Aetna Drug Rehab Coverage

Aetna Insurance Coverage for Addiction Partial Hospitalization Programs in Los Angeles

Aetna PHPs

Harmony Place provides various substance abuse recovery services and accepts Aetna insurance in Los Angeles, California. Our structured addiction recovery programs offer personalized treatment plans, holistic addiction treatment, and mental health intensive care. Our programs deliver the required behavioral health services, including dual diagnosis treatment.

Does Aetna cover PHP in LA? Aetna California PHP providers accept most health insurance plans, including outpatient rehab options like PHP day treatment. Contact us for help verifying your benefits for drug and alcohol addiction recovery support in Los Angeles, California.

Check Your Insurance Call: (855) 652-9048

About Aetna Insurance

Who Is Aetna, a PHP Insurance Provider?

Aetna insurance is a noteworthy health insurance provider in the U.S., offering various plans, including coverage for comprehensive addiction therapy, mental health services, and therapeutic day programs, such as partial hospitalization programs (PHP). As a subsidiary of CVS Health, Aetna prioritizes integrated care to enhance physical and mental health. Their extensive network provides various treatment options, ensuring comprehensive coverage.

Established in 1853 in Hartford, Connecticut, Aetna has transformed over the years into a significant entity in the health insurance sector. Their extensive history showcases a strong commitment to adapting to the evolving healthcare environment. It is essential to understand that Aetna operates separately from Elevance Health. Elevance Health, known as Anthem Inc., rebranded in June 2022 to better represent its broadened focus beyond conventional insurance. Aetna continues to offer a wide array of insurance products, including employer-sponsored plans, Medicare Advantage, and Medicaid services. Covered services include medical detoxification, inpatient care, continuing care programs, relapse prevention strategies, and outpatient treatment services, such as partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). Aetna aims to provide accessible, high-quality mental health care and assist you through all recovery phases.

Other Brands, Products, and Services of Aetna

Aetna, a part of CVS Health, is a prominent healthcare provider in the United States. In addition to its primary health insurance services, Aetna offers a diverse range of products and services while partnering with various brands to promote comprehensive health and wellness:

Aetna Medicare: Provides a variety of Medicare Advantage plans, prescription drug plans, and Medicare Supplement Insurance, ensuring comprehensive healthcare coverage for older adults.
Aetna Dental and Vision Plans: Standalone dental and vision plans exist for individuals, families, and employers. These plans cover preventive care, routine check-ups, and corrective treatments.
Aetna Behavioral Health: Delivers mental health and substance abuse support through comprehensive addiction therapy and a network of therapists, counselors, and various treatment programs.
Aetna Pharmacy Services: Offers integrated pharmacy benefits management, helping you effectively manage your medications and associated costs.
Resources For Living: A program dedicated to employee assistance and work-life support services, offering counseling, coping skills development, eldercare, and wellness resources.
Aetna International: Provides global health benefits and insurance for expatriates and multinational companies, facilitating access to healthcare abroad.
Attain by Aetna (in partnership with Apple): A wellness application that merges health data with personalized goals to promote fitness and healthy habits while rewarding you with incentives.
Aetna Whole Health: A value-based care initiative that collaborates with Aetna CA PHP providers to deliver coordinated, high-quality healthcare, focusing on outcomes and cost-efficiency.

Information and Attractions of LA

Los Angeles is the entertainment capital of the world, boasting Hollywood, the epicenter of the film and television industry. Major studios such as Universal, Warner Bros., and Paramount create blockbuster films and beloved shows here. The city draws visitors from around the globe with its celebrities and iconic landmarks, including the Hollywood Walk of Fame and the Hollywood Sign.

LA is also celebrated for its diverse neighborhoods, ranging from the luxurious Beverly Hills and Rodeo Drive to the artistic atmosphere of Venice Beach and the historical charm of Downtown LA. Aside from the glitz and glamour, Los Angeles offers an array of attractions and experiences. Tourists can visit the Griffith Observatory for breathtaking city views, unwind on the sunny beaches of Santa Monica and Malibu, or explore world-class museums like The Getty Center and LACMA. The city is famous for its multicultural cuisine, vibrant music scene, and numerous outdoor activities, from hiking in Runyon Canyon to surfing the Pacific Ocean.

What Is Aetna Insurance Coverage for Addiction Treatment?

Aetna insurance coverage pertains to how much a health insurance plan compensates for medical expenses associated with Aetna partial hospitalization programs (PHPs) for addiction treatment. An actuary-assisted assessment will be performed through underwriting to determine your premium rates, policy terms, and eligibility for PHP.

If you are insured and incur a medical loss due to an unforeseen event or peril, Aetna will assess the risk associated with your claim. An insurance adjuster will evaluate your claim to verify coverage and identify any policy exclusions. If your claim is approved, your health insurance may offer indemnity, protecting you from liability or financial loss while reimbursing your medical expenses. Occasionally, an endorsement may alter your policy terms, and the insurer might share some risk with another company through a reinsurance agreement.

Additionally, if a third party is deemed responsible for the loss, Aetna may pursue subrogation to recover its expenses. You could receive extra coverage beyond your typical health plan if you have an umbrella policy. After completing all evaluations, the claim settlement will be finalized, and the necessary payment will be processed. For any questions regarding your Aetna insurance coverage in Los Angeles, please contact us at Harmony Place.

Does Aetna Cover PHP for Addiction Treatment?

Aetna partial hospitalization programs (PHPs) for alcohol or drug addiction treatment are covered, though the level of coverage may differ depending on your specific health plan. It’s essential to note that the Affordable Care Act (ACA) mandates insurance providers to include Aetna PHP in their offerings.

You may face out-of-pocket expenses, including coinsurance, copayments, and deductibles. Moreover, your plan may require prior authorization. If you need help deciphering your coverage, please contact us at Harmony Place in Los Angeles, California. We understand that navigating insurance policies and making decisions like PHP vs. inpatient rehab can be daunting and complex. Our committed team is here to assist you in reviewing your insurance benefits and share our countless substance addiction recovery success stories.

What Are the Expected Out-of-Pocket Costs for Aetna Covered PHPs?

The anticipated out-of-pocket expenses for Aetna partial hospitalization programs (PHPs) can fluctuate depending on the specific insurance plan, deductible status, and whether the provider is in-network. You may have to pay a daily copayment, a coinsurance percentage, or both after your deductible has been met.

For instance, a plan might impose a copayment ranging from $50 to $150 per day for PHP services or a coinsurance rate of 20 to 40 percent of the covered amount. Moreover, out-of-pocket maximums limit the total amount a member pays annually for covered services. Once this threshold is reached, Aetna typically pays 100 percent of any additional in-network PHP expenses for the rest of the year. However, services from out-of-network providers may incur higher costs or may not be covered at all, leading to substantial out-of-pocket charges. Confirming coverage details directly with Aetna or referring to the benefits summary to fully understand your financial obligations for PHP care is crucial.

Indoor sitting area at Harmony Place addiction rehab center in Los Angeles

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Aetna PHP Coverage

Aetna Covered PHPs in Los Angeles, California

There are several Aetna partial hospitalization programs (PHPs) in Los Angeles, California. PHPs can treat a variety of substance abuse issues, including alcohol and drug addiction, as well as dual diagnosis treatment. Here are the details of these PHP programs:

PHP for Alcohol Addiction

A PHP for alcohol addiction is a controlled form of outpatient treatment that is best if you require more attention than standard outpatient care, but don’t need the constant supervision that comes with residential care. PHPs consist of several hours of treatment each day, including support groups, therapy, medication management, addiction workshops, and mental health support.

With Aetna Insurance coverage, you may pay $50 to $150 per day as copayments. Still, the exact degree of coverage will depend on your location, PHP facility, and policy.

PHP for Drug Addiction

A PHP for drug addiction is an intense form of care without 24/7 medical supervision at a residential inpatient facility. A PHP program serves as transitional care services from inpatient rehabilitation, or if your drug addiction is severe enough that you need daily assistance. Still, you are stable enough to live at home during your care.

Without insurance support, a PHP can often cost anywhere from $500 to $1,500 daily; however, if you have Aetna coverage, your out-of-pocket expenses are significantly decreased to $50 to $150 daily.

PHP for Dual Diagnosis Treatment Rehab

A PHP for dual diagnosis treatment will assist you if you’re struggling with addiction and a co-occurring mental health disorder. Treating both conditions simultaneously will enable a lasting recovery. Even though a PHP is a step down from inpatient rehab, it is more intense than traditional outpatient treatment services.

Thanks to the Affordable Care Act (ACA), Aetna Insurance coverage will cover a large portion of your costs. However, you still may be responsible for certain out-of-pocket expenses, including deductibles, copayments, and coinsurance.

Map of areas around Harmony Place addiction rehab near LA

PHP Treatment Centers in LA

Many addiction treatment facilies in Los Angeles offer PHPs. However, Harmony Place is an Aetna inpatient residential facility, tailored for mental health intensive care and holistic addiction treatment. Contact us at (855) 652-9048. Our facilities foster healing and personal growth. Our programs include counseling, group therapy, relapse prevention, and medication management to address addiction’s root causes.

Harmony Place on Hatteras: 23041 Hatteras St, Woodland Hills, CA 91367
Harmony Place East: 22913 Burbank Blvd. Woodland Hills, CA 91367

Check Your Insurance Call: (855) 652-9048

Checking Insurance Coverage

Checking My Aetna Insurance Coverage for PHPs

Evaluating your Aetna insurance coverage for partial hospitalization programs (PHPs) and other treatment options is vital to your recovery. Although many insurance providers include PHP treatment programs, the details of your plan—such as deductibles, co-pays, and in-network benefits—can differ significantly.

We collaborate with a range of insurance companies to guarantee you receive optimal care without added financial burden. Our dedicated team is here to assist you in understanding your benefits and verifying your coverage quickly and confidentially. Please contact us at (855) 652-9048 or complete our Aetna insurance verification form to determine if your insurance covers inpatient rehab at Harmony Place. This process is efficient, secure, and carries no obligations. Once you submit the form, our admissions specialists will evaluate your coverage and contact you to discuss your treatment options.

How to Get Aetna to Pay for PHPs in LA

To access Aetna PHP rehab, start by confirming your insurance coverage. Next, secure a referral from your primary care provider (PCP) or gather prior authorization documents. After that, choose an approved PHP rehab center and verify that you meet all eligibility requirements.

It’s essential to recognize that your plan may involve copayments, deductibles, or premiums, allowing you to evaluate your total costs accurately before beginning your PHP rehab treatment. Remember to keep copies of all submitted documents for your records. Aetna PHP rehab centers can assist you in navigating the authorization process. If your coverage is denied, you have a legal right to appeal. Once you finish your Aetna PHP rehab, you can submit a claim to recover any expenses incurred.

How Many Times Will Aetna Pay for PHPs in Los Angeles?

The extent of insurance coverage for Aetna partial hospitalization program (PHP) depends on various factors, such as the type of care required, the specific PHP day treatment program, and your circumstances. Although there isn’t a strict cap on how often Aetna PHP rehab programs can be covered, certain guidelines govern the types and frequency of eligible services.

These restrictions largely depend on the medical necessity of your Aetna PHP rehab, as assessed by a healthcare professional. Understanding the intricacies of insurance coverage can be daunting and confusing. We’re here to assist you in verifying your coverage and its frequency so you can focus on your recovery. Please contact us at Harmony Place in Los Angeles, California, for support.

Drug and Alcohol PHP Rehab Stats in Los Angeles, CA

The Public Health Department of Los Angeles County shared in April 2024 that annually, in Los Angeles County, there are 139,179 substance abuse-related hospitalizations, including drug and alcohol addiction.
The 2019 National Survey of Substance Abuse Treatment Services for California, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), showed that 324 of the 1,787 treatment facilities in California provided day treatment or partial hospitalization programs (PHPs).
In 2022, about 1,482,612 individuals in Los Angeles County needed treatment for Substance Use Disorder (SUD), such as addiction partial hospitalization programs (PHPs).
The California Health Care Foundation revealed that between 2017 and 2019, the quantity of Southern California facilities providing substance abuse treatment, including addiction PHPs, grew by 68%. Also, the number of hospital inpatient care facilities doubled during this period.
The National Alliance on Mental Illness in California shared that 9.5 million United States adults experienced substance use and mental health disorders in 2019.