In-Network Aetna Insurance Coverage for Drug and Alcohol Rehab

Cost often plays a role in deciding whether or not to seek treatment for addiction. Many people feel more comfortable knowing that their insurance plan covers a large part of treatment.

Having insurance coverage can make treatment more affordable. Knowing what your insurance plan covers can help you plan ahead before choosing a rehab center.

To learn more about your insurance plan benefits and how to access those benefits for treatment you can visit your insurance plan’s website or contact them directly to verify if you have insurance.

For clients without health insurance, private pay options may be available in certain places.

Aetna works with individuals’ needs to find nearby treatment programs for drug and alcohol addiction. Aetna’s insurance plans have different options for inpatient and outpatient rehab, as well as additional services to help on your road to recovery.

Finding a rehab center in a network with Aetna can be challenging. Knowing what costs you will be liable for can make this process much easier. We understand how stressful finding the right Aetna in-network rehab can be.

If you’re looking for the best treatment center for yourself or someone you care about you should call Aetna directly and discuss options with a Customer Service Representative.

Aetna is committed to continuing care. It keeps patients connected after discharge by meeting them weekly and offering support. Social events help people feel better about themselves and their achievements. Aetna’s call center offers recovery resources anytime, day and night.

Aetna Health Insurance Plans Explained

What plans are available? Individuals may be covered for detoxification, inpatient rehab, residential rehab, partial hospitalization, intensive outpatient treatment, continuing care programs, or any combination thereof.

The amount of health care coverage you have varies greatly depending upon where you reside and if the facility is in-or out-of-network. Your insurance plan level determines how much you pay for treatment.

The cost of drug/alcohol rehabilitation depends upon the facility attended, as well as the type of program attended.

Aetna health insurance plans vary by state and tier. 

Bronze Aetna Plans

These plans typically cost less in premiums but have high deductibles and out-of-pocket costs. Aetna pays around 70% of the cost after the deductible is met, and you pay the rest.

Silver Aetna Plans

Silver Plans are the cheapest, but they have higher deductibles and will cost more out-of-pocket.

Gold Aetna Plans

are the most expensive, but they have the lowest deductibles.

Aetna provides plans in many states across the country and also offers plans for Medicare, which offers health insurance through the federal government for adults aged 65 or over, and in some cases younger people with disabilities. Check with your plan to see if you’ll be covered out of state.

What are Co-Pays?

Co-pays are the amount you must pay out-of-pocket before your insurance begins covering costs. Aetna health plans are health insurance plans that only charge you co-pays after you’ve paid for your deductible. These plans usually cover the cost of generic medications and doctor visits.

What is an Open Access Aetna Policy?

Open access doesn’t mean you get to choose your doctor. You may be forced to use an out-of-network provider if you want to stay covered by your plan. This means you won’t always get the same level of service as people who pay full price for a private plan.

High Deductible Aetna Policies

High-deductible health plans provide members with various preventive health savings accounts. Their members also get the benefits of their primary care physicians if they meet their deductibles. Aetna’s high deductible plans may even cover the costs of their members’ primary care doctors after they reach their deductibles.

What Does it Mean When a Rehab Center is In-Network?

In-network insurances are facilities that offer Aetna insurance and members reduced fees in exchange for customer referrals.

All addiction treatment centers that are within Aetna’s framework must meet a high level of practice. Members can trust that the care that they receive when receiving treatment at an in-network behavioral health provider offers an excellent level of care.

All programs offered by the addiction treatment center that is in-network with Aetna health insurance must also meet the insurance company’s clinical criteria of coverage.

That way, insured members can receive the discounted fees and payments that they deserve when receiving care from an in-network mental health provider.

Insurance members are allowed to get behavioral healthcare at addiction and psychiatric treatment centers that are not part of Aetna’s network, but they will be charged higher prices. As an Aetna insurance customer, it’s more efficient to go to a treatment center that’s part of the Aetna network.

What are Out-Of-Network Drug Rehab Facilities?

Out-of-network Aetna drug rehab insurance plans help cover costs at rehab facilities that aren’t part of Aetna’s network. However, these plans don’t offer discounts or lower rates than in-network Aetna plans.

So, if you go to a rehab facility that isn’t part of your Aetna drug rehab plan, you may be charged higher prices. You can avoid this problem by making sure that the rehab facility you choose accepts Aetna as an out-of-network provider.

There are various Aetna drug rehab out-of-network insurance plans. The type of Aetna drug rehab out-of-network insurance plan that you get will determine what you’ll pay out-out-of-pocket.

Two main factors affect how much an Aetna customer must pay out-out-out-of-pocket when receiving treatment at a rehab facility that’s outside of Aetna’s drug rehab network.

One is the method used by one’s Aetna out-of-network plan to set the allowed amount and the other is the percentage of the allowed amount that one’s Aetna out-of-network insurance plan is set to.

Paying an out-of-network drug rehab plan based on Medicare rates may allow you more money than other plans.

Certain Aetna plans base the allowed amount on any reasonable, usual, and customary, and prevailing charge.

Other plans use different factors to determine the allowed amount of your out-of-network benefit. Zero out-of-network benefit plans still cover emergencies.

Drug and Alcohol Addiction Rehab Centers That Take Aetna Plans 

Treatment centers will assess you as a unique person. They will develop a treatment plan that fits you specifically. Understanding treatment levels can help you better understand what you will experience during the next few years.

Aetna Insurance For Addiction Treatment & In-Network Rehab (1)Knowing what different types of treatments there are can also help you understand what your insurance covers.

There are many types of treatment programs available. Some people want to get help right away while others prefer to wait until they are ready.

Some people need to go into rehab after failing several times before they decide to change their ways. Others may choose to go into rehab when they first start drinking or using drugs.

American Addiction Centers (AAC), with various facilities located in:

Rhode Island

This center provides high-quality, inexpensive treatments for addiction. Their system of care offers a detox facility and an array of outpatient offices throughout Rhode Island.

AdCare’s Continuum

This includes outpatient and inpatient services as well as telehealth.

Greenhouse Treatment Center

This facility is near Dallas, Texas, Greenhouse provides customized treatment plans and different tiers of care such as detoxification services, residential stays, or a mixture of the two.

Oxford Center

Offers rehab with gender-specific options while also providing sessions to help connect with the outdoors and engage in new things.

Providers include detoxification services, residential rehabilitation, treatments for multiple issues, outpatient and inpatient treatment, intensive services as well as telehealth, all of them with customized treatment programs tailored to each client.

River Oaks

For those in Florida, River Oaks is located in Riverview. Both provide evidence-based therapy combined with high-level care. The center offers a customized care package while River Oaks offers a continuum of care.

Sunrise House

Sunrise House is based in Lafayette Township, NJ. It provides comprehensive programs for people with addictions offering a holistic approach.

It offers several well-established therapeutic treatments including residential treatment, detox or combined treatments, as well as Outpatient options.

It’s useful to remember that there are different options for people struggling with addiction. Be patient even if the program you choose isn’t right for you.

There are rehabs nearby that can help you get clean. Search by area to find others that accept Aetna insurance.

Each type of addiction treatment center offers a unique set of services to help people recover from addiction. Some may require more than others, but they all provide valuable assistance to those who need them.

Medical Detoxification Centers

Medical detox centers are designed for people who want to stay there for a few days to weeks until they’re ready to leave. Staff will look after you to make sure you safely withdraw.

Most certainly the first step in recovery is detoxification. Treatment center staff monitor you around the clock to make sure you’re okay. Medication to ease withdrawal symptoms may be provided.

Withdrawal affects everyone differently, but some people experience more severe symptoms than others.

The length of time symptoms last depends on the individual. It’s important to not go through withdrawal alone. A medically supervised detoxification program gives you the support you need to get through this difficult period.

Inpatient Drug Addiction Treatment

After the body goes through the detoxification process, treatment begins. Treatment includes counseling sessions and a variety of recovery activities. Patients will live on-site during their treatment.

During this time, patients will be encouraged to make behavioral changes that will lead to long-term sobriety. Inpatient treatment focuses on helping the patient stay focused on their goals and stay sober.

Residential or Inpatient or drug and alcohol rehab centers usually involve individual or group therapies.

It is often the best treatment for those who have additional problems or double diagnoses of mental health issues, limited support outside the facility, home environments that support sobriety, and poor outcomes previously.

Partial Hospitalization Program (PHP)

This allows patients to stay at home during the day while receiving outpatient treatment.

These programs typically involve attending substance-abuse treatment programs three evenings per week. People in these programs can live at home and attend work during the day.

You can choose whether to go to an outpatient facility or a residential facility. Outpatient facilities let you see doctors and therapists regularly but won’t give you a place to stay.

Residential programs have a lot more structure than outpatient facilities do, but they also require you to be there every day.

If you’re looking for something in-between, check out halfway houses. Halfway houses offer some of the advantages of both types of facilities.

Outpatient Addiction Treatment Programs

Outpatient treatment programs allow patients to receive treatment without having to stay overnight. Treatment is provided on a limited basis, usually five days per week. Patients are expected to return home each evening.

Outpatient programs are often ideal for those who want to start recovery but still maintain some responsibilities at home or at work. In outpatient treatment, patients get better faster than if they were in inpatient treatment.

They get more time to recover from their drug or alcohol abuse.

Medication-Assisted Treatment

Medications are very important to help people who want to quit drinking or using other substances. MAT helps people get better by taking these medicines. Some insurance companies won’t pay for MAT unless you’ve been approved by a doctor.

You might need to get approval before getting any prescription medicine.

Insurance companies usually have limits on how much medicine you can take. Substance abuse treatment varies from place to place, and not all treatment centers offer medication-assisted treatment (MAT).

Some rehabs may provide treatment to co-occurring issues (such as depression), opioid maintenance, on-site detox, holistic therapies, and treatment to specific populations (such as men, women, LGBTQI individuals, certain faiths, and business executives).

Many of Aetna’s plans offer cover for MAT but again this varies so be sure to check before starting a program.

Rehab Aftercare

After completion of treatment, you must continue to stay sober and work towards achieving long-term sobriety. You should attend support groups and/or AA meetings.

These groups can help you stay focused and committed to your goals. Also, these groups can provide you with valuable social connections that can be helpful during difficult times.


Getting better from a serious addiction is challenging but worth it for long-term health and happiness.