How to Get Reimbursed for Online Therapy with Aetna
How to Get Reimbursed for Online Therapy with Aetna Insurance
Online therapy has made mental health care more accessible than ever, but if you’re using Aetna insurance, understanding how to get reimbursed can still be tricky. Whether you’re seeing an in-network therapist via telehealth or paying out-of-pocket for an out-of-network provider, this guide explains everything you need to know about Aetna online therapy reimbursement—from eligibility to successful claim submission.
Does Aetna Cover Online Therapy?
Yes, Aetna covers various online therapy services under its behavioral health benefits. Coverage typically includes individual therapy, family counseling, and psychiatric evaluations conducted by licensed professionals. However, the extent of coverage depends on your specific plan and whether your therapist is in-network or out-of-network.
- In-Network Providers: Often fully or partially covered with minimal paperwork.
- Out-of-Network Providers: Typically require you to pay upfront and file for reimbursement.
It's important to note that certain therapy services may require precertification (also known as prior authorization) before they are covered. For instance, CPT code 90834, which represents a 45-minute psychotherapy session, may necessitate precertification under some Aetna plans. This means you or your provider must obtain approval from Aetna before the service is rendered to ensure coverage. Failure to secure precertification when required can lead to claim denials.
To determine if your therapy sessions require precertification, consult Aetna's Precertification Lists or use their CPT code lookup tool.
📌 Helpful Link: Aetna Mental Health & Well-being Resources
Understanding Aetna’s Reimbursement Policy
When you see an out-of-network therapist, Aetna may reimburse part of your session cost through what’s called an insurance reimbursement claim. This means:
- You pay your therapist directly.
- You submit proof of your session (a “superbill”).
- Aetna reviews and, if eligible, sends you a partial refund.
Not all plans offer out-of-network coverage, so it's essential to check before booking sessions.
Eligibility Requirements
Before submitting a claim, confirm you meet Aetna’s criteria:
- Your plan includes out-of-network mental health benefits.
- Your therapist is licensed and credentialed.
- The therapy service is medically necessary and includes a formal diagnosis and CPT code.
Tip: Use Aetna’s member portal or call support to verify the specific requirements of your plan. The phone number on the back of your car will provide the most personalized information on what mental health services are covered.
Step-by-Step Guide: How to File a Reimbursement Claim
- Check Your Plan’s Coverage
- Log in to your Aetna member portal or call the number on your insurance card.
- Ask specifically about “out-of-network mental health reimbursement for telehealth.”
- Gather Your Documentation
- Superbill from your therapist: Should include session dates, provider information, CPT codes, diagnosis codes, and amount paid.
- Therapist’s license number and address.
- Member ID and policy details.
- Download and Complete Aetna’s Reimbursement Form
- Visit Aetna’s website or download the reimbursement form directly.
- Submit Your Claim
- Submit via mail or upload through the Aetna member portal.
- Keep a copy of everything submitted.
- Follow Up
- Claims are typically processed within 30 days.
- If denied, Aetna must provide a written explanation, and you have the right to appeal.
Tips to Maximize Your Reimbursement
- Always ask for a detailed superbill after each session.
- Double-check that the diagnosis and CPT codes are accurate.
- Submit claims as soon as possible—delays can risk denial.
- Track your claims through Aetna’s online portal.
Common Issues and How to Avoid Them
❌ Claim Denied? Common causes include:
- Missing diagnosis codes.
- Submitting after the deadline.
- Using a non-licensed therapist.
✅ Solution: Review your claim carefully and ask your provider to correct and resubmit if needed.
If your claim is denied unfairly, file an appeal through Aetna’s member services.
Alternatives If You’re Not Covered
If Aetna doesn’t reimburse for online therapy, consider these options:
- HSA/FSA Accounts: Use pre-tax dollars to pay for therapy.
- Sliding Scale Fees: Many therapists offer income-based pricing.
- Low-Cost Clinics: Check nonprofit or university-based therapy programs.
✅ Need support finding affordable, Aetna-reimbursable online therapy?
Try Online-Therapy.com—a trusted platform offering licensed therapists and superbills for easy insurance claims.
🎯 Start your therapy journey today and explore flexible plans that fit your mental health needs and budget.
Conclusion
Getting reimbursed for online therapy through Aetna may seem daunting, but with the right information and documentation, it’s entirely possible. By understanding your coverage, gathering the right paperwork, and following a clear process, you can take full advantage of your mental health benefits.
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