Aetna Insurance offers plans in several states, including Texas. How much of your drug rehab stay will be covered by your Aetna plan depends on the type of plan. Largely, the amount of treatment coverage depends on if you have a private plan, or one provided through an employer.
Employer plans may be restricted by federal regulations. This means that you may have certain limitations to coverage for substance abuse and addiction treatment services.
The only way to know for sure is to go through your Aetna plan and review the constraints and limitations. Why is it important to know what is covered by your plan ahead of time?
Some insurance providers require that you certify for treatment before you begin. Also, some plans may not cover your entire stay, and others may not cover certain treatment services at all.
Before heading to rehab, it’s a good idea to know where you stand with your coverage so you can make plans for expenses, know which services you can receive, and find a treatment center that accepts your plan.
Some plans will allow you to seek treatment with rehab centers not listed in their network, and this is something you will want to know ahead of time. You’ll also want to make a decision about where to receive treatment based on both which rehab centers offer the best treatment for your needs and which ones are covered under your plan.
Is Drug Rehab In Texas Covered By Aetna?
Aetna insurance plans, in general, do cover drug rehab. Most plans cover drug rehab now, as insurance providers are required not to discriminate against substance abuse treatment. In short, treatment of substance abuse and addiction must be covered to the same extent of other medical conditions.
The extent to which your treatment will be covered is what varies. Each person’s plan is unique to him or her. You may have a higher co-pay than another person, but you’ll still be covered for services. Or, you may have a sizeable deductible to meet before your treatment is covered.
These are the things you’ll want to know before you begin your rehab stay. Knowing which specific services are covered, if you have to meet a deductible, your co-payment and out-of-pocket expenses, and what is required of you by your insurance provider will ease some of your stress in heading to treatment.
If you have insurance through an employer, something else you may want to know is if your company provides any Employee Assistance programs that connect you with further resources for treatment.
What Services Are Covered By My Aetna Plan?
So, how do you find out which services are covered by your Aetna plan? The best way to start is by talking to your insurance provider. If you aren’t sure how to get a hold of them, human resources at your work may be able to provide contact information.
Or, a specialist may be of great help. What can a specialist do? Professionals at Vertava Health Texas can contact your insurance provider (with your permission) and get the specifics of your plan.
This is an important step because some plans do not cover inpatient stays, or only cover a small percent of those stays. Some plans will only cover inpatient services if they are deemed medically necessary.
If that’s the case, an assessment of your condition may be required in order to receive coverage. Many plans that cover inpatient treatment cover anywhere from 60 to 80 percent of your stay, with you paying whatever is left. That percent may seem small, but your out-of-pocket expenses can still add up depending on the length of your stay.
That’s why it’s great to have resources to connect you with scholarships, grants, or assistance from employee programs that may cover the rest. Our specialists can help with that, too.
Inpatient Versus Outpatient Care
There are a few things you’ll want to check into before deciding what type of treatment you need, and one is the difference between inpatient and outpatient care. Many plans don’t cover outpatient services. You may be wondering, do I even need inpatient rehab care?
Inpatient care is care you receive at a facility, like a drug rehab. With inpatient care, you stay at the facility for the duration of your treatment. You also receive medical care, supervised detoxification, medication assisted treatment, counseling, therapy, and other treatment methods as needed.
With outpatient treatment, you attend services while still maintaining your daily life. For some, this method can be effective. For those who have suffered or continue to struggle with addiction, inpatient treatment is the optimal choice. Why?
Removing yourself from your environment of substance abuse is important for a successful outcome in treatment. The medical field recognizes this more and more—it’s the reason that inpatient addiction treatment is covered when deemed medically necessary.
If your Aetna plan covers substance abuse and addiction treatment, it’s likely that it covers inpatient care. You can find out for sure, though, by reviewing your individual plan.
What Do I Need To Do Before Entering Treatment?
Before you begin any treatment, you may need to receive an assessment, get pre-approval from your insurance provider under your plan, or you may first have to receive detoxification. The best way to find out what you need to do is to learn what’s required not only by your provider, but under the specific guidelines of your plan.
The specifics may also depend on what type of substance abuse for which you’re being treated. For instance, you may not need detoxification services in treatment, so if it’s not covered you won’t have to worry. Or, maybe you already know you’ll need medication to help during treatment and want to know if your plan covers it.
Understanding what you need to do before entering treatment is important. Some providers won’t provide coverage if you don’t first get your treatment stay approved. As you can imagine, comprehensive addiction treatment can be pricey without insurance, so you want to make sure your plan will come through for you.
Finally, you’ll want to ask your provider which rehab centers are covered under your plan. Some plans require that you choose from a list of facilities approved by them, or receive no coverage. Whatever the case, be sure to ask for a list of privately funded rehab centers.
The Private Rehab Center Difference
Private versus public-funded, what’s the difference? Publicly funded addiction treatment centers can provide services to many who have access to no other form of care. If you have a plan that will cover private rehab, it’s an option you should strongly consider.
Here’s why: private rehab offers a superb quality of care, often offering lower patient-to-specialist ratios, evidence-based treatment modalities, customized plans tailored to the individual and so much more.
We provide a serene environment in which to heal. Far removed from the environment of abuse, you’ll be able to focus on healing with holistic addiction treatment while surrounded by the beauty of nature, learning new skills, engaging in adventures and receiving the most effective treatment available.
Here, we recognize the importance of addressing all aspects of health affected by addiction, while also making sure each individual is comfortable and at ease. It’s with this level of care that you’ll thrive in treatment, meeting your goals and learning how to combat relapse and further substance abuse long-term.
Get Help With Your Plan And Find Treatment In Texas Today
If you’re considering treatment in Texas, Vertava Health Texas has you covered. We’ll work with you to find out exactly what you need to do, what’s covered under your plan and help you estimate your total costs.