Established more than 170 years ago, Aetna is an American health insurance company that provides dental, medical, pharmaceutical and behavioral health benefits. The company works hard to put customers first and to provide excellent access to health care. In addition to health benefits, the Aetna Group also offers life insurance and workers’ compensation insurance.
Aetna mental health coverage is available to help those struggling with mental health issues locate the care they need. Whether you’re looking for mental health treatment for the first time or considering changing providers, it’s important to know what your options are and whether you have Aetna therapy coverage.
Does Aetna Cover Mental Health Care?
Approximately 1 in 5 adults in the United States struggle with some type of mental illness. Of those individuals, only around 60% receive any type of therapy or treatment. The most common reasons are lack of access, the stigmas surrounding therapy and the ongoing cost of care. If you’re one of the millions of adults requiring mental health treatment, you may wonder if your health insurance policy will cover the expense.
In 2008, federal law required insurance companies to provide coverage for mental health and substance abuse disorders under the Mental Health Parity and Addiction Equity Act (MHPAEA). In spite of federal and state laws, health insurance companies still have the ability to deny claims if they deem treatment isn’t medically necessary.
So, is Aetna mental health coverage available to those who need mental health care? Fortunately, if you have insurance with Aetna, you have access to the coverage you need. Aetna covers inpatient and outpatient programs, including online and in-person treatment. The insurance company also offers coverage for those with a dual diagnosis of mental illness and a substance abuse disorder. The exact amount of coverage you have depends on your plan, but you can contact an Aetna representative at any time to verify your benefits.
Typically, Aetna covers the general types of therapy, including:
- Cognitive behavioral therapy (CBT). Also referred to as talk therapy, CBT takes place in a clinical setting and is led by a therapist or licensed counselor. This type of treatment helps you identify the source of your mental health issues and teaches you effective coping mechanisms.
- Dialectical behavior therapy (DBT). DBT is a type of therapy that teaches mindfulness, acceptance, emotional regulation and interpersonal effectiveness. Aetna’s behavioral health coverage ensures individuals with personality disorders may receive this type of treatment, which is effective at changing behavioral patterns such as self-harm.
- Group therapy. Group therapy is extremely useful for those who feel alone with their mental health disorder. Group therapy allows individuals to share and receive information on what works for others.
- Family therapy. Mental health issues affect the individual and family dynamics. Family therapy helps all members of the family better understand what the patient is going through and teaches coping mechanisms.
- Ongoing support. Depending on your Aetna mental health coverage cap, you may receive ongoing support and treatment for your mental health conditions.
- Ketamine therapy. Ketamine is a drug used to treat depression, anxiety and conditions like PTSD. The medication is given in a clinical setting, and most patients report improvements in their condition within hours.
To check if your individual plan covers mental health treatment, log into your account and check your Aetna summary of benefits. Search for the row titled “If you need mental health, behavioral health or substance abuse services.” Under outpatient services, if cost information is listed, your plan covers mental health services. You can also contact Aetna directly for coverage details.
Locating Aetna Mental Health Treatment
The best way to find a local mental health provider through Aetna is the phone number on the back of your insurance card. You can also log into your account on the Aetna website and search for mental health providers. Aetna’s online coverage directory lets you search by doctor or clinic name, location or care type. The results provide you with the treatment facilities’ contact information so you can contact them directly.
Checking Your Coverage Deductibles Before Committing to Care
Depending on your insurance plan, your deductible will be either a specific dollar amount or a percentage of the total on your insurance policy. This amount is established when you sign up for your plan. You can check your Aetna coverage deductible on your own by logging into the member website and checking your summary of benefits or by calling your provider directly. A mental health care provider may also check your coverage deductible confidentially by performing a benefits check.
To perform the check without violating the terms of HIPAA, the provider will contact the company and provide your name, date of birth and policy number. These facts only allow access to insurance coverage information and don’t reveal any medical information protected through HIPAA. The insurance company will tell the provider how much your deductible is and how much you can expect to pay for treatment before you commit to care.
Contacting the Mental Health Hotline
If you’re looking for local mental health resources, reach out to the professionals at the Mental Health Hotline. The hotline connects you to available resources and can help you work with your insurance company to locate an available provider.
