Is Adolescent Treatment Covered by Aetna? 5 Key Facts You Need to Know

The adolescent years can be a challenging journey, laden with significant trials and tribulations. Ensuring your child's well-being during this crucial phase often involves seeking professional help — especially if mental health challenges and substance use issues are in the mix. When faced with these obstacles, this question may be ringing in your mind: “Is adolescent treatment covered by Aetna?” Today, we’ll aim to answer that question and explore five key facts about Aetna’s coverage for adolescent treatment services that every parent should know.

1. Aetna Covers Mental Health Services

The first important fact to know is that Aetna provides coverage for mental health services, including adolescent treatment. Aetna recognizes the importance of mental health and the role it plays in overall well-being. As a result, their plans often include coverage for mental health services, including therapy, counseling, and even inpatient treatment when necessary.

2. Aetna Covers Substance Abuse Treatment 

In addition to mental health services, Aetna also provides coverage for substance abuse treatment. Adolescents struggling with substance use (including vaping or THC) can access a range of treatments, from outpatient counseling to residential treatment programs. However, the specifics of what's covered will depend on the details of your plan, so it's essential to review your policy thoroughly or consult with one of our intake specialists to verify your benefits.

3. Aetna Coverage Varies 

While Aetna provides coverage for adolescent treatment services, it's crucial to understand that the extent of coverage varies significantly depending on the specific plan. Aetna offers a wide array of health insurance plans, each with different benefits and coverage levels. Some plans may cover a more extensive range of services or have lower out-of-pocket costs than others. Therefore, it's vital to review your plan specifics to understand what is covered and any associated costs. Verify your benefits to get an understanding of what you will have to contribute.

4. Preauthorization with Aetna May Be Required

For some services, Aetna may require preauthorization. This means that before your adolescent can receive treatment, your provider needs to get approval from Aetna. The goal is to ensure the proposed treatment is medically necessary and appropriate for your child's condition. Failure to obtain preauthorization when it's required can result in a denial of coverage, so it's crucial to understand when it's needed and how to obtain it. Talk with the facility that you’re interested in using for help with this as their admissions department will usually handle this on your behalf. 

5. You Can Appeal an Aetna Denial

Finally, it's important to know that if Aetna denies coverage for a treatment, you have the right to appeal. An appeal is a request for your health insurer to review and reconsider their decision. You can typically submit an appeal if Aetna denies coverage for a treatment your adolescent needs, or if they only agree to cover a portion of the costs.

Remember, your child's well-being is paramount. Aetna, like many other insurers, understands the critical role mental health and substance use treatment can play in adolescent health. Therefore, many of these services are covered — with some stipulations and variations.

Adolescent mental health and substance abuse issues can be challenging for both the individual and their family. However, it's comforting to know that there are resources available. Please feel free to reach out to us for further guidance on how to get your child back, better.