Rehab Centers That Accept Aetna Insurance In Arizona

Those struggling with substance abuse know that one of the most important steps in their recovery is finding the treatment facility and people who can help them understand their behavior and disease so they can make better choices and lead a healthier life. Unfortunately, for many patients and their loved ones, the cost of treatment is an impressive obstacle.

Depending upon the severity of the substance abuse problem and whether or not patients have already attempted rehab, there are a number of different paths that treatment can take. Those who have not gone through rehab before might find that they thrive with outpatient treatment where they can then return home to their family as a support system. Others, who might have more serious problems or lack a strong support system at home, may succeed better in an inpatient facility. The length of treatment, the need for detox, and the possibility of aftercare all provide patients with a range of different scenarios and cost structures.

Fortunately, with the Affordable Care Act, insurance companies must provide mental health and substance abuse treatment in their plans. Patients, however, need to review carefully their own unique plan, as the amount of coverage can vary. Here is what all patients should know about their Arizona Aetna plans and substance abuse treatment.

Aetna Substance Abuse Coverage in Arizona

For patients in Arizona, Aetna currently offers four levels of plans: Gold, Silver, Bronze, and Catastrophic. The plans at each differ based on how much money the patient ends up paying out-of-pocket for services and how high the premium and deductible are. The higher the level of the plan, generally, the higher the premium but the lower the deductive, copayments, and coinsurance.

What All The Plans Have In Common

There are a few characteristics that all the plans have, regardless of their level. All of the plans in Arizona currently cover out-of-network care, although it is paid at a lower rate than in-network care. You should note that you will have to pay more out-of-pocket should you go out of the designated coverage network, but the plan can help relieve at least some of the financial burden. Should you choose to go out-of-network, then the plans do require you to obtain precertification for coverage before you obtain inpatient care. Should you fail to do so, you could be penalized.

If you are interested in pursuing alternative therapies, it may be worth speaking with your insurance representative to see if they will be covered. Some treatments, such as acupuncture, are not generally covered, while others, such as chiropractic adjustment, often are.

None of the plans currently offered in Arizona require to you to see a primary care provider for a referral to see a specialist. While primary care providers can be excellent resources for you as you try to sort through the variety of therapies and treatment options available, not requiring a referral does grant you considerably more flexibility. You can select therapists and treatment centers personally.

Gold Level

Gold level plans are designed to cover about 80 percent of your healthcare costs. The plans at this level may have a requirement for you to pay a deductible specifically for your prescription drugs. If you have this deductible, then it does not apply to in-network preferred generic drugs. If you are like many rehab patients and need medications to help during detox or treatment, then understanding these stipulations can help you make a better choices with the help of your provider. All out-of-network rehab services are typically covered at a 50 percent coinsurance rate. If you remain in-network, than inpatient treatment will be covered at a 20 percent coinsurance rate or a flat $40 copay per visit for outpatient treatment.

Silver Level

Silver level plans were developed with the intention of covering about 70 percent of your healthcare costs. Some of the Silver level plans, like the Gold level plans, require you to meet a deductible for prescription drugs as well. Once again, this deductible does not apply to in-network preferred generic drugs. Silver level plans also have a 50 percent coinsurance rate for out-of-network rehab treatment. If you seek inpatient treatment in-network, you will either have to pay a lower coinsurance rate of 30 percent or coinsurance plus a copay. Outpatient treatment has a $75 copay per visit.

Bronze Level

Bronze level plans will cover about 60 percent of your healthcare costs. If you use an out-of-network provider, your costs will be covered at 50 percent. If you stay in-network, then one plan may cover you with 0 percent coinsurance or you may owe a flat copay of $50 per visit for outpatient treatment and $250 per admission for inpatient treatment. Please note that one of the Bronze level plans also offers you the option of pairing it with an HSA, a health savings account. This is a tax free account that allows you to put away money for certain expenses. For example, you can save for additional therapy after rehab or certain allowed holistic treatments.

Catastrophic

Catastrophic plans are available only for patients who are either under thirty or for those for whom insurance has been determined to be unaffordable and they therefore receive a hardship exemption. These plans will have lower monthly payments that some other plans and preventive services are covered at 100 percent. Your rehab, both inpatient and outpatient, are covered with 0 percent coinsurance for in-network treatment and 50 percent coinsurance for out-of-network.

Those preparing to enter rehab should always carefully review their insurance plans to see how coverage is structured. This can help them avoid unnecessary out-of-pocket costs. Contact an insurance agent before making any medical decisions.

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