Aetna sells traditional and consumer-directed health insurance plans and related services, including medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans.
Aetna offers health care, dental, pharmacy, group life, disability, and long-term care insurance and employee benefits, primarily through employer-paid insurance and benefit programs, as well as through Medicare. As of September 2016, the Hartford, Conn.-based company boasted more than 23 million medical members.
In 1973, Aetna created its first health maintenance organization (HMO). By 1985, Aetna was the largest private health insurer in the U.S., running such deals as a joint venture with Voluntary Hospitals of America selling HMOs and PPO plans nationwide.
In December 2017, it was announced that pharmacy giant CVS would purchase Aetna for an estimated $69 billion, a deal which the New York Timessaid will “reshape the American health care industry” since it includes a health insurer, a retail pharmacy, and a a pharmacy benefits manager, which negotiates prescription drug prices with drug manufacturers.
Aetna and Addiction Treatment
Aetna’s open-access, copay-only, and high-deductible health insurance plans can all help to pay for drug rehab and addiction treatment, but coverage options and costs can vary.
If you have Aetna health insurance, you may be covered for the following treatments:
– Inpatient/residential rehabilitation
– Partial Hospital Program (PHP) treatment
– Intensive Outpatient (IOP) treatment
– Continuing care programs
Aetna determines coverage on an individual basis, rather than setting a limit on the number of days a patient may be in treatment. To receive treatment from a provider out of network, there are additional costs. One is advised to check one’s own specific plan, or contact an Aetna representative, to confirm the level of coverage, if any, for out-of-network providers.
In 2012, Aetna announced a partnership with CRC Health Group to treat those with opioid addiction. As prescription painkiller addiction has been recognized by the Centers of Disease Control as a nationwide epidemic, the move opens up treatment options to those in the Aetna network who are in need of care.
For prescription drug abuse issues, Aetna’s plan calls for therapy and 12-Step programs, in addition to medical detox.
Verifying Coverage and Finding the Best, Most Appropriate Treatment
Studying up on insurance options can be overwhelming, especially if you or someone you know is suffering with addiction. Of course, knowledgeable advisors are available—they can verify your insurance coverage and find the best treatment for you. Call your insurance provider and ask an informed representative about the details of your individual plan.