If you or someone you love has a substance abuse problem, then your insurance company is the first place to look for help in covering treatment costs. Drug and alcohol addiction affects millions of people in this country, so mental health services like rehab are considered essential, according to the Affordable Care Act. Not all health plans are the same, though. Finding the right plan will help pay for the treatment you need this year. Consider what Aetna has to offer North Dakota residents.
A Little About Aetna
Aetna is one of the top health care insurers in the country and is listed as a Fortune 100 business. They offer health insurance plans throughout the states under different brand names such as Aetna Whole Health and even partner with subsidiaries to ensure that all citizens may obtain one form of their insurance or another.
This insurance provider has served healthcare consumers since 1853. In 2014, the company donated 1.2 million dollars in grants to support the use of digital health technology for minority or at-risk populations. With all of its accomplishments, Aetna can also help pay a portion of your substance abuse treatment.
Aetna Metal Levels
Aetna is a comprehensive insurance provider that offers plans in most states. Their diversified portfolio means not all plans are available in all areas, though. Like most insurance companies, they work on a metal level system. This means plans come in at least three levels, designated by a metal label.
Bronze plans pay 60 percent of your overall health care costs for the year. You are responsible for the additional 40 percent plus the deductible. Bronze policies tend to have high deductibles and low monthly premiums. This makes them an ideal choice for individuals with access to the health savings accounts.
The silver plans from Aetna cover 70 percent of your overall health care costs, leaving you to manage just 30 percent. The silver plans come with lower deductibles and higher monthly premiums.
A gold level plan offers the lowest deductible but comes with a higher monthly payment. Aetna gold plans pay 80 percent of the costs while you cover just 20 percent.
Aetna Insurance Plans
Finding the right Aetna plan will depend on where you live. Half of the current plans allow you to go outside the network for drug detox and treatment, but you may pay more. For example, the Aetna Bronze $15 Copay Savings Plus OAMC PD plan 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 in-network, you only pay the $6,850 for individual policies and $13,700 for family coverage deductible. Aetna covers the full cost of the treatment once you met the deductible.
Other bronze plans from this provider include the Aetna Whole Health program. This HMO plan 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 follow similar patterns. The Aetna Silver with Copay is a POS plan that allows the insured to stray outside the network, but at a cost of 50 percent, so you pay half of the total bill for both rehab and detox. For outpatient treatment, you pay a $75 copay per visit and do not need to meet the deductible. For residential or inpatient care, the copayment is $500 per admission and then 30 percent of the bill after the deductible is met.
The Silver HMO plan requires you to stay in-network for all healthcare treatment including substance abuse. The copayments are the same with this plan as they are with other silver programs. You make a $30 copay 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 the gold plans, one POS and one HMO, the deductible goes down to around $1,400. You pay a $40 copay for outpatient treatment and a 20 percent coinsurance fee for inpatient care.
Finding an insurance plan is tricky, but it can offer you the best hope of getting the help you need for a drug or alcohol problem. To start your journey toward recovery today, contact us at DrugRehab.org.