Find an Aetna Therapist
Medically reviewed by Gabriela Asturias, MD on June 24, 2024Aetna®—now part of CVS Health—covers a wide range of services, from talk therapy to inpatient treatment and digital self-help apps. What’s confusing is how to unlock that coverage without surprise bills, denials, or week-long phone marathons. This article walks you through every step, in plain English, so you can focus on feeling better instead of fighting paperwork.
Does Aetna Cover Therapy?
Short answer: yes. When a licensed clinician decides that counseling or psychiatry is medically necessary, Aetna treats it like any other covered medical service. Most HMO, EPO, and employer PPO plans list a $0–$40 copay for in-network, 45-minute individual sessions, while high-deductible plans apply 20 %–30 % coinsurance after you meet the deductible.
Key takeaways:
No preset visit cap: session frequency is driven by clinical need, not a number in your handbook.
No referral required: you can self-refer directly to a mental-health provider on almost every commercial plan.
Prior authorization is rare: only higher-intensity programs (IOP, residential, ketamine, TMS) normally require extra paperwork.
Medicare Advantage (MA): most Aetna MA plans quote a $40 copay per individual outpatient visit.
Pro tip: Open the Aetna Health app → Find Coverage Details and plug in the exact therapist you’re considering. The estimator tool tells you your copay or coinsurance before you ever pick up the phone.
Types of mental health providers in Aetna’s Network
| Provider type | What they do |
|---|---|
| Therapist (LCSW, LMFT, LPC) | Weekly talk therapy for anxiety, depression, life transitions |
| Psychologist (PhD, PsyD) | Psychological testing; advanced modalities like EMDR & DBT |
| Psychiatrist (MD/DO) | Diagnosis, medication management, complex co-morbidities |
Many members mix and match: weekly sessions with a therapist that accepts Aetna plus quarterly med check-ins with an in-network psychiatrist.
Real-Life Example: Jordan’s Two-Week Timeline
Day 1, 9 AM — Online check-in. Jordan, a 29-year-old product manager, opens the Aetna portal, completes the five-minute mental-health screener, and picks a triage-call slot for noon.
Day 1, 12 PM — Care Options Call. The case manager explains that CVS Health Virtual Care can do video therapy tomorrow, while local therapists that take Aetna have openings in about 12 days.
Day 1, 3 PM — Directory Deep Dive. Using filters (evening hours, CBT, LGBTQ+ friendly), Jordan picks Marina Ortiz, LCSW—an Aetna therapist three miles away.
Day 12 — First in-person session, $25 copay on a mid-tier PPO.
Jordan’s path shows how quickly you can connect with a therapist that accepts Aetna once you know where to click and what to ask.
Step-by-Step: Booking Therapy Through Aetna
| Step | Action | Why it matters |
|---|---|---|
| 1. Self-refer online or by phone | Online: sign in to Aetna Health → Behavioral Health. Phone: call 1-888-632-3862 (TTY 711) and say, “I’d like to schedule therapy.” Directories like MiResource.com are often easier to use and more frequently updated with accurate information about in-network providers. However, it’s always a good idea to double-check that any provider you find is also listed in your official Aetna directory to confirm coverage. | No primary-care referral needed; you’re in control of the process. |
| 2. Complete the quick screening | Five minutes of questions on symptoms, safety, and preferences. | Be honest - but if relevant - flag urgent concerns (e.g., thoughts of self-harm) to unlock 24- to 48-hour options. |
| 3. Filter the directory | Set distance, specialty, telehealth, language, evening hours; look for the green “Accepting New Patients” badge. | Add keywords like “CBT,” “trauma,” or “ADHD” to drill down. |
| 4. Confirm cost | Click Cost Estimator in each profile. | HDHP members see the exact contracted rate until their deductible is met. |
| 5. Book the slot | Pick in-person, CVS Health Virtual Care (often same week), or Teladoc. | CVS advertises many mental-health visits within seven days—or same day if you’re flexible. |
| 6. Activate free digital supports | Most plans bundle Calm, Sanvello, or myStrength. | Use them as homework between sessions or while you wait for the first visit. |
In-Network vs. Out-of-Network Care
| Stay In-Network | Go Out-of-Network |
|---|---|
| Predictable copay/coinsurance; claims filed for you. | Pay full fee up front, then submit a superbill for partial reimbursement. |
| Integrated chart and pharmacy. | Access niche specialties or shorter waits in saturated cities. |
How to Trigger a “Gap Exception”
If you can’t book an in-network appointment within 10 business days—Aetna’s own standard for routine mental-health care —call Member Services and request a network gap exception (also called a “single-case agreement”). Aetna will either (1) find you a faster in-network slot, or (2) approve out-of-network care at in-network rates. Keep the reference number they give you.
Cost Cheat-Sheet
| Plan type | Your likely share |
|---|---|
| HDHP PPO | 20 % coinsurance after deductible for in-network therapy Aetna allows. |
| Standard PPO / EPO | $20–$40 copay per visit. |
| HMO | $0–$30 copay; referral required in only a few legacy state plans. |
| Medicare Advantage | $40 copay per individual session. |
*Always verify in your Evidence of Coverage; employer carve-outs and state mandates can tweak numbers.
Not vibing after visit #1? Go back to the directory or call Behavioral Health and say, “I’d like a different provider.” No penalty, no referral, no explaining required.
Advocating for Yourself When Wait Times Drag
Call the Member Advocacy line (number on your ID card) and open a complaint.
Request a gap exception—demand a gap exception if your first appointment exceeds 10 business days and quote Aetna’s 10-business-day access standard and the federal Mental Health Parity rules.
File an online grievance. Aetna must respond within 30 days.
Document every call. Names, dates, “next available” time offered. Those details move appeals faster.
Tip: Polite persistence often unlocks a sooner slot—or secures approval to use an outside psychologist Aetna doesn’t list in your ZIP code.
FAQ’s
Does Aetna cover therapy for couples?
Yes, if the sessions address a diagnosable mental-health condition for at least one partner. Relationship-enrichment only may not qualify—check your plan.
How do I find therapists that take Aetna near me?
Log in → Find Care → Behavioral Health → set distance & specialty filters. The green badge confirms the provider is in network.
What’s the difference between an Aetna therapist and a psychologist Aetna lists?
“Therapist” is an umbrella for licensed counselors (LCSW, LMFT, LPC). “Psychologist” means a PhD or PsyD who can perform testing and provide advanced modalities.
Can I switch therapists if the first one isn’t a fit?
Absolutely. Go back to the directory or call the Behavioral Health number to request a new provider—no penalty.
Is every type of therapy covered by Aetna?
Most evidence-based modalities (CBT, DBT, EMDR) are covered. Novel or experimental treatments may need prior authorization.
Find care for Aetna
Remember, recovery is possible. With early intervention, a supportive network, and the right professional care, you can overcome the challenges of Aetna and build a fulfilling life. We are here to help you find care.
