If you are a Washington, DC resident with a drug or alcohol abuse problem, then the right health insurance plan might save your life. Substance abuse is listed as one of the essential services for insurance companies. What this means for healthcare consumers is every type of insurance covers drug treatment is some way. Certain policies offer more comprehensive coverage, however; depending on the provider and metal level. If you are shopping Aetna, consider what plans they offer in the Washington, DC area.

Aetna and Metal Levels

Like most insurance providers, Aetna categorizes their policies based on metal level. A bronze plan typically comes with a high deductible and low premium, making it a practical level choice if you have a healthcare savings account. The silver and gold level policies come with lower deductibles, but higher premiums.

On average, you can expect to cover 40 percent of all your healthcare costs with a bronze level plan. The number drops to 30 percent with silver and 20 percent with gold. This doesn’t mean you will pay 20 percent of the cost of detox and drug rehab, though. The specifics depend on the policy.

Aetna Bronze Plans in Washington, DC

The bronze plans available to insurance shoppers in the Capital City all have a high deductible, ranging from $6,450 to $6,850. They are available as either an HMO or PPO plan. With an HMO, or Health Maintenance Organization, plan, you must stay in-network of all abuse related services including detox, inpatient rehab and outpatient treatment. With the bronze HMO plan, Aetna pays the entire bill for both in and outpatient drug treatment after you meet the deductible as long as you stay in-network. You can apply any healthcare cost towards your deductible with the exception of certain office visits, preventive care and urgent care.

A PPO, or Preferred Provider Organization, the plan is more flexible. With Aetna, you can go out of network for most services and pay just half of the total cost. The bronze level PPO plans pay the full cost if you stay in-network after you meet the deductible.

Aetna Silver and Gold Plans

The silver and gold plans change things up a bit for Washington, DC residents. For a silver plan, the deductible drops to $3,500 for individuals and $7,000 for families. If you opt for the PPO plan, there is a separate deductible for out-of-network services – $7,500 for individuals and $15,000 for families.

A silver plan, either HMO or PPO, requires a $75 copay per outpatient visit and a $500 copay for each admission for inpatient care. You pay an additional 30 percent for inpatient treatment after you meet the deductible. If you go out of network with the PPO plan, you pay 50 percent copayment per outpatient visit and a $500 copay for each admission for inpatient care. You pay an additional 30 percent for inpatient treatment after you meet the deductible. If you go out of network with the PPO plan, you pay 50 percent.

The gold plans follow a similar model, but the deduction drops to $1,400 for individuals and $2,800 for families. The PPO plan offers an out of network deductible of $6,750 for individuals or $13,500 for families.

The copayment amount changes for gold plans, as well. You pay $40 for every outpatient treatment, but do not have to meet the deductible for Aetna to pay. If you require inpatient rehabilitation, there is no copay, but you pay a 20 percent coinsurance fee after you meet the deductible. The cost is the same for both PPO and HMO plans. The copayment amount changes for gold plans, as well. You pay $40 for every outpatient treatment, but do not have to meet the deductible for Aetna to pay. If you require inpatient rehabilitation, there is no copay, but you pay a 20 percent coinsurance fee after you meet the deductible. The cost is the same for both PPO and HMO plans.

Having the right insurance when you need a drug or alcohol treatment means you can get the best your state has to offer and have help paying that bill. This way you can focus on getting healthy and getting on with your life. Contact us today at DrugRehab.org for more information on getting into the treatment plan and insurance policy that meets your individual needs.