Covered expenses include charges made for the treatment of the psychological and physical dependence on alcohol or other mind-altering drugs that requires diagnosis, care and treatment. Expenses for the treatment of any physiological conditions related to rehabilitation services for alcohol, drug abuse or addiction are not covered.

Benefits are payable for charges incurred in a hospital (including partial hospitalization) and residential treatment facility for the treatment of substance abuse or addiction to alcohol and/or drugs. Covered expenses include charges for room and board at the semi-private room rate, and other services and supplies provided during your admission. Inpatient benefits are payable only if your condition requires services that are only available in an inpatient setting.

The plan covers partial hospitalization services (more than four hours, but less than 12 hours in any 24-hour period). The partial hospitalization will only be covered if you would need inpatient care if you were not admitted to this type of facility. Two days of residential treatment services are billed at the same rate as one day of hospital treatment.

Remember, you or your provider must call Aetna or Kaiser for pre-certification of overnight stays at network and out-of-network hospitals or benefits may be reduced or denied.

Covered expenses include charges for treatment received while not confined in a hospital or residential treatment facility. Coverage includes outpatient rehabilitation in an individual or substance abuse intensive outpatient therapy program.