When you’re addicted to a substance, your life is difficult enough without needing to worry about how to pay for the treatment you need. But health insurance is a resource that can help you get affordable treatment for drug abuse, addiction and/or mental illness. Aetna is one of the carriers that provides insurance coverage in the state of Florida to cover some of your treatment.
Coverage For Your Needs
Fortunately, all health plans in the health insurance marketplace are required to cover care for substance abuse, addiction, and mental health. This is great news when you are planning to go to a treatment facility, office visits with a counselor, or another type of treatment.
Aetna has different plans you can choose from in Florida that offer varying amounts of coverage. Between the different options, you should be able to find an Aetna plan that fits your life. There are bronze level plans that pay 60 percent of your care, silver level plans that knock out 70 percent, and gold level plans that cover 80 percent. You are responsible for the rest. The bronze plans usually have low premiums each month with higher deductibles, while the silver and gold plans cost more for monthly payments because they give more coverage and tend to cost less out of pocket.
The premiums can vary based on certain factors, such as your age and whether you use tobacco. For the bronze HMO plan, you could expect to pay a premium of $212.95 a month if you’re 21 or $297.49 a month if you’re 44. The marketplace can help you figure out your individual costs, and you might qualify for a subsidy that lowers the premium each month.
You have a few Aetna plan choices under the different metallic levels. You should look into all your options to find the absolute right insurance plan for your needs, but we’ll give you an idea here of what you can expect.
One bronze choice is the FL Aetna Bronze $15 Copay Savings Plus HMO PD plan. This plan comes with an individual deductible of $6,850, and it only covers care inside the plan’s network. After the deductible, you do not have to pay anything for mental health, behavioral health, and substance use treatment. This plan covers care both in an outpatient setting and an inpatient facility, so you can choose which type of treatment is better for you.
A silver option is the FL Aetna Silver $10 Copay 2750 Savings Plus HMO PD plan. You’ll pay a much lower deductible for this plan, which is $2,750 for an individual. With this plan, you can go to outpatient visits without paying the deductible first. The visits cost a $75 copay each time for both mental health and substance use care. If you opt to go to an inpatient facility instead, you would pay a 40 percent coinsurance. This plan only covers providers that are inside the plan’s network.
At the gold level, one of your choices is the FL Aetna Gold $10 Copay Savings Plus HMO PD plan. This has the lowest deductible of the three, at $1,400 for an individual. Out-of-network care is not covered by the plan, but in-network inpatient and outpatient care for mental health and substance use are covered. For outpatient visits, you would pay a $40 copay each time with the deductible waived for this option. For inpatient treatment, you would be responsible for a 20 percent coinsurance.
Another option is a catastrophic plan, such as the FL Aetna Catastrophic Savings Plus HMO PD plan. This plan comes with an individual deductible of $6,850. It only covers in-network providers. After you pay the deductible, there is no charge for your mental health and substance use treatment. That is the same whether you decide to go to outpatient visits or you enter a residential facility.
Once you are covered, check with your plan about the specific treatment facilities and providers it will cover within the network. You could check on different types of treatment, such as detox, wilderness programs, alternative treatments and more.
Insurance coverage can be a lifeline when you need help paying for drug or alcohol treatment and/or a mental health concern. Aetna offers plans that cover this type of care in Florida. For more information or for help getting into a facility that meets your needs, contact us at DrugRehab.org today.