Aetna Rehab and Heroin Detox Coverage

When you need addiction treatment, the provisions of your health insurance plan can affect your financial responsibility for treatment dramatically. Aetna offers a number of different health insurance plans that provide varied levels of coverage for heroin detox and rehabilitation treatment. Choosing a plan with sufficient Aetna Heroin Detox Coverage can mean the difference between affordable, high-quality care and serious financial distress.

Plan Options

Aetna insurance plans vary by state. However, available plans may include:

  • Catastrophic coverage
  • Marketplace bronze plans
  • Marketplace silver plans
  • Marketplace gold plans

These plans differ according to their premiums, deductibles and coverages. However, all of Aetna's plans typically provide coverage for heroin addiction treatment services.

What Will You Pay?

What you will pay for detox and/or rehabilitation treatment depends on the specifics of your plan. Some of the characteristics of the policy that may affect your Aetna heroin detox coverage include:

  • Deductible - If you have not yet satisfied your annual deductible when you begin addiction treatment, you will need to pay at least the remainder of this amount for the services you receive before Aetna will pay anything. In the case of high-deductible catastrophic plans, this cost will be significant.
  • Copay amount - After you have met your deductible, you may be required to pay a percentage of future costs up to your out-of-pocket maximum.
  • In-network versus out-of-network - Many of Aetna's health insurance plans include a network of "preferred providers." If you choose a provider within this network, you won't pay as much for treatment. However, out-of-network care can be costly. Not only will Aetna pay a smaller percentage of covered costs billed by out-of-network providers, but it may also impose a separate, higher deductible.


Another important factor that may affect Aetna Heroin Detox Coverage is the need for precertification. Certain addiction treatment services may not be covered by your insurance policy unless you obtain authorization from Aetna prior to treatment. Services that require precertification include:

  • Outpatient detoxification
  • Outpatient Electroconvulsive Therapy
  • Biofeedback
  • Intensive Outpatient Treatment
  • Partial Hospitalization Programs
  • Residential Treatment
  • Inpatient Admission, such as for medically supervised detox

Currently, Aetna does not require referrals for visits to specialists, including behavioral therapists.

Because detoxification and rehab can be so expensive, it's important to verify the specifics of your coverage before you begin treatment. Be sure to call the insurance company directly if you have further questions about Aetna Heroin Detox Coverage.

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