Aetna Mental Health Copay Coverage and Benefits

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Aetna offers copay coverage for mental health services, with a maximum copay of $50 for a 30-day supply of medication.

This means that if you're taking medication for a mental health condition, you'll only pay $50 out of pocket for a month's supply, regardless of the cost of the medication.

Aetna's copay coverage also applies to therapy sessions, with a maximum copay of $30 per session.

This can be a huge relief for people who need regular therapy sessions to manage their mental health.

What is Aetna Mental Health Coverage?

Aetna mental health coverage is quite comprehensive, covering a range of outpatient mental health services. You can receive unlimited mental health outpatient visits, which is a big plus.

Some services do require prior authorization, but that's not a problem. You're covered for services like psychological testing, mental health provider visits, and medication management.

Aetna is a nationwide insurance provider that offers medical, vision, dental, mental health, and therapy coverage. This means you can get the help you need, no matter where you live.

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Some popular mental health services covered by Aetna include cognitive behavioral therapy (CBT), family therapy, and group therapy. You can even get online therapy as well as in-person therapy.

Here are some of the outpatient mental health services you can expect to be covered:

  • Psychological testing
  • Mental health provider visits
  • Partial hospitalization
  • Intensive outpatient therapy
  • Medication management

Checking and Understanding Coverage

To check if your Aetna plan covers therapy, you can start by checking your insurance plan. This will show you what mental health services are covered, and what you might have to pay for.

You can do this by looking at your Aetna online account, calling the customer service number on your insurance card, or reading your plan documents.

Aetna may or may not cover out-of-network therapy, and if not, the cost may be much more than in-network providers.

To confirm coverage, you should refer to your Aetna summary of benefits (SOB) or contact Aetna directly.

If you're currently covered by Aetna, checking your insurance plan is the first step to finding out what's covered and what you'll pay.

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To determine what's covered, you can also reach out to your insurance company directly.

Here are the three main ways to find out if your Aetna plan covers therapy:

  1. Check your insurance plan (if you currently have Aetna insurance)
  2. Refer to your Aetna summary of benefits (SOB)
  3. Contact Aetna directly

Aetna is legally required to cover care for mental health conditions, such as anxiety, depression, OCD, and other diagnoses.

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Costs and Pricing

The cost of therapy with Aetna can vary depending on your location and insurance plan. Most people who are insured by Aetna will either be fully covered by their plan, or have to pay a small copay amount.

The average cost of therapy with Aetna by state ranges from $10 – $20 in Alaska to $80 – $90 in Idaho. A significant portion of states have an average cost between $30 – $40, with 45% of states falling into this range.

Here's a breakdown of the average therapy costs by state:

For those who haven't met their deductible yet, or for whose plan doesn't cover therapy, the typical range of therapy sessions is $80 – $200 per session.

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How Much Costs?

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The cost of therapy can be a concern for many people, especially when it comes to insurance coverage.

Most people who are insured by Aetna will either be fully covered by their plan, or have to pay a small copay amount.

The average cost of Aetna for therapy is $0 – $60 per session, after the deductible has been met.

If you haven't met your deductible yet, or for whose plan does not cover therapy, the typical range of therapy sessions is $80 – $200 per session.

It's essential to confirm your out-of-pocket costs before your appointment, as the cost of therapy will depend on your plan's specific coverage.

According to Aetna's therapy cost table, 45% of the states listed have an average cost between $30 – $40, with another 22.5% having an average cost between $40 – $50.

Here's a breakdown of the average therapy costs by state:

The most expensive state for therapy is Minnesota ($70 – $80), and the least expensive state for therapy is Alaska ($10 – $20).

It's worth noting that these costs are averages and may vary depending on your specific plan and location.

Cover Out-of-Network?

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Aetna may or may not cover out-of-network therapy, and if it doesn't, the cost can be significantly higher than with in-network providers.

If you're unsure about out-of-network coverage, refer to your Aetna summary of benefits (SOB) or contact Aetna directly.

The cost of out-of-network providers can be much more than the cost of in-network providers, so it's essential to check your coverage before seeking care outside of your network.

To confirm your out-of-network coverage, reach out to Aetna directly or review your plan documents.

Mental Health Copay and Sessions

Aetna therapy copay can vary depending on your plan and the therapist you see. It's a fixed amount you have to pay for each therapy session.

You can find your copay in the mental health coverage section of your Summary of Benefits. If you're unsure, reach out to Aetna support directly.

Aetna covers many types of therapy, including cognitive behavioral therapy, dialectical behavior therapy, and family therapy. They may also cover ketamine and esketamine, electroconvulsive therapy, and transcranial magnetic stimulation, depending on your diagnosis and plan details.

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To confirm what therapy is covered by your specific plan, it's best to reach out to Aetna directly.

Here's a quick rundown of what you can expect:

Keep in mind that this is not an exhaustive list, and it's always best to check with Aetna directly to confirm coverage.

Finding and Working with Providers

Finding an Aetna therapist is easier than you think, with several resources available online to help you find one.

You can find an Aetna therapist online, and there are three main ways to check if your Aetna plan covers therapy.

Aetna insurance plans can cover therapy sessions, making mental health care more accessible and affordable.

At the California Psychology Center, they are proudly in-network with Aetna and accept most Aetna insurance plans for therapy services, handling insurance claims directly.

You only need to worry about your co-pay for each therapy session, as the California Psychology Center handles the rest.

Their goal is to make mental health care as accessible and affordable as possible for their clients, a goal that aligns with the benefits of Aetna insurance.

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Setting Up and Managing Coverage

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To confirm that your Aetna plan covers therapy, you should reach out to Aetna directly.

You can check your insurance plan to see what mental health services are covered and what you might have to pay for. This can be done by looking at your Aetna online account, calling the customer service number on your insurance card, or reading your plan documents.

Aetna typically covers therapy, including in-person and online therapy, as well as a wide range of mental health services.

There are three main ways to find out if your Aetna plan covers therapy: checking your insurance plan, contacting Aetna directly, or reaching out to a provider who accepts Aetna insurance.

If you are currently covered by Aetna, you can check your insurance plan to see what mental health services are covered.

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Frequently Asked Questions

Does Aetna not cover mental health?

No, Aetna does not deny coverage for mental health conditions. Mental health care is covered by Aetna as long as treatment is received from an in-network provider.

What is an Aetna copay?

An Aetna copay is a fixed dollar amount you pay for covered services or prescription drugs, such as $20 for a doctor visit. This amount is typically a one-time payment and is not a percentage of the total cost.

Do mental health copays count towards deductible?

Mental health copays do not typically count towards your deductible, making them a separate expense from your overall healthcare costs.

Sheldon Kuphal

Writer

Sheldon Kuphal is a seasoned writer with a keen insight into the world of high net worth individuals and their financial endeavors. With a strong background in researching and analyzing complex financial topics, Sheldon has established himself as a trusted voice in the industry. His areas of expertise include Family Offices, Investment Management, and Private Wealth Management, where he has written extensively on the latest trends, strategies, and best practices.

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