Creating a financial plan is critical if you are anticipating drug or alcohol treatment for yourself or someone you love. Substance abuse treatment is an essential service covered by all insurance plans in some way, but each policy is different. The key is to find a plan that fits your rehabilitation needs and your budget at the same time. Aetna is a company that offers policies in most states either directly or through an affiliate. They also provide comprehensive coverage for both detox and treatment. Consider what Aetna might offer Montana residents seeking sobriety.
Establishing metal levels is part of our country’s healthcare reform strategy. The goal is to let insurance shoppers get a feel of what to expect from each policy based on the metal level. Bronze plans tend to carry high deductibles, but lower monthly payments. They work well when partnered with a health savings account. Aetna will pay around 60 percent of the overall healthcare costs when you buy a bronze plan, including coverage for medically managed detox, outpatient individual and group therapy, as well as inpatient care.
A silver plan offers a lower annual deductible, but higher monthly premiums than the bronze plans. The lower deductible makes the plan more affordable for those who do not have a health savings account to help toward their insurance. Silver plans generally pay around 70 percent of policyholder’s total healthcare costs, leaving around 30 percent to be paid by the policyholder.
Gold plans introduce a more affordable deductible, but a higher overall monthly premium. Gold Aetna plans will generally cover more of the total cost of care; generally up to 80 percent. Picking the right metal level depends on your monthly budget, your health, and how often you see a doctor, but can also depend on your addiction, in this case, as you may want coverage for inpatient care and not have to pay a higher copayment for the intensive treatment.
While Aetna offers coverage in most areas, it can change from place to place. Half of the current plans allow residents to go outside the network for drug detox and treatment, but you may end up paying more that way. The Aetna Bronze $15 Copay Savings Plus OAMC PD plan, for example, requires you to pay a 50 percent coinsurance fee if you go outside of the network for either in or outpatient drug treatment.
If you stay within the network, Aetna covers the full cost of the treatment once you meet the deductible. That means you would only need to pay the $6,850 (average) for individual policies and $13,700 (average) for family coverage deductible.
The Aetna Whole Health program changes things up a bit. As an HMO plan, it pays the full cost of substance abuse treatment and managed detox after you meet the deductible, but will pay nothing is you go out-of-network.
The silver and gold plans from Aetna introduce copayments into the drug treatment strategy. The Aetna Silver with Copay is a POS plan lets you stray outside the network, but at a cost of 50 percent – you must pay half of the total bill for both rehab and detox. For outpatient treatment, your cost includes a $75 copayment per visit, but you do not need to meet the deductible first. For residential or inpatient care, the copayment is $500 per admission and then 30 percent of the bill after the deductible is met.
With the Silver HMO plan, you must stay in-network for all healthcare treatment including both inpatient and outpatient substance abuse. The copays change with this policy, too. You make a $30 copayment for outpatient treatment and a $500 payment towards residential care. The inpatient treatment requires you to make an additional 30 percent coinsurance payment after you meet the deductible of $3,500.
With Aetna gold plans for this area, one POS and one HMO, the deductible goes down to around $1,400. You make a $40 copay for outpatient treatment and a 20 percent coinsurance fee for inpatient care.
Shopping wisely for insurance means it is there when you need it. You want a plan that fits your budget but also offers the best coverage for substance abuse treatment, so you can focus on getting your life back on track and becoming a better you. Contact us at DrugRehab.org today to get started.