Medicare and Medicaid plans under Aetna provide coverage for outpatient drug and alcohol rehab if deemed necessary by a provider. The addiction treatment that Medicare covers may include intensive outpatient programs, which meet a few hours a week, and partial hospitalization programs, which meet 20 hours a week or more.10
As noted with inpatient addiction treatment, the amount of coverage provided for outpatient treatment through Aetna medical insurance plans varies. In one Aetna insurance plan in Maine, outpatient treatment has a coinsurance rate of 30% of overall treatment cost, whereas a plan in Illinois has a $35 per visit co-pay.7,8 A typical Federal Aetna plan offers a 20% coinsurance coverage option for outpatient treatment.9
Does Aetna Insurance Cover Inpatient Mental Health Treatment Facilities?
Yes, nearly all Aetna Behavioral Health plans cover therapy for mental and behavioral health conditions. You may be concerned about other diagnosed or undiagnosed mental illnesses. It’s important to note that substance misuse and addiction are mental health disorders. However, many people who have a substance use disorder also have another mental illness.11 In fact, according to the National Institute on Drug Abuse, it’s common for people to have co-occurring conditions. 11
It is not clear whether substance abuse leads to mental illness or mental illness drives people to use substances—it could be a bit of both.11 Whatever the case may be, it’s vital to work with one of the Aetna rehab centers that specialize in co-occurring disorder treatment, as well as treat these two conditions in tandem. Doing so will ensure you receive adequate care for both issues.11
The Affordable Care Act, which creates certain mandates for insurance providers, requires that carriers provide for mental health care and substance abuse treatment. 12