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Aetna North Carolina Insurance for Rehab

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

Provider Overview

Aetna North Carolina: Rehab & Detox Centers in NC That Take Aetna Insurance

Commonly referred to as the Tar Heel State (and also The Old North State), North Carolina became the 12th state of the United States on November 21, 1789.1, slide 4, 2 The state is famous for many things, including the world’s largest private home—the 250-room Biltmore Estate located in Asheville—and being the site of the Wright brothers’ first successful flight of a mechanically propelled airplane on December 17, 1903, in Kitty Hawk.1, slide 7 and 6 respectively

Aside from these fun facts about the history of the state, North Carolina is known for being the 9th most populous state in the country, with approximately 10,457,177 people calling it home.3 What’s more, the nation’s 14th most populous city in the country is none other than the capital of North CarolinaCharlotte—home to 925,290 people.4, Table 1 line 14 The next largest city in North Carolina is Raleigh, which is home to 488,334 people and is the 40th-largest city in the United States.4, Table 1 line 40

This state, similar to every other state in the country, is facing a serious epidemic of drug overdose deaths. The North Carolina Department of Health and Human Services reported that an average of 9 North Carolinians died each day from a drug overdose in 2020—a 40% increase in deaths from 2019.5, first para

The data captured showed that among 3 surveyed racial groups, the rate of overdose deaths from 2019 to 2020 in North Carolina increased by 32% in white residents, 66% in African American residents, and 93% in American Indian/Indigenous residents.5, Overdose Death Rates by Year and Race. *Deaths per 100,000 residents; Non-Hispanic

Among North Carolinians 12 or older, during 2017 to 2019, 6.5% (562,000 people) reported past-year substance use disorder, 4.7% (405,000 people) reported past-year alcohol use disorder, 2.7% (232,000 people) reported past-year illicit drug use, and 3.5% (300,000 people) reported past-year prescription pain reliever misuse.6, pgs 26, 25,24 and 22 Of those receiving treatment for substance use disorder, in a single-day count in March 2019, 49,520 people were enrolled in a program.6, pg 27

What these statistics illustrate is that those who are struggling with addiction are not alone—and many are getting treatment for their addiction. Finding rehabs in NC, particularly NC detox centers or NC drug rehabilitation centers, or rehabs that take insurance in North Carolina can feel overwhelming. But many can use their insurance, including Aetna North Carolina plans, to finance rehab, as plans may help to cover the costs of treatment.

Does Aetna North Carolina Insurance Cover Inpatient Alcohol and Drug Rehab Centers?

If you have an Aetna North Carolina Insurance plan, you may be wondering whether it covers inpatient alcohol and drug rehab centers. As mandated by the Affordable Care Act, most U.S. health plans, including those offered by Aetna, must provide coverage in some capacity for mental health and substance abuse services, which includes rehab.7 Coverage levels can vary and depend on the Aetna North Carolina coverage that you have, where you receive care, and the amount of care that you need.

Rehab centers can help you check your Aetna North Carolina addiction treatment coverage over the phone based on the insurance and personal information that you can provide. You may also be able to check your coverage by calling the number on the back of your Aetna North Carolina insurance card.

Finally, you can have the friendly staff at American Addiction Centers (AAC) help you verify your benefits of coverage in a variety of ways, which include calling the confidential helpline , texting the AAC helpline, or filling out the form below.

What Is Aetna North Carolina?

Aetna North Carolina isn’t actually one type of insurance plan. The name is used to refer to all of the Aetna insurance plans that may be available in the state of North Carolina. Aetna is one of the most well-known health insurance providers in the country and has been providing health insurance offerings to customers since 1899.8 “1895-1915” Approximately 39 million people are covered by an Aetna health insurance plan across the country.9

Aetna provides insurance in many different health markets, including medical, pharmacy, and dental plans, Medicaid plans and services, Medicare plans, medical management plans, and behavioral health programs.9 Because of its vast reach and offerings in many different markets, it’s unknown how many different types of plans or provider networks exist across Aetna North Carolina insurance plans.

To find out how many of the rehabs in NC, including the 3 state-facilitated Alcohol and Drug Abuse Treatment Centers are in-network with Aetna, you’ll need to call the number on the back of your insurance card or enter your plan information into Aetna’s North Carolina Provider Search.10, 11

What Substance Addiction Does Aetna NC Rehab Treatment Centers Cover?

Aetna North Carolina substance abuse treatment coverage may vary by plan. This means addiction treatment for common substances such as alcohol, cocaine, heroin, crystal meth, opioid, marijuana, and prescription drugs may be covered under your plan. Please call the number on the back of your insurance card to verify your plan’s substance use coverage. You may also be able to call Project Know’s drug and alcohol rehab hotline for more information.

How Much Does Aetna North Carolina Cover (Addiction Treatment)?

Aetna North Carolina’s mental health coverage and Aetna North Carolina substance abuse treatment coverage vary in the scope of coverage based on the plan you have, whether the facility at which you receive care is an Aetna North Carolina substance abuse provider, and how much care you need. Despite the variance in coverage levels based on plan design, the following is a list of addiction treatment programs that may be partially or fully covered by your Aetna North Carolina plan:

  • Inpatient programs. With an inpatient program, a patient typically remains at the facility to receive around-the-clock medical supervision and care for a set amount of time, which can range from days to months.12, Pg 8, “What types of treatment programs are available?” Para 2, 13, pg 8, para 1
  • Outpatient programs. With an outpatient program, a patient would typically go to 1 or 2 visits per week at a facility, but they can return home after the visit is completed.12, Pg 10, Para 2
  • Intensive outpatient programs (IOP). A patient that is in an IOP typically attends a minimum number of hours of treatment each week without staying overnight.12, Pg 10, Para 3
  • Partial hospitalization programs (PHP). A patient in a PHP, which is also known as a day program, will attend sessions at a facility for 4–8 hours each day a few days a week but not stay overnight.12, Pg 10, Para 1

Does Aetna North Carolina Insurance Cover Mental Health Care?

Mental health and substance abuse services must be covered in some capacity under the Affordable Care Act, your Aetna North Carolina insurance must provide some level of coverage for mental health care.7 This means that standalone heroin rehab or co-occurring disorder treatment fall under this mandate.

A co-occurring disorder refers to when a patient has both a substance use and mental health disorder simultaneously, and it is a common occurrence.12 Research indicates that about half of those with a mental health condition or substance use disorder will develop or experience the other during their lifetime.12

How Long Does Aetna North Carolina Insurance Cover Inpatient Alcohol and Drug Rehab Programs?

The length of time during which Aetna of North Carolina Insurance covers inpatient drug and alcohol rehab programs will vary based on the specific type of plan that you have. To find out what your plan details include, you can call the number on the back of your insurance card. Despite what your coverage details may be, it’s important to note that research indicates that the longer you can stay in treatment, the more positive your outcomes may be. Specifically, research shows that treatments should last at least 3 months can help stop or reduce drug use and improve outcomes.13, bullet 5

What If My Aetna North Carolina Policy Does Not Cover an Inpatient Drug Rehab Program?

It is possible that your Aetna North Carolina insurance plan may not cover inpatient drug rehab programs fully or partially. If this happens to you, you may be responsible for paying for these costs out-of-pocket. Depending on the rehab facility that you choose, you may be able to ask for alternative payment options or private pay options. There may also be special financing opportunities or scholarship opportunities. Prioritizing the care you need over the cost of the care is essential—don’t push off getting the care you need.

Aetna North Carolina In-Network vs. Out-of-Network Inpatient Drug Rehab Centers

Knowing the difference between what an in- and out-of-network provider is can help you keep your healthcare costs as low as possible. This is because an in-network provider is one that has been contracted with Aetna to provide services to covered members at pre-negotiated rates, which are generally lower charges than what a non-covered member would pay.14 Depending on the plan you have, your Aetna plan may not cover any costs associated with out-of-network providers.

To check whether a provider is an Aetna of North Carolina in-network provider, call the number on the back of your insurance card. You can also log into your Aetna portal and use their directory. Finally, you can work directly with a rehab center to verify your benefits. To get AAC’s help to verify your benefits and coverage, call the confidential hotline.

How To Find Aetna North Carolina Covered Inpatient Drug Treatment Centers in NC?

Taking the first step to recovery, which may include finding an Aetna North Carolina-covered inpatient drug treatment center, can feel like a lot. That’s why AAC is here to help. Our admissions navigators are here to help you navigate every step of your journey, which can include learning more about treatment programs, finding a same-day admission or luxury rehab near you, or verifying your benefits and coverage right on the phone.

Given the vast reach of Aetna’s coverage, it’s impossible to know just how many people go into rehab every year financed through Aetna North Carolina. If you’re ready to take the next step and want to learn more about AAC’s leading treatment centers, which may include Sunrise House Treatment Center which is located in nearby Florida, give us a call today. You can also click here to find a treatment center near you.

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. Lee County North Carolina. (n.d.). Fun facts about North Carolina.
  2. NC Department of Natural and Cultural Resources. (2016, November 21). North Carolina becomes the twelfth state.
  3. United States Census Bureau. (2021, July 1). QuickFacts North Carolina.
  4. (n.d.). US cities.
  5. NC Department of Health and Human Services. (2022, March 21). North Carolina reports 40% increase in overdose deaths in 2020 compared to 2019; NCDHHS continues fight against overdose epidemic.
  6. Substance Abuse and Mental Health Services Administration. (2020). Behavioral health barometer North Carolina, volume 6.
  7. gov. (n.d.). Mental health & substance abuse coverage.
  8. (n.d.). Our history.
  9. (n.d.). Aetna facts.
  10. NC Department of Health and Human Services. (n.d.).
  11. (n.d.). Provider directory.
  12. Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment? (Original work published 2004).
  13. Substance Abuse and Mental Health Services Administration. (2020, April 30). Mental health and substance use disorders.
  14. (n.d.). Network and out-of-network care.

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