Aetna Rehab Coverage

For members of the Aetna Health Plan group, addiction treatment is based on whether it is deemed medically necessary. The process of screening must begin with a physician assessment and then referral. A physician will usually decide if addiction treatment is needed if he/she feels like there is a need for medical supervision during detox, whether in an outpatient or inpatient setting. The same is true for treatment/rehabilitation services, whether they are inpatient or outpatient. Some addiction treatment services that are covered by Aetna include: inpatient admissions, residential treatment centers, intensive outpatient programs, partial hospitalization programs, and outpatient detoxification. Some Aetna packages have relatively good coverage for inpatient services, if the diagnostic criteria are met for addiction/dependence along with another mental health diagnosis. This is known as co-occurring disorders, or dual diagnosis. Each plan is going to be specific about the need to treat members with various diagnoses. If you are looking for treatment for addiction and are an Aetna plan member, the best advice is to get a referral to a medical doctor if you do not currently have one assigned. Talk with them honestly and frankly about your use and abuse of drugs or alcohol. If you have any other mental health history, this is the time to discuss that as well. They will have to refer you to your Aetna advisor for authorization to treatment. If you have a place in mind that you are interested in, ask if it is covered by your plan and also call the treatment facility directly and speak with an administrator there. There are many, many different levels of copay and out of pocket expenses, which are determined by your coverage and specific plan, whether it's a PPO or HMO. If there is any doubt about this coverage and payment, visit human resources representative at your place of employment to learn more. Here is a list of plans covered by Aetna. This does not include self-paid plans or those that are specifically designed for coverage by companies who employ large numbers of people. Aetna Choice POS, Aetna Choice POS II, Aetna Golden Choice, Aetna Golden Medicare Plan, Aetna HealthFund, Aetna Open Access Elect Choice, Aetna Open Access HMO, Aetna Open Access Managed Choice, Elect Choice HMO, Managed Choice, Open Choice, Quality Point-of-Service (QPOS) and USAccess. If you would like assistance locating a specific drug and alcohol rehab in your area, contact The Good Drugs Guide at the phone number listed above today.