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Does Aetna Cover Drug and Alcohol Rehab in Florida?

Aetna does offer plans with substance use disorder treatment coverage. However, as with most insurance companies, Aetna’s coverage for behavioral health disorder treatment, including drug rehab and alcohol rehab will vary between plans. Understanding the coverage afforded by your particular Aetna plan requires a call to the number on the back of your insurance card or speaking to the admissions staff at the station hope they can help you verify your benefits at no additional cost.

Aetna is among the most forward thinking of the major insurance companies when it comes to behavioral health treatment. They typically recognize the need for comprehensive addiction treatment and care. And they back that up with 24/7 resources as well as continuing care programs to assist their members in staying clean after they complete treatment and start their long-term recovery.

What Coverages Does Aetna Provide?

If you have drug treatment or alcohol treatment benefits as part of your Aetna plan, the next step is to understand what is covered. Typically, depending on the diagnosis and assessment, the treatment program begins with detoxification which can last anywhere from 3 to 7 days. From there, Aetna may cover residential treatment, partial hospitalization, PHP, regular outpatient treatment or intensive outpatient programs. They may also cover continuing care in the form of transitional living, colloquially known as a halfway house. A full verification of benefits can be performed on your behalf by the Destination Hope admissions department. This can give you a better idea of the coverages you have and what programs may be available.

Will I Have To Pay Any Out-of-Pocket Expenses for My Aetna Coverage?

Every plan will vary, however most plans to have some out-of-pocket expense. This will include the co-pay, which is a fixed payment for each service rendered, a deductible which is the amount that you are responsible for before insurance kicks in and coinsurance, which is the percentage of treatment cost you will be responsible for once you have met your deductible. Once again, a verification of benefits can tell you exactly how much you can expect to pay, and we can work with you to generate a solid estimate of treatment costs based.

Of course, not all at the policies cover substance abuse including drug and alcohol rehab. If that is the case, we encourage you to contact us to see what other payment options may be available.

If you are under 26, Whether married or unmarried, you may be eligible for benefits under your parent’s insurance plan.

Your Rights – Health Insurance and Parity

For plans that to cover substance abuse including drug and alcohol treatment, MHPAEA states that the benefits offered four behavioral health treatment must be equal to those offered for medical or surgical coverage. This law was further strengthened by the Affordable Care Act that extended many of these benefits to individual insurance plans and not just large group.

How Does Aetna Coverage Work?

Once we have verified your benefits and you enter treatment, the services that we perform to help you recover from drugs or alcohol are billed directly to Aetna. Any out of pockets expenses will be billed directly to you based on the terms of your health insurance plan.

What if My Aetna Claim is Denied?

There are circumstances in which even a pre-approved service is ultimately denied coverage by Aetna. The vast majority of these denials are due to a clerical mistake and can often be resolved easily. On occasion we may have to resubmit the claim to Aetna for a second look. However, Aetna, as with all insurance companies, will have a comprehensive grievance policy that allows subscribers to appeal the denial. Of course, the billing experts at Destination Hope will be with you during any and all insurance concerns.

Next Steps

 If you or your loved one is suffering from a behavioral health problem, you know well that reaching out for help is often the hardest part of treatment. To that end, Destination Hope has compassionate and understanding admissions specialists looking forward to talking through your specific concerns and answering any questions you have about your Aetna policy and the treatment process more generally.


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