Aetna Health Insurance

Aetna Rehab Coverage

Aetna is a health care company originally founded in 1853, providing coverage to individuals and employers. In addition to wide-ranging mental and behavioral health services, Aetna also offers coverage options for policyholders that include detox, inpatient and residential rehabilitation, partial hospital treatment, and intensive outpatient treatment. Additionally, there are treatment programs included in Aetna’s network that offer continuing care for people with addiction or substance abuse issues.

Does Aetna Have Rehab Coverage?

Aetna does provide coverage for rehab, in a variety of settings, such as detox and both inpatient and residential treatment facilities. Aetna has a network of care providers offering treatment and therapy for people with drug and alcohol abuse problems, and these network programs are screened for quality of care, adherence to best practices regarding modern treatment, and their level of follow-up care.

If someone with Aetna insurance opts to go to an out-of-network facility, it can be significantly more expensive, and the insurance company warns the treatment might not be on the level of services and facilities that are pre-screened and in-network.

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Aetna Mental Health

Aetna offers insurance coverage with a philosophy that many illnesses people visit the doctor for are in some way related to emotional issues or stress, and with that in mind they do provide benefits related to mental and behavioral health.

Is Aetna Mental Health Covered By Insurance?

Along with Aetna providing mental health coverage, they also offer 24-hour phone access so members can get in touch with a customer service representative at any time to find answers to their mental health coverage questions. They can also access help finding a mental or behavioral health professional.

Aetna not only provides mental health coverage for a variety of services, but they also combine data from physical and mental health records to ensure that care is coordinated, and all a member’s relevant doctors and practitioners have the information they need to make informed decisions.

Aetna Behavioral Health

While Aetna does provide coverage options for mental health as well as behavioral health and a range of rehab treatment programs, in many cases precertification or preauthorization is required. Members can obtain precertification or preauthorization for coverage of these services by contacting Aetna Member Services or Aetna’s designated Behavioral Health phone number.

Is Aetna Behavioral Health Covered by Insurance?

When using Aetna insurance for behavioral health services, in most cases preauthorization isn’t required for outpatient services. This means members can simply contact their primary physician for a referral to a behavioral health provider to receive these outpatient services, although a limited number of Aetna plan sponsors do have plans that require preauthorization for all outpatient services with regard to behavioral health.

Otherwise, the behavioral health services requiring preauthorization from Aetna include inpatient admissions, psychological and neuropsychological testing, biofeedback, psychiatric home care services, and outpatient detoxification.

What To Expect From Aetna for Rehab

If you have an Aetna insurance plan and you’d like to use your coverage for the costs of rehab, this will fall into the category of behavioral and mental health services requiring preauthorization. It’s important to ensure you have this in advance of your treatment. Services requiring preauthorization include any inpatient admissions, as well as entries into a Residential Treatment Center, Partial Hospitalization Programs, and also Intensive Outpatient Programs.

Aetna also encourages members to take advantage of lower out-of-pocket costs by using behavioral health care providers that are in-network.

Assuming a member has met their deductible, if they needed chemical dependency rehab for 14 days, as an example, and they were billed $14,152 in-network, Aetna’s negotiated rate would bring this amount to $9,729. Your plan would pay 80% of that, so your coinsurance responsibility would be only $1,946. Under the same scenario, if you were to choose an out-of-network provider, your coinsurance obligation would be $6,957.

This would mean your plan pays 80 percent of in-network facilities and behavioral health visits and only 60 percent out of network. This leaves the patient responsibility at 20 percent for in-network behavioral health providers, and 40 percent for out-of-network providers.

Popular Locations for Aetna Healthcare:
• Aetna Better Health of Missouri
• Aetna Better Health Ohio
• Aetna Health Plan
• Aetna Affordable Health Choices

Further Reading About Insurance:

Aetna was last modified: March 29th, 2017 by The Recovery Village