We often talk about the importance of getting professional treatment for a substance use disorder, but many of those affected mention that cost is the single most common deterrent. Others discuss their readiness, fear, and shame as other barriers to getting help. While financial hurdles can be challenging to overcome, there are alternatives that you may not have considered.
Family Recovery Specialists views these as valid concerns, and we’ve worked tirelessly to make sure that when you invest in yourself, you will not incur substantial costs that stop you from getting the professional, quality help for a healthy future.
We proudly work with insurance companies to make your recovery a reality. We accept major insurance companies, such as Aetna Insurance, which boasts an outstanding reputation for its coverage.
While insurance companies have vastly improved their coverage over the years, there are still some restrictions. The U.S. government’s Affordable Care Act (ACA) allows select individuals with physical, mental, or behavioral health problems to be insured. The ACA, however, does not always cover those who have mental health disorders.
Those seeking coverage for mental health or substance use disorders must comply with parity requirements. Under the law, insurance companies must cover substance abuse and mental health, by law, on the same level as medical necessities.
Recent years have consisted of breakthroughs in diagnosing addiction as a complex brain disease. It received an official diagnosis as a disease in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This effectively ensures insurance companies to cover treatment for people who are battling addiction.
Insurance helps you recoup the costs of medication, inpatient and outpatient treatment, therapy, and several of the medical expenses you could incur from substance abuse. A team of medical professionals will work to ensure you receive the treatment that meets your specific needs.
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The short answer is yes. Aetna will work with you to provide robust coverage options for your drug and alcohol treatment.
The insurance company also offers around-the-clock phone coverage to ease some of the anxiety you may experience during the approval process. Aetna representatives are knowledgeable and always available to answer your questions.
In some cases, medical procedures or medication is crucial when treating mental health or medical care.
Sometimes it requires precertification, which means Aetna has to approve the procedures or medicine before it provides coverage.
Fortunately, Aetna will not require precertification for some residential treatment and outpatient services. It is the job of insurance providers to seek the best treatment options that are nationally recognized.
The guidelines they follow can be found in the ASAM criteria.
Aetna’s coverage is based on a few factors. These include your policy, the level of care required to treat your needs, and the state where you reside. To find out what Aetna will pay for, reach out to a representative, and discuss all of your available options.
Family Recovery Specialists also has knowledgeable intake specialists on staff to help determine the coverage for you or a loved one. Our dedicated team is available around-the-clock to assist you on your path to recovery. It’s our purpose to ensure you get the proper guidance and change your life.
American Psychiatric Association. (n.d.). Diagnostic and Statistical Manual of Mental Disorders (DSM–5). Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm
American Society of Addiction Medicine. (n.d.). What is the ASAM Criteria? Retrieved from https://www.asam.org/resources/the-asam-criteria
U.S. Centers for Medicare & Medicaid Services. (n.d.). Affordable Care Act (ACA). Retrieved from https://www.healthcare.gov/glossary/affordable-care-act/
U.S. Department of Health & Human Services. (2019, March 22). Health Insurance and Mental Health Services. Retrieved from https://www.mentalhealth.gov/get-help/health-insurance
Health Insurance Plans. (n.d.). Retrieved from https://www.aetna.com/