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Aetna

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Aetna Covered Drug and Alcohol Rehab

Aetna is one of the largest managed health care companies in the world, providing a variety of insurance products and services, including but not limited to medical, behavioral health, and pharmaceutical.

With thousands upon thousands of customers from one side of the country to the next, Aetna takes great pride in providing health care coverage, including drug rehab, to those in need.

Options can Dictate Coverage

There are approximately 33,000 employees working for Aetna, each one dedicated to the care and well being of its customers.

When it comes to Aetna drug and alcohol rehab, it is important to realize that the company offers a variety of services to ensure that its customers are able to get their life back on track without paying out of pocket.

HMO vs PPO

If you have plans on using your Aetna health care plan for rehab purposes, it is essential to understand that you will receive the best and most affordable level of coverage if you opt for an “in network” provider. Of course, Aetna is able to work with you even if you decide on an “out of network” facility.

Where can I find Information?

In addition to contacting an Aetna customer care representative, you can review your policy for information on the mental health and substance abuse coverage. If you don’t have a copy, it would be in your best interest to request one for future use.

As with all health insurance plans, the substance abuse benefits offered by Aetna are not identical to medical benefits. For this reason, discussing your personal requirements with an insurance representative is very important.

What is Covered by Aetna?

When it comes to determining coverage, Aetna uses evidenced-based clinical guidelines to make decisions regarding pre-certification, concurrent review, and retrospective review.

The following criteria are used as guidelines when making coverage determinations:

  • Aetna Clinical Policy Bulletins
  • Milliman Care Guidelines
  • Centers for Medicare and Medicaid Services National Coverage Determinations and Local Coverage Determinations
  • American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-Related Disorders
  • Aetna Level of Care Assessment Tool

Aetna Pre-Certification

Before inpatient admission to a drug rehab facility, pre-certification may be required.

Whether or not this is necessary depends on the procedures and services listed on the Aetna Behavioral Health precertification list.

Any service on this list may require notification and/or a coverage determination. Notification does not require judgment for benefits coverage. A coverage determination, on the other hand, is based upon plan documents and a review of clinical information.

Rehab Centers that Accept Aetna Insurance

If you have Aetna insurance and require rehab assistance, you will want to consider one of the following facilities. All of these accept Aetna, allowing you to receive “in network” care.

1. Palm Partners Recovery Center

palmpartnersPalm Partners Treatment Center is one of the most successful drug rehab centers in the country at a fraction of the price of other addiction treatment centers.

Palm Partners Treatment Center provides effective drug rehabilitation alcohol rehab programs tailored by experts to meet your individual needs. Our proven addiction treatment modalities focus on treating the whole person: mind, body and soul.

2. Orchid Recovery Center

orchidThe Orchid is an alcohol and drug treatment center designed for the specific needs of women suffering from addiction and unresolved trauma. This program heals lives by addressing the unique and specific needs of alcohol or drug dependent women. These specific needs are addressed in an environment designed to foster a holistic restoration of a woman’s body, mind and spirit. Our primary mission is to provide an opportunity for women to break the cycle of addiction and enjoy healthy, contented, serene and productive lives. This mission informs and directs the entire Orchid program, from the design of the Treatment Facilities to our diverse treatment modalities.

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