Aetna Better Health of Kentucky addiction treatment coverage
Aetna Better Health covers the clinical continuum of substance use treatment for substance use disorder. Discuss your coverage with Golden Grove Recovery in Louisville, Kentucky.
What Aetna Better Health is
Aetna Better Health of Kentucky is a CVS Health Medicaid managed care plan serving Kentucky Medicaid members across all 120 counties. The plan covers the clinical continuum of substance use treatment for substance use disorder treatment and provides integrated behavioral health services for members with co-occurring mental health conditions.
What Aetna Better Health covers for SUD treatment
- Residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on medical-necessity review
- Partial Hospitalization (PHP) and Intensive Outpatient (IOP)
- Outpatient SUD counseling and relapse-prevention programming
- Medication-Assisted Treatment — Suboxone, Subutex, methadone, Vivitrol, oral naltrexone
- Integrated care for depression, anxiety, PTSD, and bipolar when co-occurring with SUD
- Care management for members with high-acuity or repeat-admission SUD
- Pharmacy benefit through CVS Caremark for MAT and associated medications
Levels of care Aetna Better Health covers
| ASAM | Description |
|---|---|
| 1 | Outpatient (ASAM 1) |
| 2.1 | Intensive Outpatient (ASAM 2.1) |
| 2.5 | Partial Hospitalization (ASAM 2.5) |
| 3.1 | Clinically Managed Low-Intensity Residential (ASAM 3.1) |
| 3.3 | Clinically Managed Population-Specific High-Intensity Residential (ASAM 3.3) |
| 3.5 | Clinically Managed High-Intensity Residential (ASAM 3.5) |
MAT covered by Aetna Better Health
Aetna Better Health covers the following FDA-approved medications for opioid and alcohol use disorder:
SuboxoneSubutexMethadoneVivitrolOral Naltrexone
Read more about how Medicaid covers MAT, including authorization and pharmacy benefits.
How prior auth works with Aetna Better Health
Aetna Better Health of Kentucky uses ASAM criteria for medical-necessity determinations. Residential SUD admissions typically require prior authorization with concurrent review; PHP/IOP may be handled through notification.
Member benefits that apply to SUD
Aetna Better Health members have access to 24/7 nurse advice, care-coordination support for complex behavioral-health cases, and transportation benefits through MTM for SUD appointments.
More on Aetna Better Health at https://www.aetnabetterhealth.com/kentucky.html.
Talk to admissions about Aetna Better Health coverage
Call us or send a message — we'll discuss what your Aetna Better Health plan covers and the next step.
Frequently asked questions
Does Aetna Better Health cover residential addiction treatment?
Yes. Aetna Better Health covers residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on medical-necessity determination using ASAM criteria. Prior authorization with concurrent review is typical.
Does Aetna Better Health cover Suboxone or methadone?
Aetna Better Health covers Suboxone, Subutex, Methadone, Vivitrol, Oral Naltrexone as part of its MAT benefit. Methadone is delivered through licensed opioid treatment programs (OTPs).
Will Aetna Better Health cover medical detox?
Kentucky Medicaid plans cover medical withdrawal management when medically necessary, with coverage details that vary by level of care and setting. If detox is part of your situation, talk to our admissions team about the right path for you.
What does prior authorization look like with Aetna Better Health?
Aetna Better Health of Kentucky uses ASAM criteria for medical-necessity determinations. Residential SUD admissions typically require prior authorization with concurrent review; PHP/IOP may be handled through notification.
Is Golden Grove Recovery in-network with Aetna Better Health?
Golden Grove Recovery is in pre-opening setup. The information on this page is provided to help you understand Kentucky Medicaid coverage for substance use treatment. Contact our admissions team to discuss your individual situation and treatment options.