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Drug And Alcohol Rehab Programs That Accept Meritain Health Insurance

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

April 30, 2019

Getting treatment for an addiction is often the final push a person needs in order to find lasting recovery. Meritain Health offers insurance plans that provide coverage for a selection of drug and alcohol rehab services.

Many people battling addiction are looking for a way out. Formal addiction treatment centers, often called rehab programs, can provide the hope and healing that many families are seeking.

One of the first challenges of finding treatment is the matter of cost. Many people are intimidated by the notion that rehab centers are only for the wealthy, but that is not the case. Meritain Health members can cut the cost of rehab centers by properly using their insurance coverage.

Affordable, quality addiction treatment services can be found throughout the U.S. Learning how to use your Meritain Health insurance benefits can further reduce the cost of drug and alcohol rehab programs.

Do Meritain Health Members Have Coverage For Addiction Treatment?

With over 20 million Americans struggling with a substance use disorder, affordable addiction treatment is a must. Fortunately, insurance companies are now required to cover addiction treatment and mental health at the same level they cover physical health conditions.

Meritain Health is a part of Aetna, one of the largest insurance providers in the country. With more than 30 years in service, Meritain Health offers individual, family, and employer-provided plans. This company also offers a 24-hour behavioral health call center, so that members can access treatment representatives any time of day.

Each Meritain Health plan will cover addiction treatment differently. A person’s out-of-pocket costs (including deductibles and copays) will be directly affected by their plan details. It may be beneficial to contact Meritain Health directly, in order to verify the specifics of your plan.

Common Rehab Services Covered By Meritain Health

Everyone responds to addiction treatment differently, so there are now a variety of rehab services from which to choose. It’s important to learn the different approaches to addiction treatment, in order to select the services you think may work best for you or your loved one.

Meritain Health will likely provide coverage for many of these services. Some of these may require pre-authorization, which means your doctor will need to make a medical referral. Most doctors are familiar with this process and will be happy to provide a referral for treatment.

Meritain Health plans may provide coverage for treatment services that include:

  • intervention services
  • drug and alcohol detoxification
  • inpatient treatment
  • outpatient programs
  • prescription drugs
  • dual diagnosis counseling

Depending on your plan, you may be responsible for a portion of the cost of these services. This can include coinsurance, copays, and meeting your plan’s deductible. A Meritain Health representative will be able to explain this in further detail.

Medically Supervised Detox

When a person stops taking drugs or alcohol, their body goes through a natural detoxification process. The body passes the various toxins that build up from substance abuse, and begins adjusting to sobriety.

Many people experience difficult withdrawal symptoms during the detox process. That’s why it’s recommended to detox in a medically supervised environment that also provides emotional support.

Your Meritain Health plan may provide coverage for different types of detox. A medical referral may be required, which can be obtained from your primary care physician. Your Meritain plan may have lower out-of-pocket costs if you receive detox services with an in-network provider.

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Inpatient Treatment

All Meritain Health policies cover inpatient treatment programs. However, precertification is required and there may be a cap on the amount of days your plan will cover.

At an inpatient program, patients engage in various therapies that help them overcome the consequences of substance abuse. Individual counseling, creative arts therapy, and addiction education classes are provided at many inpatient treatment centers.

This type of rehab program is residential, which allow for patients to temporarily live on-site. Attending an inpatient rehab can provide people with a sense of security and support, especially if they do not live in an environment that encourages sobriety.

Most inpatient treatment centers offer 30, 60, and 90 day programs. Make sure to check your plan’s benefits, as Meritain Health may cover all or a portion of your treatment stay.

Outpatient Rehab Programs

In an outpatient rehab program, clients are offered many of the same therapies on a more flexible schedule.

Outpatient treatment may be used as aftercare, following an inpatient treatment program. Other people may try outpatient treatment if they have professional or personal commitments that keep them from attending residential treatment.

There are several levels of outpatient treatment, including intensive outpatient (IOP) and partial hospitalization (PHP). These treatment levels depend on the severity of the person’s addiction, along with other factors such as personal schedule.

PHP is the highest level of outpatient treatment, and typically offers sessions five days per week. IOP is the next step down, and is sometimes called “day treatment.” Base-level outpatient treatment programs meet twice per week, and may include drug screenings to help build a sense of accountability.

Your Meritain Health will likely cover certain types of outpatient treatment programs. The details of your coverage will vary by plan and location.

Prescription Drugs And Medication-Assisted Treatment (MAT)

When a person is new in sobriety, their body and mind are going through major changes. Many people benefit from the use of therapeutic prescription drugs, especially if they suffer from an additional mental health condition, such as bipolar disorder.

Medication-assisted treatment, or MAT, is the use of certain prescriptions that help to relieve withdrawal symptoms. MAT is especially common among those who suffer from an opioid use disorder, as it can reduce a person’s chance of relapse.

Because of the Mental Health Parity and Addiction Equity Act, Meritain Health is required to provide coverage for MAT. The exact amount of coverage will vary by plan.

Important Questions To Ask Regarding Meritain Health Plans And Rehab Centers

It can be overwhelming to take in all the information about treatment centers and insurance coverage. Remember that finding affordable treatment is a vital step in getting you or your loved one some much-needed help.

When you contact a Meritain Health representative, you may want to have a list of questions on hand to make sure all your bases are covered. Next, you can contact a treatment center directly and verify the different services they offer.

Frequently asked questions about Meritain Health treatment coverage include:

  • Does my Meritain Health plan require me to meet any treatment criteria?
  • Do my benefits cover inpatient treatment?
  • Do I have to attend an in-network rehab center?
  • What levels of outpatient treatment are covered by my plan?
  • Do I need any pre-certification or referrals before I am covered for treatment?
  • Do my benefits provide coverage for prescription drugs and MAT?
  • What are my copay and deductible levels, if any?

How To Find A Rehab Center That Accepts Meritain Health Insurance

Although the details of coverage can be difficult to navigate, it’s worth it to know you are getting the most out of your insurance benefits in the end. Learning how to best use your insurance can ease the stress of enrolling in addiction treatment.

To learn more about drug and alcohol rehab centers that accept Meritain Health insurance, contact one of our treatment specialists today.

Meritain Health - Mental Health Parity

Meritain Health - Mandated Benefits and Coverage

Meritain Health - Member Services

National Institute on Drug Abuse - Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

Substance Abuse and Mental Health Services Administration - Trends In Substance Use Disorders Among Adults Aged 18 or Older

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