A young doctor holds up pills

01 Mar Aetna Loosens Addiction Treatment Restrictions

Historically, treatment for addiction and substance abuse is something that has always struggled to get traction with insurance companies. Many companies would gouge their customers for this sort of coverage, while some didn’t offer any coverage for addiction treatment at all. However, we have started to see a shift in this paradigm, thankfully. Recently, one of the largest insurance companies in the United States, Aetna, recently announced that it will start to remove barriers that prevent their clients from getting important medication to help people with substance dependencies.

New policy

The focus of this new policy from Aetna is on individuals who struggle with opioid dependence, although that could easily expand into other types of addiction. In the past, a policy called “prior authorization” would prevent patients from getting their necessary treatment for days. While it might sound like a good idea, in theory, the problem is that the symptoms of withdrawals work much quicker than the large bureaucracies of an insurance company. Starting in March, Aetna will be cutting back on its requirements for prior authorization, which will allow patients to get medication that is necessary to fighting withdrawals, such as suboxone, when they actually need it.

The latest company to do so

Aetna is continuing a recent trend of insurance agencies to change their policies, regarding addiction treatment, and specifically policies about prior authorization, when it comes to drugs that are needed to fight withdrawals. In fall of 2016, Cigna announced that it would be making similar changes, making it the first major insurance company to do so, while Anthem announced the same thing in January.

Easier access

One of the most important aspects to fighting addiction, perhaps only overshadowed by education, is the continual expansion of access to treatment and care for addicts. Well over 33,000 people died from a drug overdose in 2015, most of these due to opioids and heroin. Cutting the red tape that is needlessly places on treatments to fight withdrawals may very well be putting more people at risk of an overdose, as they wait for approval for a medication that needs to be applied, immediately.

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