Rehab Centers That Accept Aetna Insurance in Delaware

If you’re not sure how you will afford drug and alcohol treatment and/or mental health services, consider an insurance plan that will cover at least a portion of the care you receive. Aetna’s plans through the Delaware insurance exchange provide coverage for these types of health care. There are a variety of options that differ in their coverage.

Aetna Plans in Delaware

Plans are broken down into bronze, silver and gold options depending on the amount the plan will pay toward health care.

Bronze Plans

With bronze plans, you spend less on your monthly premium, but will end up spending more on the health services you require.

Bronze $20 Copay HNOnly Plan

This HMO plan covers both inpatient and outpatient services for mental health, behavioral health and substance use disorders. A copay is required for all of these types of care, with $50 a visit for outpatient services and $250 for admission to an inpatient program. This plan only covers these visits or admissions if you go to a network provider instead of an out-of-network one.

Bronze $20 Copay PPO Plan

This is a PPO plan that covers inpatient mental, behavioral and substance use disorder services, as well as outpatient ones. It retains the same copay cost as the HMO one for in-network providers. Also, this plan does allow the use of out-of-network providers, with a cost of 50 percent coinsurance. Inpatient services require precertification for the out-of-network providers or the benefits will not cover as much.

Bronze Deductible Only HSA Eligible HNOnly Plan

This HMO plan has a 0 percent coinsurance for mental, behavioral and substance use disorder services. This plan does not cover any mental health or substance abuse services out of network.

Bronze Deductible Only HSA Eligible PPO Plan

This PPO plan comes with a 0 percent coinsurance for substance use disorder and mental health care. If you prefer to see an out-of-network provider, you can do that for a 50 percent coinsurance. On top of that, out-of-network inpatient services require precertification or the price goes up without it.

Silver Plans

At the silver level, the plan covers more of the cost of health services.

Silver $5 Copay 2750 HNOnly Plan

When covered by this HMO plan, you can expect to pay $75 copays per visit, with a waived deductible, on outpatient services for mental health and substance abuse. Inpatient care costs 30 percent coinsurance. In this plan, out-of-network providers are not covered.

Silver $5 Copay 2750 PPO Plan

This PPO plan has the same costs as the 2750 HMO plan for in-network providers. In addition, it covers out-of-network providers with a requirement of 50 percent coinsurance. Out-of-network inpatient services need a precertification or the care costs an additional amount.

Silver $10 Copay HNOnly Plan

An HMO plan, this option covers in-network mental health and substance use services, but not out-of-network ones. Outpatient visits cost a $75 copay with a waived deductible, and inpatient services require 30 percent coinsurance and a $500 copay for admission.

Silver $10 Copay PPO Plan

This PPO plan has the same charges as the $10 copay HMO version for in-network providers. It also covers out-of-network providers for 50 percent coinsurance, with the requirement of precertification for out-of-network inpatient services to avoid extra charges.

Aetna also offers these silver plans in cost sharing reduction, or CSR, versions.

Gold Plans

These plans cover the highest percentage of health service costs, with higher premiums per month.

Gold $5 Copay HNOnly Plan

This is the HMO gold plan, which requires a $40 copay for each outpatient visit, with the deductible waived. For inpatient mental, behavioral and substance abuse treatment, the cost is 20 percent coinsurance. This plan only covers providers that are in the network.

Gold $5 Copay PPO Plan

This PPO version covers both in-network and out-of-network providers. The costs are the same as the HMO plan for in-network ones. For out-of-network, you would spend a 50 percent coinsurance, plus you need precertification for out-of-network inpatient care or you get a penalty charge.

As a Delaware resident, choose the plan that best fits the health services you expect to participate in to recover from drug or alcohol abuse or addiction, and/or work on mental health concerns.

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