Aetna health plans may help pay for drug rehab, alcohol rehab, and mental health care. The care you can get depends on your plan, your health needs, and the type of treatment you choose. Your plan also affects how much you may need to pay.

Aetna offers different types of health plans, including HMO, PPO, and POS plans. Each plan can have different rules for providers, referrals, and care outside the network. Your plan may help pay for medical detox, inpatient care, residential treatment, partial hospitalization (PHP), intensive outpatient care (IOP), and therapy. 

Check your plan documents to learn what is covered, or contact Aetna for plan-specific information. We Level Up Treatment Centers can also help you check your insurance details. Call (844) 597-1011 or use our insurance verification service. Checking your benefits does not guarantee that your plan will pay for treatment.

What Is Aetna Rehab Insurance?

Aetna rehab insurance refers to addiction treatment benefits included in an Aetna health plan. These benefits may help pay for care related to drug use, alcohol use, mental health needs, and conditions that occur together. Some people have both a mental health condition and a drug or alcohol problem. This is called a co-occurring disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that people with both conditions may need care for each one.

Treatment may include detox, inpatient care, residential treatment, PHP, IOP, or outpatient therapy. Your plan determines which services may be covered and what costs you may need to pay.

Aetna HMO, PPO, and POS Plans

Aetna offers several types of health plans. The type you have can affect where you receive care and how much you pay.

Aetna HMO

An HMO usually uses a network of doctors and other health care providers. Some HMO plans require members to use in-network providers for covered care, except in certain situations, such as emergencies. Some plans may also have referral rules.

Aetna PPO

A PPO gives you more choice when picking a doctor or treatment provider. PPO plans may cover both in-network and out-of-network care, but out-of-network care can cost more. Aetna also notes that PPO members generally do not need referrals to see specialists.

For example, an Aetna PPO member may have different out-of-pocket costs for medical detox and outpatient therapy because the services can have different benefits and cost-sharing rules.

Aetna POS

A POS plan combines some features of HMO and PPO plans. Depending on the plan, you may be able to use out-of-network providers, but your costs may be higher. Some POS plans may also have referral rules. Because plan rules can differ, check your own benefits before choosing a rehab provider.

Aetna Insurance Coverage for Addiction Treatment

Aetna plans may help pay for different types of addiction treatment. The right level of care depends on a person’s health, substance use, and need for support.

Some people need care all day and night. Others can live at home while they attend treatment. We Level Up provides several treatment options. These may include: 

• Mental Health Treatment: Our programs can support people with mental health needs, substance use, or both.
• Medical Detox: We cater to people who need medical support while stopping drugs or alcohol.
• Inpatient Care: Our inpatient program provides care for people who need support day and night.
• Residential Treatment: We help people live in a safe treatment setting while they work on recovery.
• PHP: Our PHP program gives people several hours of care during the day without an overnight stay.
• IOP: We provide regular treatment for people who can live at home while getting care.

Aetna Rehab Coverage and Precertification

Precertification means that a health plan reviews certain care before it begins. Aetna’s behavioral health precertification document lists inpatient confinements and partial hospitalization programs (PHP) among services that require precertification. The inpatient category includes stays in a hospital, psychiatric hospital, substance use disorder facility, or residential treatment center/facility.

You can review the Aetna behavioral health precertification list for more information. The exact requirements can depend on your plan. Your treatment provider may be able to help you find out whether approval is needed and who must submit the request. Precertification does not guarantee that Aetna will pay for every part of your care. Your plan’s benefits, limits, exclusions, and cost-sharing rules still apply.

In-Network vs. Out-of-Network Aetna Treatment

Your provider’s network status can affect how much you pay for rehab. Before choosing a treatment center, check whether it is in your Aetna network.

In-Network Aetna Treatment

An in-network treatment center has an agreement with the health plan. Aetna says network providers agree to contracted rates, which can help lower your costs. You may still need to pay a deductible, copay, or coinsurance.

Out-of-Network Aetna Treatment

An out-of-network treatment center does not have the same network agreement with your plan. Some Aetna plans cover out-of-network care, while other plans may provide limited or no out-of-network benefits. Out-of-network care usually costs more, and some plans may have a separate out-of-network deductible or higher coinsurance. In some cases, you may also have to pay amounts above the rate recognized by the plan.

Before choosing a center, check your benefits and ask about the expected cost of care. You can also read Aetna’s network and out-of-network care guide.

Does We Level Up Accept Aetna?

We Level Up can work with Aetna insurance, but coverage depends on your plan, the facility, and the treatment you need. If you have Aetna, you can ask about treatment options in California, Washington, New Jersey, Florida, and Texas. Programs can differ from one location to another.

Call (844) 597-1011 to discuss your plan and ask about available care options. You can also use our insurance verification service to start checking your benefits.

Why Aetna Members Should Know Their Benefits

Your Aetna insurance card does not show every detail of your coverage. Learning about your benefits before treatment can help you plan for care and possible costs.

Here are some things to check:

• Which types of treatment may be covered
• Which treatment centers are in-network
• Whether out-of-network care is covered
• What deductibles, copays, or coinsurance may apply
• Whether precertification is needed
• Whether a referral is required

These details can help you compare treatment options and understand what you may need to pay before care begins.

Frequently Asked Questions

Get Help With Aetna Rehab Insurance

Aetna insurance may help pay for drug rehab, alcohol rehab, and mental health care. The services covered and the amount you pay depend on your plan. If you have Aetna and need help finding treatment, call (844) 597-1011. We Level Up can help you review your insurance details and discuss available programs.

You can also start with our insurance verification service. Checking your benefits can help you understand your options before you begin treatment, but it does not guarantee payment. Take time to review your plan, ask questions, and learn about the care available to you.