How Aetna Covers Outpatient Drug and Alcohol Rehab in New Jersey

Aetna may cover some or all of the cost of your drug and alcohol rehab at Rubicon Recovery Center in New Jersey, depending on your plan and benefits.

At Rubicon Recovery Center, we provide evidence-based treatment rehab programs for substance use disorders (SUDs) near you in Watchung, NJ. We accept various insurance plans, including Aetna, and can help with insurance verification. However, coverage depends on your specific plan and benefits. Learn more about Aetna coverage for drug and alcohol rehabilitation in New Jersey.

Key Takeaways

• Aetna often covers some or all of the cost of addiction treatment and services, including medical detox, dual diagnosis care, and outpatient programs.
• Your coverage will depend on your exact plan and benefits.
• To verify your insurance coverage, contact Rubicon Recovery Center for free insurance verification. You can fill out our web form or call to get a confidential verification done in minutes.
• If your claim is denied, you can file an appeal with Aetna within 180 days.

What Does Aetna Typically Cover for Addiction Treatment?

Aetna is a nationwide insurance provider that is part of the CVS Health family. It offers a wide network of more than 1.5 million healthcare professionals, as well as mental health and addiction support. If you have Aetna and are wondering if your coverage includes drug and alcohol rehabilitation, know that the exact coverage will depend on your specific plan and benefits. However, Aetna plans often cover various addiction treatment services, including:

Medical Detox Placement

Individuals who use certain substances, such as opioids, heroin, and benzodiazepines, are more likely to require medical detoxification (detox) than others. Our medical detox placement involves us coordinating admission to a medically supervised detox facility (one of our partners), which offers ongoing supervision to manage withdrawals and safely wean a person off substances. Aetna may cover medical detox if it is deemed medically necessary.

Partial Hospitalization Program (PHP)

A Partial Hospitalization Program (PHP) is an intensive outpatient program that provides comprehensive, structured support for individuals in addiction treatment. At Rubicon Recovery Center, PHP is our highest-level program. It runs for six hours a day, five to six days a week, and typically lasts 30 to 45 days. Aetna plans may cover PHP, but prior authorization and a clinical assessment demonstrating medical necessity are often required.

Intensive Outpatient Program (IOP)

An Intensive Outpatient Program (IOP) is another type of outpatient substance abuse treatment that offers a middle ground between PHP and outpatient programs. At Rubicon Recovery Center, our program runs for three hours a day, three to five days a week. It generally lasts 10-12 weeks. Aetna often covers IOPs for substance abuse, but specific coverage and out-of-pocket costs will vary depending on your specific policy.

Outpatient Program (OP)

Outpatient substance use treatment is typically the least intensive treatment option. The Outpatient Program at Rubicon Recovery Center runs for an hour a day, two to three days per week. Aetna plans generally cover some or all of the cost of outpatient programs, but specific details will depend on your plan.

Mental Health and Dual Diagnosis Care

People with an SUD and a mental health disorder have what is called a dual diagnosis. Dual diagnoses require integrated care to treat both the SUD and mental health disorder simultaneously. Under the Affordable Care Act (ACA) and federal mental health parity laws, Aetna plans are legally required to cover mental health and substance use services at the same level as standard medical benefits. This means at least some portion of dual diagnosis care should be covered.

How Can I Verify My Aetna Coverage at Rubicon Recovery Center?

To verify your Aetna coverage, contact the Admissions Department at Rubicon Recovery Center at admissions@rubiconrc.com or by calling (908)-274-0015. You can also fill out our online web form. We provide a quick and easy insurance verification process where you simply tell us your member ID, and we will determine your level of coverage and the possible costs you may need to pay.

What Do Out-of-Pocket Costs Look Like with Aetna?

Your out-of-pocket costs with Aetna include things like copays, deductibles, and coinsurance. These costs will vary based on your specific plan and whether you get in-network or out-of-network treatment. It will also depend on your yearly out-of-pocket maximum, as Aetna will cover these eligible costs after you reach your maximum.

Find Drug and Alcohol Rehab Near You in New Jersey

If you have Aetna and are looking for drug and alcohol rehab near you in New Jersey, turn to Rubicon Recovery Center. We provide whole-person, evidence-based treatment for various substance use disorders, and we accept Aetna. Contact us today to verify your insurance coverage in under 60 seconds, or call (908)-274-0015 for confidential help or to learn more about rehab costs and insurance. We serve patients in New Jersey, Pennsylvania, and New York.

Frequently Asked Questions About Aetna Rehab Coverage

Does Aetna cover outpatient rehab in New Jersey?

Yes, Aetna often covers outpatient rehab in New Jersey, although the specific coverage details will depend on your plan.

Does Aetna cover IOP and PHP at Rubicon Recovery Center?

Coverage varies based on your exact plan, but Aetna generally covers IOP and PHP at Rubicon Recovery Center at least partially.

How do I verify my Aetna benefits?

To verify your Aetna benefits, you can contact the Admissions Department at Rubicon Recovery Center to get a free insurance verification.  You can reach us by calling (908)-274-0015 or filling out our online web form.

What out-of-pocket cost should I expect with Aetna?

Your out-of-pocket costs will depend on your insurance plan and tier, but they typically include your deductible, copays, and co-insurance.

What do I do if my claim is denied?

Sometimes, insurance claims get denied. If yours does, you have options. At Rubicon Recovery Center, we get pre-authorization on coverage prior to admission. If you need assistance with appeals and claim denials, our internal billing will work on your behalf to try to overturn the denial and prove medical necessity.

Does Aetna cover dual diagnosis treatment?

Aetna typically covers dual diagnosis treatment at least partially under federal mental health parity laws and the Affordable Care Act.

Do I need insurance to attend Rubicon Recovery Center?

No, you do not need insurance to attend Rubicon Recovery Center. However, the cost of treatment is typically high without insurance.

What other insurance providers are accepted by Rubicon Recovery Center?

Along with Aetna, we also accept other major insurance providers, including Anthem, Cigna, Blue Cross Blue Shield, and UnitedHealthcare.