Aetna Healthcare for Addiction Treatment

Guardian IOP offers Intensive Outpatient Programs in Delray Beach. Our gender-specific and age-specific treatment programs for adults recovering from substance abuse offer structure and programming similar to residential treatment facilities, while allowing clients to return to their home, or a sober living facility, each evening. While choosing an IOP over inpatient care is not the right choice for everyone, many clients find that Intensive Outpatient Programs can be a much less expensive option than residential treatment, either due to lower total costs, or because they allow more freedom for the client to continue with work obligations while receiving treatment.

Not only are most outpatient programs covered by your insurance provider, but in some cases an outpatient program may be required before an insurance provider will provide coverage for residential in-patient treatment. Outpatient programs also tend to have less restrictive referral requirements, meaning that it’s highly likely that your specific health insurance plan will be able to help mitigate the out-of-pocket costs of your care. For assistance in clarifying your coverage and payment options, please contact a Guardian IOP Recovery Specialist who can help you understand your specific insurance plan and associated benefits.

Your Aetna health insurance plan is among the many plans that we work with at Guardian IOP to ensure an affordable, stress-free recovery. Cost should never be a barrier to life-changing treatment, and both, Guardian IOP and Aetna, understand this. It’s our goal to get you into treatment as quickly and as affordably as possible. A leader in the industry since 1953, with over 22 million insured, Aetna is among the nation’s largest health insurance providers. Your Aetna plan may also offer additional coverage for a wide range of personal issues through Aetna’s Behavioral Health Network.

The Aetna Behavioral Health program offers benefits that cover the cost of a portion or all treatments associated with your Guardian IOP treatment plan, including group and individual therapy, family therapy, cognitive behavioral therapy and dialectical behavioral therapy, as well as relapse prevention training. In addition to your substance abuse treatment, counseling for a variety of stressful and challenging co-occurring situations, including depression, PTSD, anxiety and/or anger issues, or with loss and grief, are included among behavioral health benefits. Your Aetna health plan often extends to sober living facilities as well as Intensive Outpatient Programs such as those offered by Guardian IOP.

Navigating the details of your health insurance plan may seem overwhelming but determining your out-of-pocket responsibility can be as easy as a 20-minute phone call to one of our pre-admission specialists. Your plan will typically have a deductible – the amount you must pay before your insurance kicks in, a copayment – the amount you may need to pay for any one medication or service, and a coinsurance amount – the percentage of costs after you’ve paid your deductible and copayment that your insurance provider will cover. These amounts vary for each of Aetna’s plans, whether it’s an EPO, HMO, POS, PPO or a HDHP.

Individual plans offered through the Healthcare Marketplace must cover behavioral health treatment, cannot deny you coverage due to pre-existing conditions, and have no yearly or lifetime dollar limits on substance abuse treatment. Employer-based plans that do offer behavioral health coverage must apply no less favorable lifetime or annual spending limits on substance abuse treatment as they do for any other medically necessary procedure. In addition, pre-authorization or referral requirements can’t be any more restrictive than those in place for any other medical or surgical procedure. In fact, some health insurers prefer patients seek treatment at an Intensive Outpatient Program before entering an inpatient program, if deemed appropriate. A Guardian IOP pre-admissions specialist can ensure that an IOP program is right for you with a simple 20-minute phone call.

The exact benefits and details of your Aetna insurance plan are outlined in your Aetna Summary of Benefits and Coverage (SBC). This includes an overview of what’s covered, deductible and co-pay or co-insurance requirements, and statements regarding whether or not your plan meets the minimum Affordable Care Act (ACA) requirements for essential coverage. ACA requirements include substance abuse treatment and minimum coverage, defined as 60% of total medical costs.

The quickest and easiest way to find out if Aetna can help you reduce the financial burden of our Intensive Outpatient Program is to speak with a Guardian IOP Specialist today. A Guardian IOP Recovery Specialist can help you understand your Aetna coverage and determine your financial responsibilities, if any. With just a 20-minute phone conversation, we can determine if our Intensive Outpatient Program is right for you, if your needs include treatment for any co-occurring mental health disorders, and what your financial responsibility will look like while in our care at our Delray, Florida location.