Wyoming residents have access to a diverse range of health insurance plans. This is especially critical for individuals who might have a drug or alcohol abuse problem. Insurance can offer you a better treatment plan or more comprehensive services than you get without it. Substance abuse is one of the 10 essential services defined in the Affordable Care Act, too, meaning that all policies cover it in some way, although not every plan is the same. The exact benefit will depend on the insurance provider and the plan metal level. If you are looking to make Aetna your insurance company, consider what plans they offer in Wyoming and what they each pays towards drug treatment.
Aetna, like most insurance providers, bases their plans on metal levels as defined by the Affordable Care Act. Bronze plans are designed with a high deductible and low premium, so they work well with a healthcare savings account. The silver and gold plans, on the other hand, come with lower deductibles, but higher premiums. Using metal levels allows you to see at a glance what plan might be right for you.
On average, you can expect to pay 40 percent of all your healthcare costs with a bronze level plan. That is 40 percent of everything as a group. You may pay more towards some services and less towards others, but the average will stay around 40 percent. That number drops to 30 percent with silver plans and 20 percent with gold.
Aetna may offer both HMO and PPO plans in this state, depending on your location. With an HMO, or Health Maintenance Organization, plan, you must stay in-network for all substance abuse-related services including detox, inpatient rehab and outpatient treatment. The PPO plans are more flexible. They allow you to go outside the network, but you may pay more of the total cost and have to meet to a higher deductible.
At the bronze level, the deductibles average around $6,850 for individuals and $13,700 for families. Certain services do not apply to the deductible, such as office visits, preventative care and urgent care treatments. The PPO plan has a different set of deductibles for out-of-network care. An individual will pay $13,700 and $27,400 for families.
At the bronze level, the deductible is very important when it comes to drug rehab. For both the HMO and PPO plans, the company pays 100 percent of the bill for in and outpatient treatment, but only after you meet the deductible. If you buy the PPO plan, you have the option to go out-of-network and pay 50 percent after the deductible, as well.
At the silver level, Aetna offers one PPO and one HMO option. The deductible drops down to $3,500 for individuals and $7,000 for families, but it does not apply to certain office visits, preventive care, urgent care and prescription drugs in-network. If you opt for a PPO plan, the out-of-network deductible is $7,500 for individuals and $15,000 for families. The same restrictions apply for the out-of-network deductible.
For silver plans, the deductible becomes less important for outpatient treatment. You pay just $75 for every visit and the deductible is waived. This means you make that same payment every time and Aetna covers the rest regardless of your deductible standing.
For inpatient care where you are hospitalized for detox and residential treatment, the copayment is $500 per admission. You will also pay a 30 percent coinsurance fee after you meet the deductible. Broken down that means you pay $500 plus what’s left of your deductible. Aetna pays 70 percent of the rest of the bill.
Gold plans from Aetna come with a lower deductible and copayment amount. The average deductible is around $1,400 dollars for individuals and $2,800 for families. For outpatient substance abuse treatment, you pay $40 per visit and the deductible does not apply. If you need inpatient service, the cost is 20 percent after you meet the deductible.
Insurance specifics may vary by location, too. One thing that never changes is drug rehab can give you back your life. How you pay for it matters, though. Finding an insurance company like Aetna gives you less to worry about, so you can focus on sobriety. For help getting an insurance plan that suits your needs, contact us today at DrugRehab.org.