While many Aetna plans cover various forms of both inpatient and residential rehab treatments for a variety of addictions, Aetna Internet Addiction Coverage may be problematic. Aetna specifies in its LOCAT (Level of Care Assessment Tool) for clinicians that it requires at least one valid DSM-5 diagnosis and that the patient’s problem cannot be simply generalized anti-social behavior.
DSM-5 and Aetna Internet Addiction Coverage
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, pub. 2013) is the latest update to the American Psychiatric Association’s system for classifying and diagnosing psychiatric disorders. Unfortunately, Internet Addiction Disorder (IAD) is not recognized as a real disorder in the latest release, even though many distinguished medical professionals believe it to be real. IAD is recognized in the latest DSM as an area requiring further study.
That doesn’t mean that Aetna Internet Addiction Coverage is a lost cause, however. It simply means that the patient and the treating clinician must work together to find a diagnosis that is covered by the patient’s specific plan. There are many recognized anxiety and mood disorders that Aetna does cover in many plans, including adjustment, depression or avoidant personality disorders which have similar symptoms and may respond to the same treatments as IAD.
Symptoms of Internet Addiction Disorder
The symptoms of Internet Addiction Disorder are similar to those of other addictions. If you are wondering if you or a loved one suffers from IAD, you can check this list of symptoms.
- Increasing amounts of time spent online and one or more unsuccessful attempts to cut back
- Restlessness, depression, irritability or moodiness when not on the Internet or when attempting to cut down on Internet use
- Preoccupation with the Internet including anxiety about when the next online session will occur
- Uses the Internet to relieve feelings of guilt, anxiety, depression or hopelessness or as an escape from problems; Frequently staying online longer than intended
- Significant risk of losing a job or relationship or of being expelled from school
- Frequent lies to conceal the extent of Internet use
Aetna Internet Addiction Coverage Medical Necessity Definition
Aetna coverage requires a determination of medical necessity for care. Medical necessity must meet one of more of the following criteria:
- Treatment is likely to produce a positive
- Treatment must be related to your diagnosis
- Be no more costly than generally recognized treatment alternatives
Aetna’s LOCAT also includes requirements for various treatment levels, including inpatient, residential, outpatient and hospitalization. If you are covered by Aetna Insurance, you should consult your plan documents for any plan-specific Aetna Internet Addiction Coverage criteria.