GUARDIAN RECOVERY NETWORK: AETNA HEALTHCARE

We will work to ensure that your Aetna health plan provides as much coverage possible for our world class recovery services and facilities, including detoxification programs, inpatient and outpatient care. Our continuum of care includes aftercare planning and case management services, and your Aetna plan may be able to help reduce the cost of these services as well.

Aetna was founded in 1953 as Aetna Life Insurance Company. Today, the health insurance provider covers over 22 million Americans, providing affordable access to over 1.2 million health care providers at almost 6,000 hospitals and care facilities, nationwide. Aetna provides coverage for alcohol and drug addiction treatment through behavioral health benefits that may be incorporated in your Aetna insurance plan. These benefits provide coverage for a range of services under the umbrella of mental and behavioral health, including coverage for depression, anxiety, trauma and PTSD.

Aetna believes that nothing should stand in the way of mental health and wellbeing, and this includes treatment for substance abuse. Aetna’s variety of health plan options fit several needs, from stand-alone behavioral health plans to coverage that integrates with Aetna health benefits. In many cases, outpatient care does not require precertification or preauthorization. Accessing behavioral health services with your coverage through Aetna can be as easy as visiting your primary care doctor. Services such as inpatient treatment, partial hospitalization programs, and intensive outpatient programs may require preauthorization before your Aetna health plan will provide coverage. Whether you have an Aetna Choice plan, Aetna Select plan, Aetna HealthFund, Aetna Health Network or Aetna Medicaid plan, the quickest and easiest way to see how your benefits may apply within the Guardian Recovery Network is to contact us online or call us at 877-831-2533.

Specific factors that affect the amount of coverage you receive can include the type of addiction being treated, your length of stay in the rehab facility, the length of outpatient or aftercare services, and your individual deductible and co-pay. If your plan is an Exclusive Provider Organization (EPO), or Health Management Organization (HMO), Aetna may require you to see an in-network provider or to receive preauthorization from your primary care provider before you begin an inpatient stay. Preferred Provider (PPO) plans often do not require primary care provider referrals and there are typically fewer restrictions on your choice of treatment provider.

Aetna offers both individual health plans through the Health Insurance Marketplace, as well as employer-based plans. All individual plans purchased through the Health Insurance Marketplace cover substance abuse treatment as an essential health benefit. This includes coverage for pre-existing conditions, and spending limits are not allowed. Parity protections for substance abuse treatment ensure that benefit limits must be the same as they are for your plan’s medical and surgical coverage. For example, there can be no less favorable limits on deductibles and co-pays, or the number of days or visits covered, and preauthorization requirements can be no more strict than those for general medical care. Large employer group plans do not have to comply with essential health benefit coverage, but if they do cover substance abuse treatment, they cannot place annual or lifetime dollar limits on that coverage.

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The best way to find out if your plan will mitigate the cost of your care within the Guardian Recovery Network is to call us at 877-831-2533. We know that choosing the right rehab facility can be daunting. Our goal is to help you begin your treatment as soon as possible. Should you need any assistance navigating our facility offerings, our individualized programming, or our insurance guidelines, we’re here to help. Together, we’ll secure a thriving future for you and your family.

If you or someone you love needs support for today, and hope for tomorrow, your journey begins with a phone call to 877-831-2533.