Aetna Insurance Coverage Levels and Coverage Plans
Aetna medical health insurance plans differ between states and are divided into 2 types and 3 tiers.3,4 Health maintenance organization (HMO) plans offer lower premiums and deductibles with set copays, but you need to see doctors who are in-network and obtain referrals from your primary care doctor to see specialists.3 Preferred provider organization (PPO) plans have higher premiums and lower copays and coinsurance and offer specialist and out-of-network visits without obtaining a referral.3 The PPO tiers include:4
- Bronze plans—These cost less in premiums but have the highest deductibles and will cost you more in out-of-pocket expenses. Aetna pays about 70% of the cost of care after the deductible is met.
- Silver plans—These cost more in premiums but have lower deductibles and will cost you less in out-of-pocket expenses than bronze plans. Aetna pays about 80% of the cost of care after the deductible is met.
- Gold plans—These cost the most in premiums but have the lowest deductibles and will cost you the least in out-of-pocket expenses. Aetna pays about 90% of the cost of care after the deductible is met.
Medicaid is a government-funded health insurance program for people who have disabilities or special health needs or who meet specific income requirements.5 Aetna provides plans for Medicaid in many states across the United States.5 Aetna also offers Medicare plans, which offer health insurance through the federal government for adults aged 65 or older and, in some cases, for younger people who have disabilities.6
You may be wondering what rehab centers accept Aetna Insurance coverage. Depending on your Aetna medical coverage policy, you may be able to seek addiction treatment out-of-state. HMO plans cover only in-network providers, and that may be limited by geographic area, while PPO plans may provide more coverage for providers outside of your state. However, checking with your plan to ensure that you will be covered first is always a good idea.
Checking Your Aetna Insurance Benefits
If you want to confirm if Aetna covers drug and alcohol rehab or just check your insurance coverage, you can do so by calling the number on the back of your insurance card (which contains your Aetna policy number or subscriber ID number) and speaking with a representative. You can also view your coverage by using an online account. Logging into a member account also allows you to utilize an alcohol and drug rehab cost estimator to roughly estimate how much Aetna substance abuse treatment might cost. You can also contact American Addiction Centers (AAC) free at .
There is a variety of Aetna plans tailored for federal workers and retirees. These plans vary based on your location and personal needs.7 For more information on what is available in your area, visit this page.
