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Aetna Drug Rehab Coverage in North Carolina

Once you decide that you or someone you love needs help for a drug or alcohol problem, the next step is figuring out how to get it. One resource for any healthcare needs, including substance abuse, is going to be your insurance company. How your policy handles addiction detox and rehab will affect the type treatment you get, how long you stay in a facility, and whether you need to see your primary care physician for a referral. Making smart choices starts with understanding how a health insurance company like Aetna can help you through substance abuse treatment when you live in North Carolina.

A Little About Aetna

Residents in the Old North State of North Carolina enjoy the balmy weather and beautiful shores, but what kind of health insurance can residents get? One company that comes to mind no matter where you live is Aetna. A member of the Fortune 100, Aetna has some kind of insurance available in most states in the union including North Carolina. Aetna has been a mainstay in the insurance marketplace since 1853 and, today, works intimately with communities to create a better health care system.

Aetna Metal Levels

Aetna works on a metal level model, as do most insurance companies. As you shop for a policy that fits your budget and lifestyle, take the metal level into consideration.

At the bronze level, healthcare consumers pay about 40 percent of the covered expenses, meaning Aetna will pay 60 percent of all services. This would include medically supervised detox, inpatient substance abuse treatment, and outpatient individual and group therapy. Bronze plans generally have high deductibles, copayments, and coinsurance fees, so they are an ideal choice for the North Carolina resident that has a health saving account to supplement the insurance.

With a silver level plan, you will pay about 30 percent of your overall health care costs, leaving Aetna to cover 70 percent. Silver plans tend to have lower deductibles, but higher monthly premiums.

A gold plan will allow you to lower your contribution to around 20 percent with Aetna paying 80 percent of your health care costs. This is a practical choice for the individual that wants a low deductible and out-of-pocket expense but can afford a higher monthly premium.

In some states, Aetna offers a catastrophic benefits plan, as well. Catastrophic plans generally have low monthly premiums, but they are only available for preventative services and for individuals under the age of 30.

Aetna Bronze Plans

If you are lucky enough to have an Aetna plan, then you have a healthcare partner that will be there when you need drug or alcohol detox and rehabilitation. Aetna has a diverse portfolio and not all plans are available in all areas. Even within each metal level, there are a wide variety of plan options.

In general, the Aetna bronze plans either require you to meet a deductible before the company pays towards your healthcare or you make a copayment with each visit. The title of the plan identifies the model. For example, the Aetna Coastal Bronze $30 Copay PD requires you to make a $30 copayment for outpatient drug treatment, but the deductible is waived. In other words, you will pay $30 for each session and Aetna pays the rest even if you have yet to meet the deductible. The company pays 100 percent of inpatient care after you meet the deductible.

Deductibles at the bronze level average around $6,500. For deductible only plans, Aetna pays 100 percent for both in and outpatient treatment after you meet the deductible.

Aetna Higher Metal Level Plans

The silver and gold plans are mostly copayment models. This means you make a contribution to your rehab bill for outpatient care. For residential, or impatient, treatment you will make a coinsurance payment that ranges from 10 percent to 40 percent depending on your policy.

The deductibles are lower for higher metal plans, as well. They will range from approximately $1,400 to $2,750.

On all plans, receiving treatment out-of-network will cost more to you. For most Aetna plans, if you go out-of-network for any care, including substance abuse, you will pay 50 percent of the total cost after meeting your deductible.

If you are looking at drug rehab this year, Aetna is a practical insurance choice. They offer a variety of plans, so there is one to fit most budgets. For more information on healthcare costs, getting an insurance plan for your needs, or help getting into a treatment program for your addiction rehabilitation, contact us today at DrugRehab.org.

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