Aetna is a CVS Health Company that serves more than 39 million people nationwide. It also happens to be one of the most popular insurance carriers in the state of Ohio. In addition to its standard coverage for various conditions and treatments, Aetna also goes above and beyond to provide care and resources to people struggling with substance abuse. Aetna even partners with various private rehab clinics throughout the state of Ohio — including Prosperity Haven — to ensure that you can access the recovery care you need.

In the sections below, we will examine the kind of drug and alcohol rehab available to Ohio residents with an Aetna insurance plan.

How Aetna Treats Addiction

Aetna offers dozens of online resources to people looking for information on the treatment of addiction. The insurance carrier puts particular emphasis on alcohol abuse, promoting evidence-based approaches to alcoholism treatment. More specifically, Aetna is a supporter of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) approach to alcohol addiction recovery, which is commonly used in private rehab clinics throughout the country.

But this is just the start of what Aetna can do for you. If you or someone you love is struggling with addiction and is insured with an Aetna health plan, you could qualify for substantial rehab coverage. Though Aetna does not offer more or less rehab coverage than comparable insurance carriers, it does offer the essential coverage needed whenever rehab is deemed medically necessary by a medical professional.

That said, your Aetna insurance will not cover 100% of the cost of alcohol or drug rehab. You will still have to pay the applicable premiums, deductibles, and copays associated with your plan. Additionally, you will often need to pay a percentage of the base cost of rehabilitation, with Aetna paying for the remainder.

Does Aetna Cover Rehab in Ohio?

Yes, Aetna can and does cover rehab for eligible policyholders in Ohio. However, your ability to get coverage will depend on a variety of factors. First and foremost, you will need to have an individual, family, or employer-sponsored health plan that is not associated with Medicare. If you have a Medicare or Medicaid plan through Aetna, you may struggle to get the coverage you need. This is partially due to the fact that the vast majority of private rehab clinics do not accept Medicare or Medicaid plans.

Assuming that you have an eligible Aetna plan, you will then need to seek out guidance from a healthcare professional. Depending on the type of plan you have, you may need to see your primary care physician or a qualified specialist in your network. If they determine that rehab is either medically necessary or the best available treatment for your condition, Aetna will typically cover a large portion of the cost of your rehab.

But again, you still need to consider the out-of-pocket costs of entering rehab with an Aetna plan. To get coverage, you’ll need to ensure that your plan is current (i.e. you’ve paid all of the necessary premiums). Then, you’ll need to meet your annual deductible so that your insurance can begin paying for your treatment. Finally, you may be required to pay various copays and/or a percentage of the cost of rehab.

Remember, Medicare Advantage and Medicaid plans provided through Aetna will not cover treatment at private rehabilitation clinics. So, it’s best to contact your insurance carrier before committing to any rehab provider in Ohio.

Does My Health Insurance Only Cover Certain Rehab Facilities?

Compared to many other insurance carriers, Aetna offers a wide range of plan types to Ohio residents. The type of plan you acquire can directly impact your ability to get coverage at one rehab facility over another, which makes many Aetna policyholders better positioned to get coverage at the facility of their choice. Aetna currently offers HMO, EPO, HMO-POS, PPO, and HDHP plans, though HMOs and PPOs are the most common by far.

With an Aetna HMO plan, you are limited to a relatively small network of healthcare providers. If a given rehab clinic falls within that network, you can likely get coverage, but if your desired clinic is outside your network, you won’t get any coverage. An EPO works in much the same way, albeit with a much larger network.

HMO-POS and PPO plans also have a network of providers, but by paying a higher premium, you can also get some coverage for out-of-network care. This means that you could save a lot by sticking to a rehab clinic within your network, but you could still get some coverage even if you wanted to go to an out-of-network clinic. Finally, an HDHP plan has low premiums and high deductibles, which means that you may have to pay more out-of-pocket before your coverage starts. Additionally, it’s important to note that Aetna HDHPs may or may not offer out-of-network coverage.

In short, your Aetna health insurance will likely only cover rehab at certain facilities in Ohio, but the amount of coverage you can get and the number of facilities you can choose from will depend on the structure of your plan.

Prosperity Haven – Quality Substance Abuse Treatment in Ohio

Do you have a private (non-Medicare) health plan through Aetna? Do you or someone covered under your plan require treatment at a drug and alcohol rehab clinic? Finally, are you trying to find a quality rehab in Ohio that accepts Aetna health insurance? If so, Prosperity Haven is the answer.

At Prosperity Haven, we focus our energy on giving you the tools you need to achieve long-term recovery. We offer comfortable inpatient rehab facilities and professional staff who can help attend to your needs. We also implement a wide range of treatments to help you recover, from one-on-one counseling to more holistic therapies. By choosing Prosperity Haven, you’re choosing a path of peace, serenity, and sobriety.

Don’t let addiction run your life any longer. Reach out to Prosperity Haven today to learn more.