Is Portland Treatment in-network with Aetna?

Yes. We are contracted in-network with Aetna commercial and employer plans, which means your care is billed at Aetna's negotiated rate and your coinsurance is calculated on that lower amount.

Does Aetna cover rehab and addiction treatment in Maine?

Yes. Aetna covers substance use disorder treatment, including PHP, IOP, outpatient therapy and medication-assisted treatment, as a behavioral health benefit, subject to your plan's cost sharing and authorization rules.

Does Aetna require prior authorization for PHP or IOP?

Usually for PHP and often for IOP. We complete the clinical assessment and submit the authorization request for you, then manage concurrent reviews while you're in treatment.

Does Aetna cover Suboxone and other MAT medications?

Yes, subject to formulary rules and occasionally prior authorization. We verify your pharmacy benefit at the same time as your behavioral health benefit.

How much will treatment cost with Aetna?

It depends on your deductible, coinsurance and out-of-pocket maximum. Because we're in-network, those percentages apply to Aetna's contracted rate rather than full charges. We give you a written estimate before you start.

Will my employer find out I used Aetna benefits for treatment?

No. Employers receive aggregate claims data, not individual diagnoses or provider names. Substance use records carry extra federal protection under 42 CFR Part 2.

Insurance · Aetna / CVS Health

Using Aetna insurance for rehab in Maine

In-network provider

Portland Treatment is in-network with Aetna commercial and employer plans.

Aetna covers a large share of Maine workers through national and regional employer plans, and we are in-network with them, so your treatment is billed at Aetna's contracted rate instead of out-of-network prices. Here's what Aetna typically covers at Portland Treatment in Biddeford, and how to get your real cost in one phone call.

855-449-7674

Network status: In-network with Aetna
Levels covered: PHP · IOP · OP · MAT
Verification time: Usually the same day

Accredited & Licensed

LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified

What's covered

What Aetna typically covers at Portland Treatment

Aetna covers substance use disorder treatment at parity with medical care, and because we're in-network, your cost share is calculated on the contracted rate. Levels of care we commonly bill to Aetna:

Partial Hospitalization (PHP)

Our most structured outpatient level, full days of clinical programming. Aetna plans typically cover PHP with prior authorization, which our admissions team requests for you.

More about partial hospitalization (php)

Intensive Outpatient (IOP)

Three to five sessions a week, mornings or evenings, so you can keep working. IOP is the most commonly authorized level of care under Aetna behavioral health benefits.

More about intensive outpatient (iop)

Outpatient Program (OP)

Weekly individual and group therapy for step-down and long-term maintenance. Usually the lowest-cost level under a Aetna plan.

More about outpatient program (op)

Medication-Assisted Treatment (MAT)

Buprenorphine, naltrexone and related medications, billed through your medical and pharmacy benefits. Coverage and preferred formulary vary by Aetna plan.

More about medication-assisted treatment (mat)

Dual diagnosis care

Depression, anxiety, PTSD and bipolar disorder treated alongside substance use, one treatment plan, one set of clinicians, billed under your behavioral health benefit.

More about dual diagnosis care

Detox placement

We don't run a detox unit. We coordinate placement with licensed Maine detox providers and confirm they take your Aetna plan before you go.

More about detox placement

Plan details

Know which Aetna plan you actually have

Aetna sells several product families to Maine employers, and the one on your card shapes referrals, networks and cost sharing.

Choice POS II and PPO plans

The most common Aetna employer products in Maine. Flexible networks, no referrals required, and strong in-network rates, which apply to us.

HMO and managed-choice plans

Care generally stays in-network and some plans want a PCP referral on file before behavioral health services begin.

Aetna Behavioral Health carve-out

Many Aetna plans route mental health and substance use claims through Aetna Behavioral Health, a separate phone line and authorization process we navigate during verification.

Medicare Advantage

Aetna's Medicare products cover outpatient behavioral health with plan-specific copays. We confirm the terms of your specific plan before you start.

What you'll pay

What determines your out-of-pocket cost

Two Aetna cards can produce two very different costs for the same program. What actually sets your number:

Whether you've met your deductible for the plan year, in January this is the single biggest driver of what you pay.
Your coinsurance or copay per session or per program day once the deductible is satisfied.
Network status, and this one is usually in your favor: Portland Treatment is in-network with every major Maine payer except Cigna, so most clients are billed at the lower contracted in-network rate.
Whether the level of care requires prior authorization and how many days or sessions are authorized at a time.
Your out-of-pocket maximum, once you hit it, covered treatment for the rest of the plan year is paid at 100%.

How verification works

1. You call or submit. We take your Aetna member ID and date of birth, nothing more invasive than that.
2. We call the plan. Our team gets the behavioral health benefit read directly from Aetna (a CVS Health company), in writing.
3. You get a real number. Deductible remaining, coinsurance, authorization requirements and an estimated cost per week, before you commit.
4. We handle the rest. Prior authorizations, concurrent reviews and appeals are our job, not yours.

Call 855-449-7674

Southern Maine

Using Aetna coverage close to home

Aetna shows up frequently among clients commuting to our Biddeford campus from Portland, South Portland, Scarborough, Westbrook and Saco, especially through national employers with Maine locations. Local outpatient care, evening IOP, daytime PHP, weekly therapy, is the kind of treatment Aetna plans approve most readily, because it is clinically appropriate and close to home.

Our admissions team calls the behavioral health number on your card, documents the benefit in writing, handles any prior authorization, and gives you a real estimate before your first session. If a level of care is denied, we appeal with clinical documentation rather than quietly stepping you down.

Biddeford Portland Saco All areas we serve →

Aetna coverage questions

Is Portland Treatment in-network with Aetna?: Yes. We are contracted in-network with Aetna commercial and employer plans, which means your care is billed at Aetna's negotiated rate and your coinsurance is calculated on that lower amount.
Does Aetna cover rehab and addiction treatment in Maine?: Yes. Aetna covers substance use disorder treatment, including PHP, IOP, outpatient therapy and medication-assisted treatment, as a behavioral health benefit, subject to your plan's cost sharing and authorization rules.
Does Aetna require prior authorization for PHP or IOP?: Usually for PHP and often for IOP. We complete the clinical assessment and submit the authorization request for you, then manage concurrent reviews while you're in treatment.
Does Aetna cover Suboxone and other MAT medications?: Yes, subject to formulary rules and occasionally prior authorization. We verify your pharmacy benefit at the same time as your behavioral health benefit.
How much will treatment cost with Aetna?: It depends on your deductible, coinsurance and out-of-pocket maximum. Because we're in-network, those percentages apply to Aetna's contracted rate rather than full charges. We give you a written estimate before you start.
Will my employer find out I used Aetna benefits for treatment?: No. Employers receive aggregate claims data, not individual diagnoses or provider names. Substance use records carry extra federal protection under 42 CFR Part 2.

Coverage details described here are general and change by plan year and plan design. Nothing on this page is a guarantee of benefits or payment. The only way to know your coverage is a benefit verification on your specific policy.

Other plans we work with

Anthem UMR Cigna MaineCare (Medicaid)Harvard Pilgrim Martin's Point All insurance & payment options →

Keep exploring

Using Aetna at Portland Treatment

Programs your plan may cover

Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.

Other plans we accept

Anthem coverage for rehab in Maine
What Anthem BCBS typically covers for PHP, IOP and OP.
MaineCare (Medicaid) addiction treatment coverage
MaineCare members are welcome here.
Cigna coverage for addiction treatment
Verify your Cigna benefits in a few minutes.
UMR coverage for addiction treatment
UMR/UnitedHealthcare plans and outpatient rehab.

Helpful reading

Does insurance cover rehab?
Coverage, costs and what to ask your plan.
Working during rehab
Evening IOP, FMLA and keeping your job in treatment.
Maine recovery resources directory
Local meetings, crisis lines and state programs.
All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.

Find out what Aetna covers
today