Does Aetna Cover Mental Health Services?

Navigating mental health services and insurance coverage can often feel overwhelming. Whether you’re seeking therapy for the first time or looking to better understand how to make the most of your Aetna insurance benefits, this guide is here to help. At Rowan Center for Behavioral Medicine, we understand the complexities of accessing mental health care through insurance. As a provider that accepts Aetna, we’ve written this article to demystify the process and support both current and prospective clients in navigating the often challenging journey of mental health coverage.

From understanding what services Aetna covers to tips on maximizing your benefits, our goal is to make it easier for you to access the care you need. By breaking down the details of Aetna’s mental health benefits, we hope to empower you with the knowledge to confidently pursue treatment and focus on your well-being.

Aetna Mental Health Benefits: What’s Covered?

Aetna offers extensive coverage for a variety of therapy services to address different mental health needs. Members can access individual therapy, which provides one-on-one sessions tailored to their specific challenges, whether it’s managing anxiety, overcoming depression, or working through life transitions. Family therapy is also covered, helping families address relational dynamics, improve communication, and navigate complex issues such as caregiving, divorce, or grief. For those seeking peer support, group therapy is an excellent option, offering a shared space to connect with others facing similar challenges.

Common evidence-based therapies included in Aetna’s coverage are Cognitive Behavioral Therapy (CBT), which helps identify and reframe negative thought patterns; Dialectical Behavior Therapy (DBT), which is particularly effective for emotional regulation and managing self-destructive behaviors; and Mindfulness-Based Cognitive Therapy (MBCT), which combines mindfulness practices with cognitive therapy to reduce stress and prevent the recurrence of depression.

Aetna’s coverage ensures flexibility, allowing members to select the therapeutic approach that best suits their needs.

Psychiatric Care

For those requiring a medical perspective, Aetna covers access to psychiatrists who provide comprehensive diagnostic evaluations and ongoing care. Psychiatrists can assess complex mental health conditions, prescribe and manage medications, and collaborate with therapists for holistic treatment. Medication management is a cornerstone of psychiatric care, particularly for conditions like ADHD, bipolar disorder, and severe anxiety or depression. With Aetna’s network, members have access to a wide range of psychiatric professionals, ensuring that they receive the support they need throughout their mental health journey.

Telehealth Options

Recognizing the growing need for accessible care, Aetna offers robust telehealth services for both therapy and psychiatric care. Members can connect with licensed therapists and psychiatrists through secure virtual platforms, making it easier to prioritize mental health without the logistical challenges of travel or time constraints. Telehealth is especially beneficial for those in rural areas, individuals with mobility challenges, or anyone seeking the convenience of receiving care from the comfort of their own home. This flexibility supports continuity of care, even for members with demanding schedules or during times of travel.

Substance Abuse Treatment

Aetna’s mental health benefits extend to substance abuse treatment, supporting individuals on their journey to recovery. Covered services include outpatient counseling for those who need consistent but less intensive support and inpatient rehabilitation programs for individuals requiring a structured environment to overcome addiction. Many plans also cover dual-diagnosis programs, which address both substance use disorders and co-occurring mental health conditions, such as depression or PTSD. Aetna’s comprehensive coverage empowers individuals to seek help and regain control over their lives.

Specialized Care Programs

In addition to general therapy and psychiatric services, Aetna supports treatment for a wide range of specific conditions, including anxiety disorders, depression, bipolar disorder, post-traumatic stress disorder (PTSD), and more. These programs are often tailored to address the unique challenges of each condition, utilizing evidence-based approaches to foster long-term recovery and resilience. For example, members with PTSD may benefit from trauma-focused therapies like Eye Movement Desensitization and Reprocessing (EMDR), while individuals with depression might explore interpersonal therapy to improve their relationships and emotional health. This specialized care ensures that members receive targeted treatment aligned with their mental health needs.

For a full list of covered services, visit Aetna’s Behavioral Health Coverage page.

What Mental Health Services Does Aetna Not Cover?

While Aetna provides extensive mental health benefits, some services may not be covered:

• Hypnotherapy: This alternative therapy is generally not considered evidence-based and is excluded from most plans.
• Biofeedback Therapy: Often used for stress management, Aetna typically excludes biofeedback due to limited evidence of its efficacy.
• Non-traditional Treatments: Coverage may not include emerging or experimental therapies unless explicitly stated in your plan.

To confirm what’s included in your specific plan, check your member handbook or contact Aetna directly.

How Much Does Therapy Cost with Aetna?

Understanding the cost of therapy with Aetna requires a closer look at your specific insurance plan, including deductibles, co-pays, and coinsurance. Below, we provide detailed examples and practical cost-saving tips to help you make the most of your benefits.

The cost of therapy with Aetna depends on factors like your plan type, whether your provider is in-network, and your deductible. Here’s how it works:

• Deductibles and Co-Insurance
  A deductible is the amount you pay out-of-pocket before your insurance begins covering costs. Co-insurance is the percentage of the session that you pay after you meet your deductible. For example, if your plan includes a $500 deductible and a 20% co-insurance per therapy session:
  • You would pay the full fee for each session (e.g., $150 per session) until you’ve paid $500.
  • Once the deductible is met, you would pay 20% co-insurance per session ($30 if the session rate is $150), and Aetna would cover the remaining cost.
• Co-Pays
  A co-pay is a flat rate that you pay for a service. For example, if your co-pay is $20 and the total session fee is $150:
  • You would pay $20 per session, while Aetna covers the remaining $130.

Cost-Saving Tips

Navigating therapy costs can feel overwhelming, but these strategies can help minimize out-of-pocket expenses:

• Choose In-Network Providers: In-network providers have pre-negotiated rates with Aetna, resulting in lower costs for you. Out-of-network providers may charge higher rates, and some plans may not cover them at all. Use Aetna’s online directory to find therapists within your network.
• Utilize Telehealth Services: Telehealth therapy sessions often come with lower co-pays compared to in-person visits. Additionally, telehealth eliminates travel-related expenses and time constraints, making it a cost-effective and convenient option.
• Maximize Employee Assistance Programs (EAPs): If your employer offers an EAP, you may be eligible for free or discounted therapy sessions. Check with your HR department to learn more about these benefits.
• Track Your Benefits: Stay informed about your plan’s limits, such as the number of therapy sessions covered per year. This ensures you can plan ahead and avoid unexpected costs.
• Ask About Sliding-Scale Fees: For services not fully covered by insurance, some therapists offer sliding-scale fees based on income. This can help make therapy more affordable if you face high out-of-pocket expenses.

You can check your therapy costs and benefits by logging into Aetna’s Member Portal.

Telehealth and Aetna: Expanding Access to Mental Health Care

Aetna’s telehealth benefits are designed to make therapy and psychiatric care more accessible than ever, offering members the flexibility to receive mental health support from the comfort of their own homes. This option eliminates many of the traditional barriers to accessing care, such as geographic location, transportation issues, and time constraints.

Telehealth services include virtual therapy sessions with licensed mental health professionals, as well as remote psychiatric evaluations and medication management. Whether you’re balancing a demanding work schedule, managing family responsibilities, or simply prefer the privacy and convenience of online care, Aetna’s telehealth options can help you prioritize your mental health.

Why Choose Telehealth?

Telehealth offers several unique advantages for individuals seeking mental health care:

• Flexible Scheduling: Virtual appointments are more adaptable to your daily routine, making it easier to find time for therapy or psychiatric consultations without disrupting your schedule.
• Eliminates Travel Needs: Telehealth removes the burden of traveling to a provider’s office, which is especially helpful for individuals in rural areas or those with limited mobility.
• Childcare-Friendly: Parents can attend sessions from home without needing to arrange childcare, ensuring that mental health care remains accessible even for busy families.
• Nationwide Access to Providers: Aetna’s telehealth network allows members to connect with therapists and psychiatrists across the country, ensuring you can find the right fit for your needs.

Who Benefits Most from Telehealth?

• Rural Residents: Telehealth bridges the gap for those in underserved areas where access to mental health providers may be limited.
• Individuals with Mobility Challenges: For those who find it difficult to travel due to physical or mental health conditions, telehealth offers a practical and comfortable alternative.
• Time-Constrained Professionals: Telehealth enables busy professionals to fit therapy sessions into their packed schedules without requiring time off work.

What Services Are Available?

Aetna’s telehealth options cover a wide range of mental health services, including:

• Individual Therapy: Virtual one-on-one sessions with licensed therapists.
• Family Therapy: Online therapy to address family dynamics and improve communication.
• Psychiatric Care: Remote evaluations, diagnosis, and medication management.
• Specialized Therapy Programs: Many telehealth providers offer services for specific conditions like anxiety, depression, PTSD, and more.

How to Get Started with Aetna Telehealth

1. Log into Your Aetna Member Portal: Access your plan details and search for in-network telehealth providers.
2. Use Aetna’s Online Directory: Filter results to find virtual care options, allowing you to choose a therapist or psychiatrist that meets your preferences.
3. Verify Coverage: Confirm your benefits and co-pays for telehealth services before booking an appointment.
4. Schedule Your Session: Book an online appointment directly with your chosen provider.

Maximizing Telehealth Benefits

• Prepare Your Space: Choose a quiet, private location for your session to ensure you can focus without distractions.
• Test Your Technology: Ensure your internet connection and video conferencing tools are working correctly before your appointment.
• Stay Consistent: Treat telehealth appointments like in-person sessions by committing to a regular schedule.

For tips on making the most of telehealth services, visit the National Institute of Mental Health’s Telehealth Guide.

At Rowan Center for Behavioral Medicine, we offer telehealth and online therapy services for those with Aetna insurance, combining the convenience of virtual care with the expertise of our licensed psychologists.

How to Use Your Aetna Insurance for Mental Health Services

Navigating insurance can feel daunting, but these steps can simplify the process:

1. Check Your Plan Details: Log into Aetna’s member portal or call the number on your insurance card to confirm your benefits.
2. Search for Providers: Use Aetna’s online directory to find in-network therapists and psychiatrists. Filter by specialty, location, or language preferences.
3. Verify Coverage: Before booking, confirm with the provider that they accept your plan and verify co-pays or deductibles.
4. Submit Claims: For out-of-network services, submit a claim directly to Aetna for reimbursement, if eligible.

Aetna and Mental Health Accessibility

Aetna has made significant strides in removing barriers to mental health care:

• Extensive Provider Network: Aetna’s network includes over 250,000 behavioral health providers, ensuring access to quality care.
• Integrated Digital Tools: Members can use Aetna’s apps and online resources to manage appointments, track claims, and connect with their care team.
• Support for Families and Caregivers: Aetna offers resources to help caregivers navigate mental health care for loved ones.

How to Find a Therapist Who Accepts Aetna

Finding the right therapist is essential for effective mental health care. Here are some ways to locate in-network providers:

• Aetna’s Online Directory: Search for therapists by specialty, location, and availability.
• Employee Assistance Program (EAP): If your employer offers an EAP, it may include referrals to mental health providers.
• Referrals: Ask your primary care physician or trusted friends for recommendations.
• Telehealth Platforms: Use telehealth services to connect with licensed therapists nationwide.

Overcoming Barriers to Mental Health Care with Aetna

While Aetna provides comprehensive mental health coverage, some barriers still persist when trying to access care. Below are some common challenges individuals may face and practical strategies to overcome them.

Understanding Coverage

Navigating insurance coverage can often feel confusing, especially when it comes to mental health services. Terms like “deductibles,” “co-pays,” and “out-of-network providers” can make it difficult to understand the exact scope of your coverage. To avoid surprises, it’s important to thoroughly review your plan’s details.

• Action Steps:
  • Log into Aetna’s member portal to view your mental health coverage specifics.
  • Contact Aetna customer service to clarify terms, ask about mental health benefits, and confirm your coverage.
  • Review your insurance policy each year, as plans and benefits can change.

Provider Availability and Wait Times

In some areas, especially rural locations, access to in-network providers may be limited, leading to long wait times for appointments. While Aetna’s large provider network offers a wide range of options, there may still be challenges when looking for immediate care.

• Action Steps:
  • Consider telehealth options, which may offer quicker access to licensed providers regardless of geographic location.
  • Look for therapists who offer flexible scheduling, such as evening or weekend hours.
  • If you are unable to find an in-network provider quickly, ask Aetna for an expedited list of potential therapists.

Financial Barriers

Even with insurance, out-of-pocket costs such as co-pays, deductibles, and coinsurance can make therapy unaffordable for some individuals. While Aetna covers a variety of mental health services, it’s important to be aware of any costs that may arise.

• Action Steps:
  • Choose in-network providers to keep costs lower and reduce out-of-pocket expenses.
  • Explore the use of HSA/FSA accounts to cover co-pays and deductibles.
  • If you’re concerned about high costs, ask your therapist about sliding scale options or other financial assistance programs.

Stigma Around Mental Health Care

Despite growing awareness, there is still a stigma associated with seeking mental health care. This stigma can deter individuals from pursuing therapy, even when insurance coverage is available.

• Action Steps:
  • Aetna provides resources to help normalize mental health care, such as educational materials and community support groups.
  • Many employers offer Employee Assistance Programs (EAPs) that can help you access therapy confidentially and at little or no cost.
  • Normalize mental health care in your community by encouraging conversations with family and friends about the benefits of therapy and mental well-being.

By understanding and overcoming these barriers, individuals with Aetna insurance can more easily access the mental health care they need, ensuring that insurance doesn’t stand in the way of well-being.

Why Choose Rowan Center with Aetna Insurance?

For those seeking mental health support, Rowan Center for Behavioral Medicine offers tailored services that align with Aetna’s coverage. By choosing Rowan, you gain access to:

Expert, Evidence-Based Care
At Rowan, we specialize in providing evidence-based therapies delivered by licensed psychologists. We offer a range of therapeutic approaches, including Cognitive Behavioral Therapy (CBT), Acceptance & Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and more. These proven therapies are designed to help individuals manage their mental health challenges and achieve lasting improvements.

Specialized Expertise in Mental Health and Chronic Conditions
Rowan’s team includes licensed psychologists who specialize in treating a wide range of conditions such as anxiety, depression, PTSD, and chronic illnesses. Our team includes health psychologists with expertise in chronic pain, aging, multiple sclerosis, and other conditions that affect mental health. Whether you are dealing with a recent life transition or managing a chronic condition, Rowan’s experts are here to guide you through personalized treatment plans.

Flexible In-Person and Telehealth Options
Rowan offers both in-person and telehealth services, ensuring you have access to therapy no matter your schedule, location, or circumstances. With Aetna’s coverage for telehealth, you can continue your therapy journey from the comfort of your own home, reducing barriers like travel time or busy work schedules.

Personalized Treatment Plans
We understand that every patient is unique. At Rowan, your treatment plan will be tailored to your specific needs, preferences, and goals. Whether it’s one-on-one therapy or family counseling, we work with you to design a treatment approach that is effective and aligned with your personal journey to well-being.

By choosing Rowan Center with Aetna, you benefit from a comprehensive, supportive approach to mental health care, ensuring that your treatment is both effective and affordable.

Ready to start your mental health journey? Contact Rowan Center today.