Does Aetna Offer Mental Health Coverage for Substance Abuse?


If you or someone you love is struggling with Substance Abuse Disorder, your AETNA policy may cover some or most of your treatment expenses. While things like the level of care you need and the types of substances you're struggling with can help to determine your benefits, coverage varies from policy to policy. The easiest way to see what your treatment will cost is to call us.

Ready to take your life back?

Call (503) 850-2474

About Anthem HealthSCOPE

Founded in 1853, Aetna grew to become one of the nation’s largest insurance companies. Currently, their network has about 1,200,000 health care professionals and 690,000 primary care doctors. As one of the United States’ largest insurance providers, Aetna has many policies with excellent coverage.


Aetna GEHA Rehab (Government Employees Health Association): GEHA is an insurance company that provides medical benefits to over 2 million federal employees, retirees, and their loved ones in the state of Missouri. Because they want to help federal employees access the best quality of care for substance abuse, some of their policies allow you to access Aetna’s huge network of treatment providers.

Aetna Nippon Rehab Coverage: Since 1991, Nippon has provided its policyholders with coverage for a wide range of healthcare services. Nippon’s mission is to put the humanity back in healthcare. That’s why some of their policies allow you to access Aetna’s network of rehab treatment providers for in-network prices.


Rehab for Substance Abuse Disorder is considered one of the 10 essential health categories for every insurance policy. This means that every Aetna plan will provide some coverage for:

  • Alcohol Abuse.
  • Heroin or Fentanyl Addiction.
  • Benzodiazepine Addiction (like Valium or Xanax).
  • Prescription Pain Pill Abuse (e.g. Vicodin, Codeine, or Oxy)
  • Cocaine Addiction.
  • Methamphetamine Addiction.
  • Marijuana Addiction.
  • Crack Addiction.

Ready to take your life back?

Call (503) 850-2474


Tree House Recovery

A Better Way To Treat Addiction: 

Tree House Recovery has helped many people with AETNA insurance. Ours is an approach that includes more than just talk therapy, and focuses on creating sustainable practices for long term sobriety.   

 Get Optimized: 

  • PHYSICAL FITNESS: Get stronger. Movement strengthens your body, but it can also alter brain chemistry, affect mood, and decrease cravings.
  • MENTAL FITNESS: Build a better perspective. Identify what feeds your addiction and learn healthy ways to avoid or cope with them.
  • SOCIAL FITNESS: Connect. Form a tight-knit band of brothers to rely on for fun or support after treatment. 


Even though rehab outside of Aetna’s network may initially cost more money, that doesn’t mean your policy won’t provide some coverage. You can submit a claim to Aetna to recover some of the cost, create a payment plan with your treatment center, or discuss making a single case agreement between the treatment center and your insurance that will increase coverage and save you money.  


  • PPOs: PPO policies work by splitting the cost of your treatment with you after you’ve paid a certain amount (called a deductible). Once you’ve met your deductible, Aetna will cover a portion of your costs and leave you with a smaller cost. That remaining cost may be a fixed amount (called a co-pay). Or you may be responsible for a certain percentage of your costs (called a co-insurance payment).
  • HMOs: HMOs work by lowering the total cost of your treatment if you go to the providers inside Aetna’s network. Like PPOs, some plans may require you to meet a deductible first.
  • Deductible: The amount you must pay before your HMO will reduce treatment costs. Or the amount you must pay before your PPO will share costs with you.
  • Co-Pay: The fixed total remaining after your policy has reduced your costs. For example, after you meet your deductible you could see the same in-network doctor and the copay would always be the same.
  • Co-Insurance: A fixed percentage of your total that remains after your policy has shared the cost of treatment with you. For instance, your Aetna policy may pay 60% of your costs at an in-network provider. This would make your co-insurance the remaining 40% of the cost.
  • Out-of-Pocket Maximum: Some plans will cover 100% of your costs after you pay a certain amount. This is called an out of pocket maximum.


Medical Detox: Detox ends the physical addiction on narcotics and is the highest level of care for rehab. For the safest detox possible, we recommend checking into a detox facility with 24-hour care.

Inpatient Care: For inpatient rehab, you live in a hospital and receive resources to help connect you to therapists and group meetings.

Partial Hospitalization Program (PHP): PHP includes a set of therapies that help you create a life where you are happy and successful without substances. At Tree House Recovery, PHP is 5-6 hours a day for 5 days a week and includes group and individual therapies that:

  • Help heal possible sources of addiction using guided stream-of-conscious writing with a trained therapist.
  • Reduce and control cravings with cardiovascular training.
  • Teach coping skills for stress and anxiety.
  • Build connections with and support others.
  • Create strong lifelong bonds with teammates who you can rely on after treatment.
  • Help you create a positive perspective and world outlook.
  • Creates custom relapse prevention techniques.
  • Help you practice new skills with teammates.

** Our Group Therapies are based on evidence-based practices (proven therapies/methods for treating substance abuse) such as  Motivational Interviewing and Cognitive Behavioral Therapy. These have high success in treating Substance Abuse Disorder. Tree House’s innovative 1-on-1 therapy also uses the same evidence-based practices as our group therapies. 

Intensive Outpatient (IOP): IOP is 3-5 hours per day for 5 days a week and works on reinforcing techniques from PHP. You will also receive leadership, interview, and job-search training before graduating.

Outpatient (OP): OP or “aftercare” is for people who have already completed a rehab program and want help maintaining their sobriety. Our outpatient program has three 1 hour sessions per week. All of these are in the evenings.

How Do I Begin Recovery? 

Insurance companies like Aetna exist to help provide Americans with affordable access to high-quality treatment. If you or someone you know is struggling with addiction or if you have questions about your policy don’t wait to reach out. Call us now at 503-850-2474.