment you receive. Depending on your plan, you may be required to pay both copay and coinsurance.
Out-of-pocket maximum – Your out-of-pocket maximum is the most you will need to pay for covered services within a year. Once you pay the maximum amount listed on your policy, Aetna will pick up costs for the remainder of the year. You won’t need to pay deductibles, co-pays, or coinsurance.
Aetna Drug & Alcohol Rehab Coverage Specifics
In addition to general treatment services, such as inpatient and outpatient rehab, Aetna may also provide coverage for:
If you’re struggling with opioid addiction, it’s essential to know that naloxone is a life-saving drug that can prevent an overdose by blocking its effects. Also sold as Narcan, naloxone is covered by all of Aetna’s insurance plans through the pharmacy claims system. You can also pay up-front and send the bill to Aetna for payment.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) is a highly effective treatment approach for addiction, particularly when used along with traditional treatment or counseling. The medications used in MAT, such as methadone, disulfiram (Antabuse), buprenorphine, or naltrexone, work in different ways. In general, they either block the euphoric effects of alcohol or drugs or reduce cravings.
Most of Aetna’s plans provide some coverage for medication-assisted treatment, although requirements vary. For instance, Aetna will cover buprenorphine without prior authorization if you are insured through an employer-based plan; however, you’ll need authorization from your medical provider if you have Aetna Medicare or Medicaid coverage. There may also be a limit on the quantity prescribed.
Drug and alcohol addiction treatment varies from place to place, and not all treatment centers offer MAT, even those that accept Aetna Insurance.
Aetna Better Health Coverage
Aetna Better Health is a federal and state-funded program that provides health benefits for people enrolled in Medicaid or the Children’s Health Insurance Program. Although Better Health plans vary, they generally cover all or part of the costs of addiction treatment. The program is available in several states, including Florida, and each maintains its own website and contact information. This is the best place to go for specific information about your particular plan or availability in your state.
Aetna Rehab Facilities: Is 1st Step’s Florida Addiction Treatment Center in-Network or Out-of-Network?
Before selecting an addiction treatment center, it’s essential to know if they are in-network or out-of-network for Aetna. 1st Step Behavioral Health in Pompano Beach, Florida is in-network with Aetna so your policy should cover the majority of your substance abuse treatment costs. The best way to verify your coverage is to give us a call at (855) 425-4846 or contact us to speak with an admissions counselor so you can get the help you need. If you’re considering drug or mental health treatment, don’t wait, call today.
1st Step Accepts Aetna Coverage for Substance Abuse Treatment in Florida
Do you have Aetna health insurance or are looking for an Aetna rehab provider network in Florida? 1st Step Behavioral Healthcare is in-network with Aetna health insurance plans, and there’s a good chance that all or part of your treatment will be covered with us.
We offer a continuum of care with a step-down level of treatment that begins with inpatient care. Going through graduating levels of care allows patients to take steps towards recovery at their own pace so they can slowly make the life changes necessary for a lasting recovery.
1st Step Behavioral Health offers the following options in treatment programs:
- Long-term care up to one year
- Family therapy
- Relapse treatment
- Essential life skills
- Residential treatment
Give us a call or text at (855) 425-4846 or contact us online and we’ll help you determine what your plan offers and what you may be expected to pay. You can also verify your insurance online. We’re here, and we’re ready to help. Let’s get started.
Take the First Step Today
We can help you get better. Contact us today to find out which program might be right for you, or to begin the process of arranging for treatment.