Waiting on Rehab Because of Cost? Aetna PPO May Already Cover Treatment in RI
The price of rehab without insurance can be terrifying. For instance, a 30-day inpatient stay in a Rhode Island center can cost you up to $20,000 out of pocket.
Needless to say, that big number is a brick wall for many and makes them hesitate, no matter how badly they need substance abuse or mental health rehab.
If these concerns make you think things like “I’ll wait until I save more,” or “I’ll quit on my own,” let us help. Since this waiting can be downright dangerous or life-threatening, we want you to know all the options you can avail to uproot this evil.
Previously, we talked about using UnitedHealthcare and BCBSRI for rehab, and today, our focus is on Aetna PPO. This blog will explain if you can access Aetna addiction treatment RI, and if so, what its specific features are. So instead of letting the possible expenses scare you, keep reading. You never know if there’s a better way out of this mess.
What is Aetna PPO?
Aetna PPO is a health insurance plan that lets you choose any rehab center without needing your primary doctor to give a referral. But know that when you receive the treatment from in-network facilities that have a contract with Aetna, you’ll pay less. But if you wish to go with an out-of-network rehab center, you can still have Aetna addiction treatment RI, but it will be slightly more expensive.
Here’s how Aetna PPO differs from other insurance providers:
Most insurance plans make you see a family doctor first to get a referral, which can waste a lot of precious time. But Aetna removes that barrier, and here are some reasons that make it helpful for someone battling an addiction:
- You can call a treatment center in Rhode Island today and start the process without a middleman telling you where to go.
- You can directly access specialists and rehab programs. And if a facility seems suitable for Aetna addiction treatment RI, you can use your benefits there immediately.
- Even if a rehab center isn’t on Aetna’s “preferred” list (out-of-network), your insurance will still help pay for it. Sure, you’ll pay more out of your own pocket in this situation, but you aren’t forced to rely on a certain provider.
Does Aetna PPO Cover Rehab in Rhode Island?
Here is the good news: Aetna PPO plans cover drug and alcohol rehab in Rhode Island. The Affordable Care Act (ACA) requires insurance providers to cover substance use disorder treatment as an essential health benefit.
In simpler words, your plan will support Aetna addiction treatment in RI. Here are some rehab services you can avail with an Aetna insurance plan:
Medical Detox:
Aetna PPO plans cover medically supervised detox to help you safely overcome drug withdrawal symptoms.
Inpatient (Residential) Rehab:
If your addiction is so strong that you must get admitted to overcome it, you can benefit from Aetna addiction treatment RI.
It’ll partly pay for your residential stay, while you receive around-the-clock therapy and support.
Partial Hospitalization Program (PHP):
PHP is the middle ground where you spend 5–6 hours a day at a center, but don’t technically live there.
If your addiction requires regular monitoring but not as strict as an inpatient stay, you can pay for it with an Aetna PPO.
Intensive Outpatient Program (IOP):
Another treatment model that Aetna addiction treatment in RI covers is IOP.
This model helps when you occasionally visit a rehab center to attend therapy and counseling sessions.
What is the Difference Between In-Network and Out-of-Network Addiction Treatment in RI?
The main difference is obviously what you’ll pay and the choice of providers you can work with, and the amount of choice you have. In-network facilities have a contract with Aetna to provide services at a discounted rate, which means that Aetna pays a much larger portion of your bill.
However, out-of-network facilities do not have a contract. So while you have more freedom to choose any center in Rhode Island, you will pay a significantly higher out-of-pocket cost.
Aetna’s in-network list is much like a VIP discount club. Since these facilities have a pre-arranged deal with Aetna, prices are locked low. On the other hand, out-of-network providers haven’t agreed to Aetna’s rates, so they can charge what they want.
Here is how these differences impact you:
Paying for Freedom
People prefer Aetna addiction treatment RI for its flexibility. You pay a higher monthly premium (the cost to keep your insurance active) just so you can leave the network when needed. So when other plans lock you into a list of doctors, your PPO doesn’t. You pay this bigger premium for the peace of mind that no door is completely closed.
In-Network Charges
If you get treated from an in-network center, Aetna can even pay up to 80% of the bill, meaning you’ll pay the remaining 20%. Of course, staying on Aetna’s list of providers is the most budget-friendly way to get high-quality rehab.
Out-of-Network Gap
If you go out-of-network, the math changes. Aetna may only pay 50% of the cost, forcing you to cover the rest.
Also, more importantly, Aetna only pays 50% of what it thinks the service should cost, which will not necessarily be what the rehab center charges. So if a rehab facility charges more than Aetna’s allowed amount, you are responsible for that 50% plus the entire difference.
And that’s why out-of-network care is much more expensive, even though your PPO technically covers it.
Does Aetna Cover Dual Diagnosis Treatment?
Yes, Aetna PPO plans cover dual diagnosis treatment in Rhode Island. Insurance companies treat mental health and substance use disorders with the same level of urgency as physical health.
Eventually, your Aetna plan will cover treatment for co-occurring disorders, such as depression, anxiety, or PTSD, alongside your Aetna addiction treatment in RI.
Get the Help Without Going Broke
Insurance providers like Aetna PPO and UHC are helping hands for RI residents seeking addiction treatment. Having these plans means you won’t pay for substance abuse help out of your pocket and can eventually complete it.
Therefore, we recommend all our readers to ask questions about their insurance plans and make the most out of what they pay these insurance companies. Good luck getting your finances in order.