Feeling overwhelmed by mental health concerns is difficult enough without the added worry of navigating your insurance. If you have an Aetna PPO plan, we’re here to simplify the process and help you access the residential care you deserve. Call us 24/7 to verify your Aetna benefits in minutes.
How Aetna Covers Residential Mental Health Care
Aetna PPO plans offer comprehensive coverage for mental health services, including residential treatment, also called inpatient treatment. With an Aetna PPO plan, you can seek care from providers both in-network and out-of-network, though your costs will differ depending on the provider’s status.
For 2025, Aetna does not place caps on mental health visits but requires pre-authorization for inpatient and residential mental health care. Understanding your coverage details ahead of time ensures that you can focus on your recovery, not your finances.
Is Lenape Wellness Center In Network With Aetna
Currently, Lenape Wellness Center is considered out-of-network with Aetna PPO. However, when clinically appropriate, we sometimes pursue Single Case Agreements (SCAs). An SCA is a special arrangement between your insurer and us, allowing your care to be billed at in-network rates, significantly reducing your out-of-pocket expenses.
Typically, securing an SCA takes around three to five business days. Our experienced team handles this entire process on your behalf, advocating directly with Aetna to streamline approval and ease your administrative burden.
Simplifying Aetna Pre Authorization
To make your experience stress-free, we handle the entire pre-authorization process required by Aetna for residential mental health treatment. Our dedicated team follows a clear three-step workflow:
- Clinical review packet: We compile all necessary clinical documentation and treatment justifications.
- Electronic submission: We submit these documents via the secure Aetna Behavioral Health provider portal.
- Tracking and follow-up: We actively monitor your case, handling any additional requests or appeals promptly.
You can rest easy knowing we manage all the paperwork and follow-ups, freeing you to concentrate on your well-being.
Typical Approval Timelines
Approval timelines for pre-authorization vary based on urgency:
- Urgent requests: Typically reviewed within 72 hours.
- Routine requests: Usually reviewed within five business days.
We expedite every submission by initiating the process the same day you reach out, ensuring that there are no unnecessary delays in beginning your treatment.
What You Will Pay With Aetna PPO
With an Aetna PPO plan, your out-of-pocket costs depend on your deductible, coinsurance, and annual maximum:
- Deductible: Ranges typically from $1,000 to $3,000 annually. You pay this amount out-of-pocket before insurance coverage kicks in.
- Coinsurance: After meeting your deductible, you’re generally responsible for around 30% of covered costs until reaching your annual out-of-pocket maximum.
- Single Case Agreements (SCAs): When approved, SCAs enable billing at in-network rates, significantly reducing your financial responsibility compared to standard out-of-network costs.
- Flexible payment options: We also offer guidance on using Health Savings Accounts (HSAs) and can discuss payment arrangements that suit your financial situation.
We’re committed to helping you navigate these financial aspects clearly and transparently, ensuring you fully understand your expected costs upfront.
Why Aetna Members Choose Us
At Lenape Wellness Center, we’ve cultivated an atmosphere designed specifically to support deep healing. Nestled on a tranquil, 18-hole golf course, our residential facility offers a peaceful escape where personalized care and expert treatment come together seamlessly.
Our experienced care team integrates evidence-based therapies like Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), mindfulness practices, and Equine-Assisted Therapy, creating a comprehensive and holistic treatment approach. We emphasize transparency in every interaction, especially regarding billing and insurance coverage, so you always know what to expect.
Step by Step Admission Checklist
To make the admissions process as smooth as possible, follow these clear steps:
- Initial contact: Call us or submit your benefits information via our online contact form.
- Insurance verification: Our team verifies your Aetna coverage the same day you reach out.
- Clinical documentation: Send us recent clinical notes or medical records as requested by our admissions team.
- Prepare for your stay: Pack essential personal items, medications, comfortable clothing, and any specific items recommended by our staff.
- Arrival: Upon arrival, you’ll meet your dedicated care team and begin your personalized treatment journey immediately.
Success Stories
“After weeks of stress trying to navigate mental health treatment and insurance, finding Lenape Wellness Center was a relief. Their team quickly handled all communication with Aetna, securing approval efficiently. Beyond simplifying the insurance aspect, the genuine care and exceptional therapy provided have been life-changing, marking the beginning of a hopeful, healthier chapter.”
Map and Directions
950 Golf Course Rd, Ford City, PA 16226
For GPS navigation, enter our full address above. We’re located approximately 50 miles northeast of Pittsburgh, easily accessible via major highways. Open our address in Google Maps for step-by-step directions.
Ready To Take The Next Step
Your well-being matters, and we’re here to help you navigate every step toward recovery. Call us today!