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Aetna New York Insurance for Alcohol and Drug Addiction Treatment

On this page, you will learn about Aetna NewYork coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
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AETNA New York COVERAGE FOR DRUG AND ALCOHOL REHAB PROGRAMS

Provider Overview

Aetna New York: Rehab & Detox Centers in NY That Take Aetna Insurance

New York boasts a population of more than 19 million spread over the state’s 47,000 square miles. From its capital city of Albany to New York City, home to the Statue of Liberty and the New York Stock Exchange, to the Adirondack Mountains, New York has both regions of nature and bustling city life. Residents of the state find success in careers such as tourism, finance, healthcare, manufacturing, and more.1

These residents, however, are also familiar with the struggles of a substance use disorder, with approximately 3,617 overdose deaths occurring in New York per year.2 It’s also estimated that 4,473 annual deaths in the state are attributed to the abuse of alcohol.3

If you or a loved one living in New York is struggling with substance abuse and looking for help, there are resources available to you within the state to get you on the road to recovery.

Does Aetna Better Health of New York insurance Cover Inpatient Alcohol and Drug Rehab Centers?

Aetna Better Health of New York provides Medicaid-managed long-term care plans to those who qualify through the state’s health insurance marketplace, NY State of Health.4 All Medicaid plans offered through the health insurance marketplace are required by the Affordable Care Act to cover certain essential health benefits (EHBs). These EHBs include substance use disorder services and treatment.5

Therefore, if you have an Aetna Better Health of New York insurance policy, some form of substance abuse treatment is covered at least in part by your plan. While not all plans cover inpatient drug and alcohol treatment, all plans provide coverage in some way for you to receive the help you need. The amount and type of coverage you receive are highly dependent on your specific case and plan.

If you are interested in receiving care from a particular rehab center, representatives at that center will be able to discuss your coverage and options with you. Give them a call directly and provide them with your insurance information to see how much of your treatment there may be covered. You can also call the number on the back of your insurance card to speak directly with a representative from your insurance provider.

American Addiction Centers is also here to help you verify your insurance coverage for treatment. Our admissions team is available 24/7 through the chat feature on our website and by phone at (866) 407-9651. You can also enter your Aetna Better Health of New York insurance information into this form to check your coverage options.

What Is Aetna Better Health of New York?

Aetna Better Health of New York provides managed long-term care programs to adults needing long-term care in certain boroughs/counties of New York who qualify for Medicaid. Residents of Brooklyn, Manhattan, Queens, Bronx, Nassau, and Suffolk have access to their plan options.4

It’s a state-specific insurance offering from Aetna Better Health, Aetna’s Medicaid managed care plan, created to meet the specific needs of qualifying populations in New York. Aetna Better Health has provided Medicaid plans for over 30 years to residents across 16 states.6

What Substance Addiction Does Aetna NY Rehab Treatment Centers Cover?

As mandated by the Affordable Care Act, your Aetna Better Health of New York insurance plan will provide some form of coverage for drug and alcohol rehab as a part of the required coverage of EHBs.5 It is vital that you receive the best treatment for your needs; therefore, you should find a rehab center where you can receive coverage that provides treatment for the specific substance use disorder (SUD) you are struggling with.

With your Aetna Better Health of New York insurance plan, you could receive coverage for addiction treatment for the following commonly abused substances, as well as others:7

  • Alcohol
  • Cocaine
  • Heroin
  • Crystal meth
  • Opioids
  • Marijuana
  • Prescription drugs

How Much Does Aetna Better Health of New York Cover (Addiction Treatment)?

The amount of and types of treatments covered by your Aetna Better Health of New York insurance plan will depend on your needs and specific plan. There are many options for different types of addiction treatment that may be covered in full or in part by your policy. These options include but are not limited to the following:

  • Inpatient/residential rehab: Inpatient rehab programs are a treatment option where patients live full-time at a rehab facility to receive 24/7 care. These programs can be highly structured and are designed to allow patients to recover without the distractions of everyday life. Depending on a patient’s needs, programs can be both short-term and long-term.8
  • Outpatient rehab/therapy: Outpatient therapy programs provide rehab treatment to patients while still allowing them to return home after treatment sessions. As with other rehabs, outpatient treatment programs are developed based on each patient’s needs. These programs determine the length and frequency of how long a patient will go to the facility for treatment, including therapy sessions and more.8
  • Intensive outpatient programs (IOP): Intensive outpatient programs are a form of outpatient therapy providing a higher intensity of treatment, similar to that of an inpatient program. Patients still return home at the end of their treatment sessions, but sessions are often longer and/or more frequent than regular outpatient programs.9, Description of the service
  • Partial hospitalization programs (PHP): Partial hospitalization programs are also a form of more intensive outpatient therapy.9, Description of the service Patients receive treatment in a clinical setting from medical staff but are still allowed to return home after treatment sessions. Generally more intensive than an IOP, PHPs can offer a broader spectrum of care and usually require a higher frequency of treatment sessions.10, b) Partial hospitalization programs and intensive outpatient programs

Does Aetna Better Health of New York Insurance Cover Inpatient Mental Health Care Facilities?

Those who struggle with substance abuse may also have a mental health disorder. This is not uncommon. According to the 2020 National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration, 21% of all adults had a mental illness that year. Of that 21%, the report also states that 6.7% (17 million people) had a substance use disorder in addition to their mental health disorder.

Whenever a mental health disorder and substance use disorder occur simultaneously, they are referred to as co-occurring disorders. It is recommended that both disorders are treated in tandem. The presence of one can affect the other, leading to different treatment needs.11, pg. 3, 47

As discussed above, the Affordable Care Act requires all health insurance plans provided through the health insurance marketplace to cover a list of essential health benefits for all policyholders. This list of EHBs includes not only substance use treatment but also mental health care and treatment.5

This means that your Aetna Better Health of New York insurance policy must cover, at least in part, treatment for substance use and mental health disorders. This includes both standalone treatments for these disorders and treatment for co-occurring disorders.

How Long Does Aetna Better Health of New York Insurance Cover Inpatient Alcohol and Drug Rehab Programs?

The type and length of treatment your Aetna Better Health of New York Insurance policy will cover is specific to your needs and your policy. Because there are many different policies and tiers of coverage, the length of time covered by your Aetna Better Health of New York insurance policy will depend on your specific plan.

Every patient’s needs are different, so the length of treatment will be different for everyone. The National Institute on Drug Abuse (NIDA) stated that a key element of effective drug rehab is that patients stay in treatment for their needs for the proper length of time.8 NIDA also states that research shows most people need at least 3 months in a treatment program and that longer treatments yield better outcomes for patients.12

Ultimately, it is essential that you receive the treatment you need for the length of time that will be most effective for you. If you want to look into how long your specific plan will cover different types of treatment, call the number on the back of your insurance information card to speak with an Aetna representative about the coverage your plan provides.

What If My Aetna Better Health of New York Policy Does Not Cover an Inpatient Drug Rehab Program?

If your Aetna Better Health of New York insurance policy doesn’t cover an inpatient drug rehab program, there are still plenty of options available to you. Other types of effective treatment may be covered by your plan instead (outpatient, partial hospitalization, etc.). Additionally, many rehab centers offer financing and scholarship options to patients based on their specific needs and circumstances. If you’re interested in a particular facility, call them with your information and see what resources they may have available to you.

Though your insurance may not provide the exact coverage you want, there are still options that can provide the help you need. It is vital to get the treatment you need right now while you’re ready rather than pushing it down the road.

Aetna Better Health of New York In-Network vs. Out-of-Network Inpatient Drug Rehab Centers

All insurance providers have a group of providers and facilities considered “in-network” for their policyholders. These are healthcare providers who can administer care to members of a health plan, and those members can expect the cost of the care to be at least partially covered by insurance. If a provider or facility is not a part of this group, they are considered “out-of-network.” Policyholders can still receive care from an out-of-network provider but should expect to pay more for the care out of pocket as their policy will likely not cover any of the care provided.13, pg. 2

There are a few ways to check if a provider or facility is within the network for your Aetna Better Health of New York insurance plan. You can call the provider directly and provide your insurance information to see if their offices or facility provide covered care through your policy.

You can also call the number on the back of your insurance information card to speak with Aetna directly about your provider options. You can also visit aetnabetterhealth.com/ny/find-provider to enter your plan information and search for the kind of provider you’re looking for. The website will present you with options available to you within your network.

What Rehab Centers Take Aetna New York Insurance?

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have an Aetna insurance plan, the following AAC facilities accept Aetna for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and telehealth.
  • Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with individualized treatment programs.
  • Recovery First Treatment Center: Located in Hollywood, Florida, Recovery First treats substance use disorders by combining evidence-based therapeutic modalities with top-level care. Recovery First provides a personalized continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth.
  • River Oaks Treatment Center: Located in Riverview, Florida, River Oaks treats substance use disorders through combining evidence-based therapies with world-class amenities. Provided care includes detox, residential treatment, behavioral disorder treatment, dual-diagnosis treatment, outpatient services, and telehealth, all with individualized treatment programs.
  • Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Aetna insurance.

How To Find Aetna Better Health of New York Covered Inpatient Drug Treatment Centers in NY?

If you are an Aetna Better Health of New York policyholder searching for drug treatment options near you, American Addiction Centers is ready to help you verify your insurance and discuss your coverage and facility options. We’re available to help you 24/7 via by phone at . Our admissions team is ready to speak with you and check your benefits while you’re on your phone together. You can also verify your insurance coverage using our form found here.

We also have a list of New York addiction treatment centers available here. Scroll to the bottom to filter by the area of the state that you live in. Those looking for treatment near New York might be interested in AAC’s leading treatment center Sunrise House Treatment Center in Lafayette, New Jersey. It provides a top-notch quality rehab program focused on getting you on the right path.

If this facility or any other interests you as a choice for rehab, please reach out to our admissions team. We want to get you on the road to recovery from your addiction at the facility best suited to meet your needs.

How to Read Your Insurance Provider Card
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  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
Sources
  1. S. News & World Report. (n.d.). New York.
  2. National Center for Drug Abuse Statistics. (n.d.). Drug overdose death rates.
  3. National Center for Drug Abuse Statistics. (n.d.). Alcohol abuse statistics.
  4. Aetna Better Health of New York. (n.d.). Become a member.
  5. S. Centers for Medicare & Medicaid Services. (n.d.). Information on essential health benefits (EHB) benchmark plans.
  6. Aetna Better Health. (n.d.). Who we are.
  7. National Institute on Drug Abuse. (n.d.). Commonly used drug charts.
  8. National Institute on Drug Abuse. (2019, January 17). Treatment approaches for drug addiction DrugFacts.
  9. McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance abuse intensive outpatient programs: assessing the evidence. Psychiatric Services (Washington, D.C.), 65(6), 718–726.
  10. American Psychiatric Association. (2010). Practice guideline for the treatment of patients with substance use disorders: second edition.
  11. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  12. National Institute on Drug Abuse. (2020, September 18). Principles of effective treatment.
  13. S. Centers for Medicare & Medicaid Services. (2022, February). What you should know about provider networks.

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