Medical Providers:
Dr. Michael Vines, MD
Alex Spritzer, FNP, CARN-AP, PMHNP
Clinical Providers:
Natalie Foster, LPC-S, MS
Last Updated: June 9, 2021
Aetna, founded in 1850, has grown into the third-largest health insurance provider by membership. In 2018, CVS acquired the national insurer, broadening treatment options at their locations for Aetna members.
With Aetna rehab coverage, the cost of addiction treatment across different settings can be significantly reduced.
Aetna is among the national insurers that specifically offer coverage for addiction rehab. Their HMO and PPO plans include substance abuse treatment, typically covering a range of services such as:
Aetna’s substance abuse guidelines align closely with the American Society of Addiction Medicine’s criteria for diagnosing alcohol use disorder and substance use disorder. While not a complete list, your first conversation with an addiction specialist will likely cover questions like these to help determine the level of care your insurance may cover:
Following the Affordable Care Act, all insurance providers are required to cover behavioral and substance abuse treatments. Although coverage can vary by individual policy, Aetna typically covers the most common types of addiction, including:
In short, yes. The medical community increasingly recognizes that addiction often co-occurs with mental health conditions, both of which require treatment to support long-term recovery. Depending on your plan, Aetna may cover widely used therapies such as Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, and even Biofeedback.
The medications covered by Aetna depend on your specific plan. By knowing your plan name and year, you can check the exact coverage for any prescription on their website.
While medication-assisted treatment (MAT) isn’t required for everyone, it can be highly effective for many, particularly those dealing with opioid addiction. Combining prescription medications with behavioral therapy often supports long-term recovery.
At Arizona IOP, we provide a specialized MAT program designed to help clients overcome addiction and maintain lasting sobriety.
Suboxone (buprenorphine + naloxone) is an FDA-approved treatment for opioid use disorder. Aetna generally covers Suboxone under most pharmacy plans, though the exact coverage depends on your plan and deductible. Some plans may require a referral to a doctor authorized to prescribe it, while employer-based coverage often has different requirements.
At Arizona IOP, our team is qualified to prescribe Suboxone on-site and will collaborate closely with you and your insurance provider to ensure the most cost-effective treatment.
Methadone maintenance differs slightly from Suboxone, as it is dispensed at specialized Methadone clinics. Because of this, Methadone is usually covered under your medical plan rather than your pharmacy plan, which can affect how much your plan will pay based on your specific coverage.
For guidance on understanding your individual Aetna benefits, contact our addiction specialists today.
Although substance abuse treatment is considered an essential service under the Affordable Care Act, the level of coverage varies by insurance plan. Generally, you can choose a higher-coverage plan with higher monthly premiums or a lower-coverage plan with lower monthly costs.
Individuals who have met their annual medical plan deductible may qualify for full insurance coverage. Those who haven’t reached their deductible will likely be responsible for part of the treatment costs. Some of the most common payment options include:
In Arizona, Arizona IOP partners with Aetna to help clients reduce the cost of treatment while receiving personalized care from masters-level clinicians. In 2017, Aetna was among 16 health insurers to adopt the National Principles of Care for Substance Abuse Treatment. These principles emphasize working with treatment centers that provide individualized diagnoses and treatment, access to FDA-approved medications, and care from trained, accredited behavioral health professionals.
At Arizona IOP, we are committed to upholding these National Principles of Care for Substance Abuse Treatment.
Aetna is a national plan with coverage in all 50 states, allowing you to seek treatment outside the state where you’re insured. While out-of-state treatment may not be ideal for everyone, it can provide an opportunity to step away from environments that contribute to addiction and support a fresh start in recovery.
Aetna is one of several insurance providers that offer coverage for addiction treatment. If you or a loved one have a different insurance plan, be sure to review that provider’s benefits carefully, including:
