Aetna Student Health Insurance | Mental Health Insurance Coverage — Zencare

Aetna Student Health Insurance for Therapy

Aetna is a major health insurance company that provides millions of Americans with healthcare and mental health care coverage. They provide health insurance plans for many academic institutions and universities under their Student Health Plan. Because most schools require that all students have active health insurance, hundreds of colleges contract with Aetna to offer affordable health insurance for all of their undergraduate and graduate students. This coverage includes therapy services.

Does the Aetna Student Health Plan cover therapy?

Yes, all Aetna Student Health Plan health insurance plans provide coverage for therapy services. However, the rate of coverage depends on your unique health insurance plan. Because each university creates their own Student Health Plan with Aetna, the coverage for services varies from plan to plan. This means that coverage for outpatient mental health services also varies widely.

Some of the Aetna Student Health Plan plans provide coverage for both in-network and out-of-network providers. This means that you can use your mental health benefits with any therapist, not just those within the Aetna network — which opens the opportunity to find a great therapist in your area.

How do I check if my Aetna Student Health Plan plan covers therapy?

To check if your Aetna Student Health Plan health insurance plan covers therapy services, head over to your Summary and Benefits document. You can find your specific school’s policy information through the Aetna Student Resources website and search for your school. Within the policy documents section, you’ll find the different rates of coverage — including copayment or coinsurance amounts — for each type of service available. Look for the line that includes “mental health” or “behavioral health” to see your coverage for therapy.

Example Aetna Student Health Plan Summary of Benefits, with Outpatient Mental Health section highlighted

If your Summary and Benefits document does not share this information with you, give the phone number on the back of your insurance card a call. The Aetna Student Health Plan customer service department will share with you the coverage available to you through your specific university’s plan.

How much does therapy cost with the Aetna Student Health Plan?

When using your Aetna Student Health Plan’s mental health benefits, expect to pay a copayment between $25-60 for each visit with your in-network therapist. Often, you must meet your deductible before you receive this coverage, which means that you need to pay for services out-of-pocket until a certain amount.

Because each Aetna Student Health Plan offers is different based on the specific school’s policy, how much a person will pay for therapy out of their own pocket varies depending on their school, specific plan, and whether or not their therapist is in-network.

Some plans offer coinsurance rates for therapy with out-of-network therapists, which is a percentage of the therapist’s session fees that’s your responsibility to cover. This coinsurance rate generally ranges from 10% - %50. However, not all plans offer out-of-network benefits, so be sure to understand your plan’s policy before you begin your search for an excellent therapist.

What types of mental health conditions does the Aetna Student Health Plan cover?

The Aetna Student Health Plan covers many mental health conditions. To reimburse therapists or clients, Aetna requires that the client receive a diagnosis from their therapist. This diagnosis guides treatment and insurance coverage.

Examples of eligible mental health conditions include:

There are many more diagnosable — and reimbursable — mental health conditions, all of which Aetna covers.

What types of therapy does the Aetna Student Health Plan cover?

The Aetna Student Health Plan covers many different types of therapy. As long as the therapist provides an evidence-based, clinically rigorous therapy modality that is appropriate for the given diagnosis, Aetna will provide coverage.

These evidence-based therapy modalities include, but are not limited to:

What types of therapy does the Aetna Student Health Plan NOT cover?

Aetna will not provide coverage for therapy costs associated with services that are not evidence-based. This means that all treatment modality needs to have empirical research backing its efficacy.

The Aetna Student Health Plan does not cover life coaching and career coaching, as these disciplines are less based on evidence and are more reliant on goal-setting and achievement outcomes. There is also no coverage for holistic approaches to treatment like aromatherapy, massage therapy, acupuncture, reiki healing, or nutritional therapy. They also do not cover ketamine, psychedelic, or hypnosis treatments, even if the purpose of this treatment is for a mental health condition.

Does the Aetna Student Health Plan cover online therapy?

Yes, the Aetna Student Health Plan offers coverage for online therapy. This opens the doors for many clients who aren’t able to physically attend therapy sessions each week, whether for a physical limitation or because of the constraints of a busy student schedule.

Your coverage for therapy costs will remain the same, whether you visit your therapy in-person or online. This includes the same copayments or coinsurance rates.

Does the Aetna Student Health Plan cover couples therapy?

No, Aetna does not provide coverage for couples therapy. Often, health insurance companies do not have mental health benefits for couples because of the lack of a reimbursable diagnosis, so it is not uncommon for this health insurance plan to deem couples therapy ineligible.

However, many couples still benefit from seeing a therapist together. If your Aetna Student Health Plan health insurance plan does not include a couples counseling benefit, there may be ways to decrease the cost of couples counseling, such as sliding scale.

Do I need to see my primary doctor before starting therapy?

Whether or not you need a referral from your primary care physician before you start therapy depends on the type of plan your school offers. If your plan is an HMO plan, then you will need to see your primary care physician to attain a referral for mental health services before Aetna will begin its coverage. However, if you have a PPO plan, then you will not need a referral and can begin your therapy journey when you’re ready. The same is true for the EPO student health insurance plans.

It’s important to understand your school’s policies around therapy referrals before you begin your search for a great therapist. Many schools require that their student health center providers meet with you before you seek support from a non-university affiliated therapist. To learn more about your school’s requirements, visit your student health center’s website and look for mental health resources.