The Mental Health Parity Act of 1996 was a watershed moment in our country’s understanding of mental health and the acceptance of mental health disorders as diseases like any other physical disease. As part of this legislation, large group health plans, like Aetna, could no longer offer annual and lifetime coverage limits on mental health benefits that were lower than medical or surgical counterparts on the same policy. This legislation was updated in 2008 to include substance abuse disorders.
To start, it is essential to distinguish between the parity of services within the plan and coverage. These government protections did not mandate that all insurance companies cover mental health and substance abuse disorders. Instead, these protections required that substance abuse and mental health issues be treated equally to medical or surgical conditions.
Eventually, the Affordable Care Act further increased coverage to individual plans, insured small group plans, and Medicaid expansion plans by requiring them to cover ten essential health benefits. Specific goals could no longer impose annual and lifetime limits, and preexisting conditions could not factor in cost or the denial of services.
Will Aetna Cover Me for Mental Health?
Most Aetna policies cover mental health and substance use disorder treatment, but coverages vary. It is important to remember that if you are in crisis, the first call you or your loved one should make is 9-1-1. If you or they have suicidal thoughts, call 9-8-8, and connect to the suicide prevention hotline.
Understanding your Aetna policy benefits is important, and we suggest making two calls about your coverage. We encourage you to call us and confirm your benefits; our admission specialists will perform a complete benefits analysis that will guide us, in part, when developing your treatment protocols. Then, feel free to contact the number on your policy documentation. This will connect you with Aetna subscriber services, where you can further verify your benefits and ask any questions that you may have about mental health coverage, as well as financial obligations. If you have further questions about coverage or financial obligations, we strongly encourage you to contact our billing department or speak directly with Aetna. We want to provide you with the support you need to address all your questions and concerns.
Most Aetna plans cover preventative care and screening, and you can speak to our admission specialists to understand precisely what that entails. During this time, you can also discuss your coverages for Partial Hospitalization (PHP) and outpatient mental health and substance use disorder treatment. Once again, costs and coverage may vary between plans.
What about out-of-state Aetna plans? Coverages may vary between programs in different states, but we can accept many insurance plans from most states. When you call us, please have your insurance card ready. Providing us with this information allows for simple insurance verification, at which point we can discuss coverages with you and the steps to enter treatment.