Aetna Insurance Coverage for Drug and Alcohol Rehabilitation

Aetna is one of the most commonly used insurances at drug and alcohol rehabilitation centers nationwide. There are many great benefits within each policy and it’s our priority to get you the best treatment, at the lowest cost. Although becoming familiar with insurance policies and benefits may come across as intimidating at first, it’s quite easy with the right team of dedicated experts. 

Keep reading to learn more about what your Aetna insurance covers for drug and alcohol rehabilitation. 

Does Your Policy Cover Rehab?

Here at Amethyst, we help those in need of finding a drug and alcohol treatment plan at our facility using Aetna insurance. We verify your coverage, explain your benefits to you and then help you find a program that uniquely suits your needs.

Most people are uninformed which then leads them to have a lot of misconceptions about their policy. For example, you may be able to receive a longer length of inpatient coverage, as well as a dual diagnosis option.

Aetna Insurance for Drug and Alcohol Treatment

Fortunately, drug and alcohol rehabilitation with Aetna insurance is generally one of the more favourable insurance options. This includes a higher amount of costs covered, as well as the ability of staying at a center for a longer amount of time. Our primary goal is to place you in a treatment that not only suits all of your needs, but sets you off on the road to recovery.

Many people seeking drug and alcohol rehab treatment look for what they want versus what they actually need. We want to make sure that we communicate with you openly and come to a common ground on what needs to happen in order for you or a loved one to achieve long-term sobriety. 

Policy Coverage for Substance Abuse with Aetna Insurance

Aetna also provides employee assistance program (EAP) coverage. This program makes sure you still have your job after you return from treatment at drug and alcohol rehabilitation center. Also, Aetna offers an iPhone and Android app that gives a ton of health information to make your life easier. 

Within the app, you can securely check a claim, pay bills, refill medications and go over coverage details. Aetna is one of the most adaptable and client-friendly insurance providers on the market, especially when it comes to those looking for treatment. 

Aetna Policies Work for Addiction Treatment Centers

Aetna policies can vary from state to state when it comes to drug and alcohol rehabilitation. Stipulations may apply in some scenarios. Certain plans allow hospital treatment, while others may not offer any. There are different aspects within each policy and plan that are important to work through, thus determining eligibility for the best form of treatment possible. 

We will work through all of these parts, taking the stress away from you. Although you can speak with Aetna directly, we recommend going through us as sometimes going through the provider will lead to misconceptions about the full scope of benefits.

Aetna Covers Inpatient and Outpatient Treatment

Aetna’s policies for inpatient drug and alcohol treatment are dependent upon your or a loved one’s specific policy. The services available through inpatient treatment versus outpatient treatment vary as well. At our drug and alcohol rehabilitation center, you’ll be sure to find the help you need with Aetna insurance. 

Aetna can also provide you with HMO plans and PPO plans. In addition, Aetna also offers point of service (POS) plans and exclusive provider organization (EPO) plans. Inpatient rehabilitation is typically covered by every plan, although other details may vary. In certain states, Aetna organizes there different kinds of plans through levels. This includes bronze, silver, gold, and platinum. 

  • Bronze plans provide the monthly premiums at the lowest price, but have the highest deductibles.
  • Platinum plans offer higher monthly premiums, while providing a more cost-effective deductible.
  • As for silver and gold, they are in-between and can best be explained by calling one of our specialists today.

The specific guidelines and coverage for each policy can be explained to you through our team of experts. Once we do a thorough review of your plan, we’ll be able to explain everything that you need to know about your benefits. 

Outpatient treatment and residential treatment operate differently as well. In some cases, it’s less expensive and the length of time may be shorter. However, coverage will still vary depending on the type of plan you have, the state where you live, along with a couple other factors.

Whether you’re dealing with opioid addiction or alcoholism, you can get the financial help you need regardless of the substance. We proudly use Aetna as one of our insurance providers and assure you that we will work together to make treatment work for you or a loved one.

Costs and Services at Inpatient Rehab

Inpatient programs provide the highest level of treatment care, with medically supervised detoxification and 24/7 supervision. Below are some of the general terms used when becoming acquainted with your health plan coverage:


Your health insurance plan premium is the payment you make to your health insurance company that continuously keeps your coverage active.

Out-of-Pocket Maximum

The highest amount you have to pay for covered services in a plan year. Once you spend this amount on deductibles, copayments, and coinsurance, your health plan will take care of 100% of the costs of covered benefits. The out-of-pocket limit doesn’t incorporate your monthly premiums.

Policy Effective Date

Your policy begins being effective on this date, thus allowing you to access your benefits. Open enrollment period is typically a set amount of time that takes place once a year, or during a specific enrollment period. 

This date will be agreed upon before the date is established. After official enrollment, it generally occurs within a few weeks or months.


This is the amount you pay for covered health care services in a given plan year before when your insurance will start to pay for them. For example, let’s say you have a $2,000 deductible. In this case, you pay the first $2,000 of covered services yourself. 

After you pay your deductible, Aetna will generally cover the remaining costs.


A copayment is a monetary charge that your health insurance plan requires you to pay to receive a specific medical service or supply. For example, your health insurance plan may require a $15 copayment for pharmaceutical medicine. 

Aetna Coverage for Mental Health Treatment

Aetna insurance can help you find drug and alcohol rehabilitation, as well as a mental health treatment plan. When it comes to substance abuse, mental health and behavioral issues tend to co-occur. This is referred to as dual-diagnosis. Dual diagnosis is a really important part of you or a loved one’s treatment plan, as it targets the underlying issues as well. Mental health concerns and physical problems should be treated equally by your insurance provider. 

Common mental health disorders in a dual-diagnosis include:

  • Anxiety
  • Depression
  • Eating disorders
  • Bipolar disorder
  • Post-traumatic stress disorder

Aetna provides mental and behavioral health benefits, along with the treatment of the physical addiction itself. This is really helpful for those who need dual-diagnosis treatment, which tends to be most patients.

It may seem obvious that somebody going through a physical addiction needs some form of hospitalization or physical treatment. However, some may forget that there is a major mental challenge that comes with addiction.

Walking You Through Your Aetna Benefits

Here are some other benefits as an Aetna policyholder with our treatment center:

  • We’ll review your entire Aetna health insurance plan.
  • We’ll help you understand your specific benefits at a drug and alcohol rehabilitation center.
  • We’ll help determine exactly what kind of treatment you or a loved one needs.
  • We’ll make sure you get the most out of your benefits at the lowest price possible.

Amethyst Is Here for You

Here at Amethyst, we put our patients first. It is our priority to make this process as smooth as possible for you. You may have lots of questions about your insurance coverage and what steps to take next. 

We assure you that calling us is a great first step. We’ll make sure to give you an in-depth review of everything, without much effort on your part. It’s important for you to focus on getting better while we focus on the nitty-gritty details like insurance. Give us a call at 888.447.7724 or contact us here, and let us take the first step with you on the road to recovery


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