How to Use Meritain Health Insurance for Addiction Treatment

Meritain Health is an insurance provider under the Aetna & CVS family that can be used for detox and rehab. Learn how to use your plan here.

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Does Meritain Health Cover Addiction Treatment

Meritain Health, like other insurance providers, is required to provide substance use disorder treatment coverage as is required by the Affordable Care Act. In fact, family members and dependents may be covered for services as well. The specific addiction treatment services you receive will depend on the terms of your Meritain Health plan.

Types of Addiction Treatment Covered by Meritain

Your substance abuse treatment plan will be tailored to your specific needs. Factors that determine your personal treatment plan include your substance of choice, the length of your addiction, a mental health diagnosis, and the number of drugs or alcohol you consume. Your treatment plan may be crafted to suit your particular insurance plan, your previous health conditions, and the state where you live as well. Although exact coverage will vary by plan, if you are a Meritain member and seeking treatment for a substance use disorder, you can likely expect coverage for the following services:

  • Detox.
  • Inpatient Rehab.
  • Outpatient Rehab.

Detox—the process by which substances are eliminated from the body—is the initial step in taking control of their substance abuse. Detoxing from drugs and alcohol is often wrought with intense and sometimes severe withdrawal symptoms. People often choose to undergo this process in the comfort of a treatment facility on an inpatient basis. Inpatient detox ensures around-the-clock care; your symptoms will be monitored and medical interventions can occur if needed.

Although it’s not required, inpatient rehab usually occurs after detox and consists of living at the facility for anywhere from 28-90 days. Lastly, outpatient rehab consists of living at home and traveling several times a week for therapy sessions.

How Much Can Meritain Health Cover?

The amount of coverage that Meritain Health insurance provides will vary greatly depending on a variety of factors. Some of these factors include:

  • The type of Meritain insurance plan you have.
  • Where you attend treatment.
  • Whether a facility is in-network with Meritain Health.
  • The intensity of treatment.
  • The length of treatment.
  • The accommodations and amenities offered at a rehab.

It’s important to reach out to your Meritain representative to verify your coverage before committing to drug or alcohol rehab.

Do Rehab Facilities Need to Be In-Network with Meritain Health?

Oftentimes, insurance plans will require participants to attend treatment at in-network facilities in order to maximize the benefits they receive. While one may attend treatment at an out-of-network facility, they can expected Meritain to cover less of the treatment costs. In some cases, Meritain health may not cover any treatment received at an out-of-network facility. It’s important to make sure that any rehabs are in-network with Meritain health to get your full insurance benefits.

How to Check My Meritain Health Coverage

In order to check one’s coverage, you’ll need to reach out to a Meritain Health representative. This can be done online or via phone. Most Meritain representatives can discuss the extent of any coverage for rehab. Some other ways to check your Meritain Health insurance include:

  • Web login.
  • Call the number on insurance card and speak to a customer service representative.
  • Checking directly with the rehab provider.

How to Use Your Meritain Health Plan

Once you’re verified your coverage for substance use disorder treatment, you’ll need to prepare to use your Meritain Health insurance to pay for treatment. And important first step would be to reach out to any prospective rehab and confirm that they work with Meritain. Attending treatment at an in-network facilities will help to maximize the amount of coverage you receive, while attending treatment at an out-of-network facility will often carry additional out-of-pocket costs. Many health insurance plans also require you to obtain preauthorization before starting treatment. You can obtain preauthorization by communicating with your doctors and prospective rehabs.

Types of Meritain Health Plans

Meritain Health is a subsidiary of Aetna Insurance. Meritain offers a variety of different types of insurance plans. They include:

  • Self-Funded Plans
  • Traditional Provider Network Plans
  • Consumer-Directed Health Plans
  • Value-Based Benefit Designs

Meritain Health also offers ancillary services such as dental and vision coverage as well as a Medicare Part D option.

There are differences among the four plans. A Self-Funded Plan allows employers to pay for members’ services as they arise, as opposed to paying a premium every month.2 Traditional Provider Network Plans follow the PPO model most people are familiar with. Meritain partners with more than 60 healthcare networks across the country.3 Consumer-Directed Health Plans are designed to address specific healthcare needs for groups of people, while Value-Based Benefit Designs offer cost-efficient healthcare services and choices.4&5

Using Meritain Health With Medicare

Meritain Health offers Medicare Part D coverage for people 65 and older who qualify for Medicare. Medicare is a government-funded healthcare insurance program for people 65 and older and younger people who have specific health conditions.6 Medicare can cover costs associated with many types of services, from primary care visits and prescription drugs to substance abuse treatment services.

Finding Rehab Centers that Take Meritain health

Once you’ve decided to commit to treatment, you’ll need to find a rehab center that is in-network with Meritain Health insurance. A good first step would be to reach out to your doctor or a trusted medical professional. They may be able to help determine your medical needs and could possibly refer you to a rehab facility. It’s also wise to contact Meritain Health in order to determine your coverage and to see if they can direct you to any in-network facilities. You may also consider visiting the SAMHSA treatment locator to find nearby rehabs that accept Meritain insurance.

You may also benefit from reaching out to an addiction helpline. Addiction helplines provide callers with 24/7 support for any concerns they may have about addiction or the rehab process. The American Addiction Centers helpline can connect you with trained professionals who can help verify your Meritain Health coverage. They may also be able to help you find a facility that accepts Meritain insurance. Don’t delay finding critical care, reach out to us now at .