Aetna Health Insurance | PAX Memphis TN Substance Abuse Treatment Coverage


Aetna provides coverage to nearly 39 million individuals nationwide, making it one of the most popular insurance providers out there. Aetna policyholders who are in need of drug and alcohol rehab have access to a broad network of treatment providers who work with Aetna. At PAX Memphis, we are an in-network facility that accepts patients with Aetna health insurance.

Aetna health insurance is especially dedicated to helping those who suffer from addiction find the treatment they deserve. In order to mitigate the high costs of substance abuse, Aetna uses a method of screening, brief intervention, and referral to treatment (SBIRT). SBIRT methods help identify, reduce, and prevent dangerous alcohol and drug use by helping individuals find the treatment that they need.


Aetna Health Insurance Coverage for Substance Abuse


The Affordable Care Act passed in 2010 requiring benefits to cover addiction treatment. Since addiction is officially defined as a disease by the American Medical Association, it can no longer be denied coverage under both private and group health insurance plans. Instead, health insurance providers are now required to cover portions of behavioral health services – including residential addiction treatment.

Rehab for alcohol or drug abuse is offered through Aetna. However, specific coverage and copay requirements will depend on the specific policy you have. Aetna insurance plans are categorized as either HMO or PPO plans. The type of plan an individual has will determine how much coverage Aetna will provide for drug and alcohol rehab.

Health Maintenance Organization (HMO): HMO plans only cover services provided by HMO contacted treatment facilities.

Preferred Provider Organization (PPO): PPO plans generally give individuals greater options for healthcare providers to choose from. Individuals with PPO plans can receive treatment at both out-of-network and in-network facilities. However, out-of-network facilities will require more money out of pocket.

While both plans will cover portions of addiction treatment at PAX Memphis Recovery Center, it is best to speak directly with your insurance provider to learn more about the coverage your policy provides.


Levels of Care Available With Aetna Health Insurance

Although every insurance plan is different, there certain types of common services that are frequently covered by Aetna health insurance. These services include:

  • Medical Detox – most people who suffer from drug or alcohol addiction require professional medical supervision during detox. Medical detox helps individuals cope with withdrawal symptoms safely and comfortably. This step is crucial before an individual can begin the treatment process. PAX Memphis is prepared to help clients through the detoxification process.
  • Medication-Assisted Treatment (MAT) – Most Aetna plans provide coverage for MAT programs. MAT is considered the gold standard for drug and alcohol treatment programs today due to the effectiveness of patient outcomes. It uses programs like Suboxone treatment to help ease withdrawal symptoms and mitigate cravings. However, doctors will need to provide specific information about this type of treatment to your insurance provider so you can gain coverage.
  • Inpatient/Residential Rehab – Residential treatment at PAX Memphis Recovery Center is the next suggested step after medical detox. This type of treatment consists of 24-hour care while patients live in a structured, therapeutic environment. If a person is deemed unable to function in the community with only outpatient treatment programs, Aetna will provide coverage for residential rehab.
  • Intensive Outpatient Program (IOP) – IOP is typically a step down from inpatient rehab. It is beneficial for individuals who need continuing care and relapse prevention services. Aetna provides coverage for IOP for individuals who require this level of care.


Here at PAX Memphis, our goal is to ensure that every client receives quality addiction treatment that addresses all of his or her needs. We strive to help as many people recover as possible by working with a number of insurance providers.

PAX Memphis proudly works with Aetna Health Insurance. Since every plan is different, the number of services covered by each Aetna plan will vary. We know that trying to understand insurance coverage while desperately trying to find a loved one help can be overwhelming. Fortunately, you don’t have to do it all alone. Our admissions team is here to help you better understand your insurance coverage for substance abuse treatment in Tennessee. We will help ease the stress of insurance coverage and monetary insecurity. Give us a call for a confidential and free insurance benefits verification. If you prefer to verify your insurance benefits online, simply fill out the form below!

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