Aetna Virginia Insurance Coverage for Drug or Alcohol Rehab

Aetna Virginia: Rehab & Detox Centers in VA That Take Aetna Insurance

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The state of Virginia is home to 8,631,393 people as of April 1, 2020.1 The estimated population as of July 1, 2022, increased by 0.6%, reaching 8,683,619.1 Across the state, Fairfax, Prince William, Loudon, Chesterfield, and Henrico counties are home to the largest number of residents.2 “Virginia counties”

Respectively, the following number of Virginians reside in these 5 counties: 1,150,309 people, 482,204 people, 420,959 people, 364,548 people, and 334,389 people.2, “Virginia counties” What’s more, Virginia Beach is the most populous city in Virginia, with 459,470 people calling the city home.2, “Virginia counties”

Also known as The Old Dominion State, Virginia achieved statehood in 1788, making it the 10th state of the United States.3 “Virginia” The state was given its nickname because it was home to the first colony in North America established by the English in 1607, and colonies were also referred to as dominions.3, “History, Why’s it called that?” Some other fun facts about the state of Virginia include the state’s bird, the cardinal, and the state’s flower, the American dogwood.3 “Virginia – Fast Facts”

Now that you know some light-hearted facts about Virginia, it’s time to explore some more sobering stats. Among Virginians aged 12 or older, between 2017 and 2019, 488,000 (roughly 6.9% of the population) cited past-year substance use disorder.4, pg 26

Additionally, within the same time period, 357,000 (5.1% of the same population) reported past-year alcohol use disorder, 195,000 (2.8%), reported past-year illicit drug use disorder, and 237,000 (3.3%) reported past-year prescription pain reliever misuse.4, pg 25, 24, 22

What these statistics illustrate is that if you’re a Virginian struggling with substance use disorder, you’re not alone. For many, getting treatment for their condition is the first step toward recovery. If you have an Aetna Better Health of Virginia insurance plan, you may be able to use your insurance coverage to help afford the costs of getting treatment.

Does Aetna Better Health of Virginia insurance cover Inpatient Alcohol and Drug Rehab Centers?

Aetna Better Health of Virginia is what Aetna’s Medicaid managed plan is known as.5 A Medicaid insurance plan is a type of insurance plan that’s available for certain residents of the state of Virginia.6 It is designed to provide coverage for eligible residents at little to no cost out of pocket.6 Depending on whether you are eligible for Aetna Better Health and the plan you’ve chosen, you may be able to use your plan to help cover the costs associated with alcohol and drug rehab.

To find out what is covered under your plan, you can call the number on the back of your Aetna Better Health plan card. Or you can work with a rehab center directly to check your coverage based on the information that you provide to them. You could also work with American Addiction Centers (AAC) via various channels, such as chat or confidential phone calls to verify your benefits. Finally, you can enter your benefits information in the online benefits verification form below to instantly verify your coverage.

What is Aetna Better Health of Virginia?

For over 30 years, Aetna has worked to serve millions of covered members in 16 different states through managed care programs, including Medicaid, Children’s Health Insurance Program (CHIP), long-term services and support, and programs for the aged, blind, and disabled.6

The Aetna and CVS Health family work together to provide Aetna Better Health programs, which help members get more from their Medicaid plan.7 There are a wide range of health plans for pregnant mothers and their children, children up to the age of 19, people who need help living independently, adults and children living with serious health conditions or disabilities, and elderly people who qualify for Medicaid and Medicare.7

Specifically, the following plan options may be available to you.8, “Your plan options”

  • Medallion plans: These plans are designed for low-income or working individuals, families and their children, pregnant women, and those who are in foster care or qualify for adoption assistance.
  • FAMIS: These plans are designed to provide coverage for children of working parents that wouldn’t otherwise qualify for Medicaid.
  • CCC Plus: These plans are designed to provide full Medicaid benefits to children or adults with disabilities, people aged 65 years or older, people receiving long-term services and support, and nursing facility residents.
  • Dual Special Needs plans: These plans are designed to provide coverage to those who have Medicare, may need special healthcare needs, or receive assistance from Medicaid.
  • Medicaid expansion: In Virginia, eligibility for Medicaid has expanded, enabling more individuals and families to potentially receive coverage under Virginia Medicaid.

To find out what’s covered under your plan or more about your specific plan type, call the number on the back of your plan card. Every plan provides different levels of coverage and may treat substance abuse treatment differently based on your plan design.

What Substance Addiction Does Aetna VA Rehab Treatment Centers Cover?

There may be a variety of different types of substance abuse treatment that may be covered under your Aetna Better Health of Virginia plan. Some common substances that you may become addicted to that may be covered under your plan could include alcohol, cocaine, heroin, crystal meth, opioid, marijuana, and prescription drugs.

Call the number on the back of your Aetna Better Health card to find out what types of substance use disorder coverage are extended to you under your plan.

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

What is covered under your Aetna Better Health of Virginia plan will depend on a multitude of factors, including the plan you have and where you seek care. Depending on these factors, among others, your plan may cover some or all of the costs associated with the following treatment methods:

  • Inpatient or residential rehab. For patients who are enrolled in an inpatient or residential rehab program, you’ll be living at the facility for the entirety of your treatment. Here, you’ll receive round-the-clock, medically supervised care, which may include medically supervised detox.9, Pg 8, “What types of treatment programs are available?” Para 2,
  • Outpatient rehab or therapy. For patients who are enrolled in an outpatient rehab or therapy program, you’ll typically attend 1–2 sessions each week, or maybe less frequently. You’ll travel to the facility for your treatment, and at the end of the session, you’ll return home.9, Pg 10, Para 2
  • Intensive outpatient programs (IOPs). For patients enrolled in an IOP, you’ll typically need to attend a minimum number of hours of outpatient care sessions each week, returning home after the session is complete.9, Pg 10, Para 3
  • Partial hospitalization programs (PHPs). For patients enrolled in a PHP, you’ll typically attend care sessions for between 4 and 8 hours a day, multiple days a week. There is no overnight stay or hospitalization required.9, Pg 10, Para 1

Please keep in mind that although these treatment methods are listed above, they may not be recommended for your situation or covered under your insurance. As such, it’s recommended that you verify your benefits and coverage prior to seeking care whenever possible. Call the number on the back of your insurance card to learn more about your coverage.

Does Aetna Better Health of Virginia Insurance Cover Mental Health Care Treatment Facilities?

You may be wondering whether your Aetna Better Health insurance plan provides coverage for mental health care services. Under the Affordable Care Act, almost all insurance plans in the United States must provide coverage for mental health care and substance use disorder services.10 While this doesn’t guarantee that your Aetna Better Health plan will fully or partially cover mental health care services without parameters, it does mean that your plan may be required in some capacity to offer some level of coverage for such services.

Be sure to call the number on the back of your card to find out what treatments may be covered under your plan, including stand-alone heroin rehab or co-occurring disorder treatment.

If you are not familiar with what a co-occurring disorder is, it is when someone experiences both a mental illness and substance use disorder.11 Co-occurring disorders, also known as dual diagnosis, are common; approximately 9.2 million American adults in 2018 were reported to have this condition.11 This goes to show that if you too have a co-occurring disorder, you’re not alone.

Getting tandem treatment for co-occurring disorders is essential, as this type of approach treats each condition as its own during the course of larger treatment.11 “what should I do? Tandem treatment is recommended because those who have a mental illness or substance use disorder are twice as likely to develop the other condition at some point in their lifetime.12

To find out whether your plan provides coverage for this type of treatment, work with a rehab center directly or call the number on the back of your insurance card

How Long Does Aetna Better Health of Virginia Insurance Cover Inpatient Alcohol and Drug Rehab program?

The length of time that your Aetna Better Health Medicaid managed care plan may provide coverage for an inpatient alcohol or drug rehab program is dependent on a multitude of factors. The plan that you have, where you seek care, prior authorization, and treatment type may all play a role in your plan’s coverage detail. Because there are many different types of policies and tiers of coverage, you’ll need to work with your Aetna Better Health plan’s representative to discuss what your coverage entails.

Regardless of what your plan agrees to cover, it’s important to note that remaining in treatment for an adequate length of time is essential to your overall recovery. Experts recommend that patients remain in treatment for at least 90 days to improve your overall outcomes of treatment, including reducing or stopping drug or alcohol use.13

Please note that how long you should remain in treatment may not align with this statement. Work with your provider to determine what is appropriate for you in terms of how long you should remain in treatment. Additionally, you’ll need to work directly with your insurance plan to find out how long your treatment may be covered.

What if my Aetna Better Health of Virginia policy does not cover an Inpatient drug rehab program?

Depending on your plan, your Aetna Better Health of Virginia policy may not cover an inpatient drug rehab program. If this is the case for you, you may be responsible for paying for the costs associated with treatment. Be sure to ask the rehab center directly if there are any available financing or scholarship payment options available to you to help offset some of the associated costs. Regardless, it’s important to prioritize getting treatment now rather than pushing it down the road.

Aetna Better Health of Virginia In Network vs. Out of Network Inpatient Drug Rehab Centers

Each plan offered by Aetna Better Health of Virginia has its own provider network. A network is what it is referred to when there’s a group of doctors, providers, and facilities that work with your Aetna Better Health plan to provide coverage for eligible medical expenses at prenegotiated rates.14

To find out more about your plan’s network, call the number on the back of your insurance card. Your plan representative can also provide details about whether your plan provides coverage for providers who may be outside of your plan network.

How to find Aetna Better Health of Virginia covered Inpatient drug treatment centers in VA?

If you’re ready to take the first step toward overcoming your drug or alcohol addiction. AAC is here to help you throughout every step of your journey. As an industry leader in addiction care, we’re here to help you learn more about treatment options, as well as your insurance and benefits that may help you pay for treatment options.

You can call our helpline today to speak to a person who can check your benefits for you right while you’re on the phone. We can also work with you to check whether your Aetna Better Health plan is accepted at any of the renowned, top-notch AAC treatment centers around Virginia, including the Sunrise House Treatment Center.

Or, we can help you find a covered facility near you, even if an AAC facility isn’t covered by your plan. Don’t wait any longer to get the care that you need. Reach out to our specialized team today.

Will my insurance pay for treatment?
  • We’ll instantly check the coverage offered by your insurance provider.
  • You may receive treatment at one of our facilities at a reduced rate.
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