As vital as addiction treatment is to a person that suffers from addiction, addiction treatment isn’t free. The best and most cost-effective way to pay for addiction treatment is through health insurance. This is because, according to the Affordable Care Act (ACA), all health insurance companies must provide just as much coverage for behavioral health issues such as addiction as they do for physical ailments. Aetna is one health insurance company that can help you receive coverage for behavioral health issues.
What is Aetna Insurance?
Aetna insurance is a health care benefits company here in America. Through Aetna health insurance, individuals can provide medical, behavioral health, pharmacy, life, disability, and medical management insurance plans and services.
Types of Aetna Insurance Plans
Not all Aetna insurance plans are created the same. In fact, there are three distinctly different types of Aetna insurance plans. You can learn about these three different types of Aetna insurance plans below.
Copay Only Plans
Copay only plans are Aetna health insurance plans that only require their members to pay the copay after paying for the deductible when receiving behavioral healthcare. Aetna health insurance copay only plans typically cover the cost of generic drugs and visits to one’s primary care physician.
Open-access Aetna health insurance plans don’t require a referral or notification of a primary care physician from members. Therefore, Aetna’s open-access plans allow its members to choose their own physicians.
High Deductible Plans
High deductible Aetna health insurance plans offer their members various preventative care services and health savings account options. Aetna high-deductible plan members receive these offers prior to meeting their deductibles. High deductible Aetna insurance plans will sometimes even offer their members coverage for the cost of their primary care physicians once they meet their copayments.
In-Network Aetna Insurance Providers
In-network Aetna insurance providers are healthcare facilities that offer Aetna insurance and its members discounted fees and payments in exchange for customer referrals. All addiction and mental health treatment facilities that are in-network at Aetna health insurance must maintain a certain level of practice. Therefore, members can trust that the care that they’re receiving when getting treatment at an in-network behavioral healthcare provider is of high-quality.
All of the treatment programs that are offered by the addiction and mental health treatment facilities that are within Aetna’s network must also meet the insurance company’s clinical criteria of coverage. That way, insurance members can receive the discounted fees and payments that they deserve when receiving care at an in-network behavioral healthcare provider.
Aetna health insurance members are allowed to receive behavioral healthcare at addiction and mental health treatment facilities that aren’t within the insurance company’s network. They’ll likely just have to pay more money for treatment. Thus, as an Aetna insurance member, it’s more cost-efficient to receive behavioral healthcare at a treatment facility that’s within Aetna’s network.
Out-of-Network Aetna Insurance Providers
Out-of-network insurance providers are healthcare facilities that aren’t within Aetna’s network. Therefore, members don’t receive special discounted fees and payments when receiving care at an out-of-network Aetna insurance provider. This ultimately makes receiving care at treatment facilities that are out-of-network more expensive than receiving care at treatment facilities that are within Aetna’s network.
There are two factors that affect how much you’ll need to pay out-of-pocket as an Aetna insurance member when receiving care at an addiction or mental health treatment facility that’s out of Aetna’s network. One of these factors is how your Aetna out-of-network insurance plan will set the allowed amount. The other factor is the percent of the allowed amount that an out-of-network insurance plan is set to pay.
The allowed amount is the price that a health insurance company decides is a reasonable fee for a service. Factors that influence an out-of-network Aetna health insurance plan’s allowed amount include current Medicare-based rates, prevailing charges of the Aetna insurance member, and other types of rate schedules.
There are Aetna out-of-network insurance plans that offer zero out-of-network benefits. If you’re a customer of such an insurance plan, you’ll still receive basic out-of-network insurance coverage in emergency situations.
Addiction Treatment Programs That Aetna Health Insurance Offers Coverage For
Aetna health insurance companies tend to offer coverage for certain addiction treatment programs. These addiction treatment programs are listed below.
Most Aetna health insurance plans cover the cost of inpatient detox. To receive outpatient detox coverage, Aetna members must provide pre-authorization and a medical referral. Aetna health insurance companies don’t offer coverage for rapid detox.
Aetna insurance plans normally provide coverage for inpatient treatment. The amount of coverage that an Aetna health insurance plan provides for inpatient treatment varies though. These variation costs are based on the state that an Aetna insurance member lives in and Aetna insurance’s policies and programs.
Aetna health insurance’s policies and programs include the Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Point of Service (POS), and Exclusive Provider Organization (EPO).
Each of these Aetna policies and programs has different rules in different states. Therefore, the deductible levels of each Aetna policy and program will also vary with each state. Ultimately, this means that the inpatient insurance plan services will vary depending on the insurance policies that a person has and the state that a person lives in.
Levels of Aetna Inpatient Treatment Plans
There are four levels of inpatient treatment plans, platinum, gold, silver, and bronze. These four Aetna inpatient treatment plans vary in their deductibles and monthly premiums.
The higher the deductible, the more that a person pays out-of-pocket before one’s insurance kicks in. The lower the deductible, the less a person pays out-of-pocket before one’s insurance kicks in.
The lower the monthly premium, the less amount of money that one’s monthly health insurance payment is. The higher a monthly premium, the more amount of money that your health insurance payment is.
Most people that value financial security prefer having health insurance plans with lower deductibles and higher monthly premiums. Individuals will never have to pay much for their medical bills when receiving healthcare.
Financially secure individuals also prefer health insurance plans with lower deductibles and higher monthly premiums because such plans allow them to know almost exactly how much money they’ll need to pay for health insurance each month (including the cost of monthly medical bills from doctor visits), even if it causes the monthly payment for such health insurance to be greater.
Still, individuals that want to save money and are young and healthy, may want to pick a health insurance plan with a higher deductible and lower monthly premium. Such individuals will have to pay little money each month to maintain his or her health insurance. Individuals will also only need to pay larger bills the once in a blue time that the person receives medical care.
Platinum Inpatient Treatment Plan
Platinum inpatient treatment plans are the highest level of Aetna health insurance plans. These plans have lower deductibles and higher monthly premiums.
Gold Inpatient Treatment Plan
The gold inpatient treatment plan is the second-highest Aetna health insurance inpatient plan level. This plan has a slightly higher deductible and slightly lower monthly premium than the Aetna platinum inpatient plan.
Silver Inpatient Treatment Plan
The silver inpatient treatment plan is the third-highest Aetna health insurance inpatient plan level. This plan has a higher deductible than both the platinum and gold Aetna inpatient plans. It also has a lower monthly premium than both the platinum and gold Aetna inpatient plan.
Bronze Inpatient Treatment Plan
The bronze Aetna plan has the highest deductible of all the inpatient Aetna treatment plans. It also has the lowest monthly premium of all the Aetna inpatient treatment plans.
The amount of coverage that an Aetna health insurance member receives for outpatient treatment varies depending on the American state that the person lives in. This is because the rules and deductible levels of Aetna health insurance policies and programs change from state to state.
A person’s insurance policy also affects the amount of coverage that an Aetna health insurance member receives for outpatient treatment. This is because some Aetna health insurance policies offer coverage for regular outpatient treatment while others don’t. For example, while some Aetna health insurance policies don’t provide coverage for regular outpatient treatment, others have a fixed copay or coinsurance for outpatient treatment.
Receive Cost-Efficient Addiction Treatment At Florida Center for Recovery
Aetna health insurance is a well-respected health insurance company that offers behavioral healthcare coverage. As a well-respected addiction treatment center, it’s no wonder why we here at Florida Center for Recovery (FCR) work with Aetna insurance.
Here at Florida Center for Recovery, we aim to provide each and every patient with compassionate and affordable care. Part of doing that includes accepting in-network and out-of-network healthcare coverage from well-respected insurance companies like Aetna.
Here at Florida Center for Recovery, we also provide our patients with effective, specialized treatment through inpatient services. Thus, if you’re looking for a rehab center that offers high-quality inpatient addiction treatment, look no further than FCR.
To learn more about Florida Center for Recovery and the other forms of health insurance that we accept, contact us today. We would love nothing more than to make your journey to achieving sobriety as cost-efficient and easy as possible.