Will Aetna Insurance Provide Coverage for Alcohol Rehab?

Since the passing of Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) health insurance companies have to ensure parity between mental health benefits and other medical and surgical benefits.1

In 2010, Congress enacted the Affordable Care Act which expanded on MPAHEA and defined 10 essential health benefits that all Marketplace health plans must provide coverage for, behavioral and mental health services for addiction treatment being one of them.2

The short answer then would be yes Aetna will provide coverage for alcohol rehab, with the extent of coverage depending on the type of Aetna healthcare plan that you have. Aetna has a long tradition as one of America’s oldest insurance companies. It has been one of nation’s leaders in providing insurance to Americans for nearly 170 years.3 Today, almost 40 million people place their trust in Aetna when it comes to health care.4

People at Aetna work hard to make the system more accessible and easier to use for their members offering them health insurance plans including:2

  • Medical, pharmacy and dental plans.
  • Medicare plans.
  • Medicaid services.
  • Behavioral health programs.
  • Medical management.

aetna insurance drug treatment providers nationwide

What’s included in Aetna Insurance Coverage of Alcohol Rehab?

If you are one of more than 14 million adults in the US who suffer from alcohol use disorder (AUD) you should use your Aetna health insurance coverage to use the professional help you have at your disposal.5 Existing research indicates that one-third of individuals who underwent some form of treatment for alcohol related issues experienced no symptoms 1 year later.5

Your nationwide Aetna coverage for alcohol rehab will usually start with a visit to a doctor who will do a medical screening to determine your specific situation. He might conclude that you need an early intervention or detox depending on how far your addiction developed.6

After that you will be matched with an appropriate treatment approach in one of nationwide in-network rehab centers that accept Aetna insurance and offer:6

What isn’t Included in Aetna Coverage for Alcohol Treatment?

Since no two people are the same, no two mental health situations and addiction disorders are identical. Aetna mental health insurance coverage usually doesn’t extend to things that are not thought of as part of standard medical practice when it comes to treatment of alcohol addiction.7

In practice this means that services and treatment techniques that have not been put through extensive medical research and testing or that haven’t shown well supported scientific evidence of their effectiveness won’t warrant coverage.8

For this reason unless your specific plan includes them, you should not expect Aetna rehab coverage for:8

  • Non-medical amenities like hospital television and telephone or a private room,
  • Various recreation programs,
  • Alternative therapies such as acupuncture,
  • Holistic care,
  • Massage therapy,
  • Food delivery.

What are the Overall Costs of Alcohol Rehab?

First thing to keep in mind when thinking about the costs of alcohol rehab is that it’s for various reasons almost impossible to determine out of hand how much it will cost in the end. Major factor that determines the cost of Aetna detox and addiction treatment is the location of rehab and the amenities and services on offer.2

Another reason is that people react differently to different types of treatment and their progress is susceptible to changes and has to be monitored constantly.7 The possibility of transitioning between treatments is an important rat of continuum of care and a successful rehabilitation.9

Cost of Aetna alcohol rehab can also be impacted by the fact that one treatment approach can greatly vary in intensity, for instance the number of sessions per week or the duration of each session.9 There is also the fact that one person might achieve great results in 6 months of treatment whereas someone else might need 9 months, a year, or even more.7

What about the Costs of Aetna Inpatient Alcohol Rehab?

Individuals that suffer from acute alcohol addiction issues that are impairing their ability to function in everyday environment or have been a long time abusers of alcohol might have to enroll into an inpatient rehab. To determine the cost of Aetna inpatient drug rehab you should take into consideration the duration and intensity of treatment program.10

Since these Aetna programs take place inside a specialized inpatient drug rehab center their costs will be greatly influenced by the type of substance abuse treatment facility that the treatment is taking place in and the type of services it offers. There are facilities that provide executive or luxury rehabilitation options that resemble a resort with a long list of amenities and services.11

What about the Costs of Aetna Outpatient Alcohol Rehab?

Outpatient rehab is the most popular form of alcohol rehab nationwide. One of the reasons is that it’s a flexible type of rehab that can be adjusted to meet the needs of various types of patients. This flexibility makes it hard to calculate the costs of outpatient treatment.9

It can be a good option for those who suffer from mild symptoms and don’t need more than doctor’s counseling, but it can also come in the form of intensive outpatient programs (IOP) that have at least 9 hours of sessions per week.12

Because outpatient programs are so diverse in terms of settings, intensity, and duration of services they can serve as an entry point for alcohol addiction treatment.12 Outpatient rehab can also be a stepping stone for those that underwent more intensive forms of alcohol rehab and are slowly returning to their normal functioning lives.12

What about the Costa of Alcohol Partial Hospitalization Programs (PHP)?

Partial hospitalization programs are a good choice for those who suffer from severe forms of alcohol addiction but can’t afford an inpatient or some type of residential treatment, or who just don’t like the stigma associated with checking in a substance abuse treatment facility.12 They can be very similar to IOP except they are more intensive.12

Sometimes it’s hard to say at what point IOP becomes a partial hospitalization program, but there is a general consensus that programs with daily appointments that last more than 5 or 6 hours should be considered as PHP. They can last as much as 10 hours per day in cases of medically monitored ambulatory detoxification.12

What about the Costs of Medication-Assisted Treatment (MAT)?

Medication-assisted treatment is one of the most promising rehab programs that has been proven very effective but that suffers from prejudices associated with people mistakenly thinking they will just substitute one addictive substance with another.13

In addition to being clinically effective in reducing the need for detoxification, MAT has been shown to:13

  • Improve the chances of survival for its patient.
  • Increase the rate of retention for those receiving treatment.
  • Decrease the use of opiate and related criminal activity for individuals suffering from AUD.
  • Increase patients’ chances of gaining and maintaining employment.
  • Improve birth rates for women who are pregnant and suffer from AUD.

Besides duration and the setting in which the Aetna addiction treatment is administered, cost of MAT rehab will be influenced by the choice of medication that is used. FDA has approved 3 evidence-based options as effective in treatment of alcohol use disorder.14

Medications used in MAT are:14

  • Disulfiram, that causes highly unpleasant symptoms when a person drinks thereby diminishing their desire to drink.
  • Naltrexone, that blocks receptors that make individuals crave for alcohol.
  • Acamprosate, that reduces symptoms of withdrawal as well as cravings.

How do Costs of Alcohol Rehab Compare with the Costs of Alcohol Addiction?

One of the biggest costs associated with alcohol use disorder is the toll it takes on people’s body as it becomes hard to shake off physically. In addition to shortening people’s life expectancy, alcohol has a damaging effect on almost every aspect of a person’s physical and mental wellbeing.15 Excessive alcohol consumption will likely increase a person’s chances of getting several types of cancer and severely weaken their immune system and key organs, including their:15

  • Brain
  • Heart
  • Liver
  • Pancreas

The costs of substance abuse are not to be underestimated since regular alcohol consumption represents a significant drain on an individual’s budget on top of the costs that it has for the whole society. For the period of 2015–2019, excessive alcohol use took each year an average of 140,000 lives and resulted in the loss of more than 3.5 million years of potential life whose costs to society can never be calculated.16

Since alcohol affects our brain in a very negative way causing the loss of balance, impairing our memory and ability to speak and think clearly. AUD results in diminished awareness and judgment making people unaware of their alcoholism. All of these things make our professional lives much harder increasing the chance of getting fired or falling behind and losing potential job advancement and future income opportunities.17

There is enough scientific evidence to supports the claim that treatment for AUD, weather inpatient, residential, or outpatient, is cost-effective compared with no treatment at all. If you know someone who obviously needs help but is hesitant, in certain states, like Florida for instance, there is a law allowing loved ones to seek help for those that won’t submit into rehab but would greatly benefit from it.6

What Length of Alcohol Rehab Will Aetna Insurance Cover?

It’s commonly accepted that no single addiction treatment will be an ideal fit for every patient. AUD rehab will vary according to the specific needs and characteristics of affected individuals.18 Proper mental health rehab has to match an individual’s particular situation with treatment setting, approach and duration. Rehab can be considered a success only once a person is able to returning to its life as a functioning member of the workplace and community.6

Recovery can be a lengthy process that requires commitment since relapsing tends to occur, especially with long term-term users, signaling a need to reevaluate or readjust the Aetna mental health treatment.6 There is ample evidence that staying in treatment for long enough time is crucial and the appropriate duration of rehab will depend on many factors, such as:18

  • Severity of AUD,
  • Length of time the persons has AUD,
  • How well he/she responds to medication,
  • Existence of other mental health issues,
  • Commitment and willingness to stay in treatment long enough.

If you feel you could use some extra information about your nationwide Aetna rehab coverage options and benefits, just look up the number located on the back of your Aetna insurance card and you’ll get all the feedback you need.4

How to Choose between Aetna’s Inpatient and Outpatient Alcohol Rehab Centers?

First and the most important thing to keep in mind is that for severe cases and people who lost the ability to function on their own in everyday circumstances there might not be any choice but inpatient rehab. This type of intense alcohol rehab program is a great help for those who would benefit from;6

Inpatient rehab is considered the highest level of care as it offers patients quality on-site medical supervision 24/7, giving health professionals the option to monitor patient’s progress and adjust the overall treatment accordingly.6 It also provides a more focused and structured treatment ecosystem that includes support groups and fosters accountability.6

Outpatient rehab could be a good option for those who don’t have the option of committing to a rehab center due to their job situation or some previous engagements.12 It could be a good option for those that enjoy a stable living arrangement and live in an environment that is supportive and devoid of triggers.12

How Can I Use My Aetna Insurance for Alcohol Rehab?

To start treatment using your Aetna insurance coverage, patients need to see a doctor first. Since there are many levels of addiction and many available treatment approaches, the doctor will have to examine your individual situation and condition before he’s able to give you a suitable rehab recommendation.6

Once a doctor is acquainted with your specific condition he will look into your ability to use insurance to get into treatment as quickly as possible because the earlier you enter into treatment the greater the likelihood of full recovery.18

After you’ve completed your appointment with a doctor, you can do a bit of research to choose one of Aetna’s nationwide inpatient drug rehab centers you feel will best suit your needs and preferences. You could then call the rehab center and their confidential and informative admissions team will help you determine the extent of your Aetna insurance coverage. In certain cases there is also the option of a state funded treatment.4

What’s the Easiest Way to Find Alcohol Rehabs that Accept Aetna Insurance?

American Addiction Centers (AAC) is a nationwide leader running a network of top-notch rehab centers that provide proven rehabilitation programs for treatment of various types and levels of addiction. AAC has the largest number of rehabilitation facilities in the US that are located in every part of the country giving you the option to make a choice that will satisfy all your demands.If Aetna is your substance abuse provider, you could also call a helpline dedicated to people who suffer from alcohol misuse and have a pleasant and informative talk with one of their trained and caring professionals that will ask you questions, verify your insurance and provide you with answers to help you make a decision about what’s the best step to take. All calls are absolutely confidential so you don’t have to worry and are free to open up about your situation.4