Does Aetna Cover Therapy (Physical, Mental & HRT)?

Aetna does cover therapy, but it is not completely open-ended coverage. Aetna offers some coverage for mental health and substance abuse treatment, but these conditions are tightly regulated by the company.

Aetna’s policy covers only “medically necessary” treatments that have been approved by the insurer in advance.

If you are in need of any therapy, you may be able to get help through your insurance provider if they approve this type of treatment for your specific condition and diagnosis.

However, many people struggle with other types of health issues that often do not qualify under their strict requirements. This can make finding affordable care difficult because most therapists don’t offer sliding scale fees like doctors’ offices.

Does Aetna Cover Mental Therapy?

Yes, Aetna insurance has several different insurance plans that cover mental health. In the past, many insurance companies would not or only partially cover mental health and therapy for their clients.

However, it is becoming more common for these types of services to be covered by most major copays and deductibles.

If you need any help finding appropriate therapists in your area make sure to check out their website.

They focus only on professionals who specialize in psychiatry cognitive-behavioral therapy (CBT) social/family psychology existential psychology psychodynamic psychotherapy holistic counseling and lifestyle coaching with a Master’s or Ph.D., certification as a psychologist intern or with an LPC license, or who are at a doctoral level.

Does Aetna Cover Physical Therapy?

Yes, Aetna covers physical therapy if and when it is determined as a medically necessary procedure.Aetna physical therapy coverage

When physical therapy is ordered by a chiropractor, DO, MD, nurse practitioner, podiatrist, or other health professionals who are qualified to prescribe physical therapy under state law, Aetna considers it medically necessary.

For reimbursement purposes, the payment for physical therapy evaluations will be available once every 180 days.

Aetna Physical Therapy Fee Schedule & Billing

Aetna’s provider cost calculator tool assists your practice in determining how much a patient will owe for an office visit or procedure.

It also gives a rough estimate of how much Aetna will pay for therapies. You can even use it in advance of a patient’s doctor’s meeting as well as a procedure.

The cost estimator uses your fee schedule and your patients’ coverage plans after you provide basic patient and claim information. It is a great tool because of the following:

  • Financial surprises for you and your patients can be reduced, if not eliminated.
  • Assist you in initiating financial discussions with patients before or during treatment.
  • We’ll show you how much we think we’ll be able to pay you.
  • Forecasts of patient copayments, coinsurance, as well as deductibles should be provided.

Aetna Physical Therapy Authorization

You can always download the Aetna Physical Therapy Authorization form to fill out before you get prior authorization for the physical therapy sessions with the patients.

In certain plan designs, physical therapy may necessitate precertification. Physical therapy may have minimal usefulness depending on the plan benefit descriptions.

Physical therapy benefits in Aetna HMO plans are typically restricted to a 60-day treatment term. In this scenario, the 60-day therapy time refers to a specific ailment.

The limitation is implemented on a calendar year or contract-year basis in some plan designs. In some cases, it is a one-time restriction. Details can be found in the benefit plan descriptions.

Nonetheless, a member may receive more than one 60-day physical therapy treatment course as a treatment for various diseases.

Does Aetna Cover Hormone Replacement Therapy?

Yes. Aetna has plans that cover various aspects of hormone replacement therapy as indicated on their website. for more information please check the detailed table here.

  • Does Aetna Cover Couples Therapy?
  • Does Aetna Cover Massage Therapy?

READ: Does Aetna have dental insurance plans?

Check Also

Does GEHA Cover Acupuncture & Chiropractic Care?

Are you wondering if GEHA covers acupuncture? The answer is yes! While there are limits …

Leave a Reply

Your email address will not be published. Required fields are marked *