Meritain Health Insurance Coverage For Drug And Alcohol Rehab

The right addiction treatment program can be the key to overcoming a struggle with addiction. Meritain Health members have access to coverage for alcohol and drug rehab programs, decreasing the cost of treatment and allowing them to focus on recovery.

Meritain Health Insurance Coverage For Drug And Alcohol Rehab

For those who find themselves battling an addiction, drug and alcohol rehab programs offer a beacon of hope. Finding a way to pay for rehab is one of the first challenges someone seeking treatment must overcome, and Meritain Health is an insurance provider that includes coverage for addiction treatment in many plans.

About Meritain Health

Meritain Health is an insurance provider that operates as a subsidiary of Aetna. The company has over 30 years of experience in the industry and is focused on ensuring patients have the right coverage to protect their health. Meritain Health offers an extensive list of insurance products, including individual and family plans and employer-sponsored plans.

Within each of these plans, the coverage for drug and alcohol rehab varies significantly. All include coverage to some degree, but out-of-pocket costs will depend on the specific plan’s guidelines for:

  • Deductibles
  • Copays
  • Coinsurance costs
  • Out-of-pocket maximums
  • In-network and out-of-network costs

One benefit Meritain Health members have access to when dealing with addiction is the company’s integrated behavioral health services and 24-hour phone line. This ensures that members can get assistance finding the right treatment provider the moment they are ready to seek help.

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Does Meritain Health Cover Drug And Alcohol Detox?

Meritain Health insurance plans may cover drug and alcohol detox when recommended as medically necessary by a primary care physician. Medically supported detox programs take place in an inpatient environment, so coverage would fall under the member’s inpatient insurance benefits. The patient would be responsible for any copays, coinsurance and deductibles. Detox programs, both inpatient and outpatient, require precertification or preauthorization from the insurance provider.

Detox is the process of withholding drugs or alcohol and allowing a patient’s body to begin adjusting to sobriety. When these substances are withheld from a person who is chemically dependent, uncomfortable withdrawal symptoms begin. Close medical monitoring and emotional support is necessary during detox and withdrawal.

Does Meritain Health Cover Inpatient Rehab?

All Meritain Health and Aetna policies cover inpatient rehab at residential treatment facilities. Inpatient admissions require precertification or authorization, and limitations on length of stay may apply.

Inpatient rehab combines a number of therapies and group activities, and the patient lives at the facility during treatment. Residential addiction treatment services can include medical monitoring, medication-assisted treatment, therapy, counseling and psychological evaluation. Constant support and accountability combined with a group living environment ensures the patient is protected from triggers and day-to-day stress while in the early stages of recovery.

After completing an inpatient treatment program, patients are able to transition into outpatient treatment to ensure long-lasting sobriety and a positive overall outcome to their time in addiction treatment.

Does Meritain Health Cover Outpatient Rehab?

Most Meritain Health insurance plans will cover outpatient rehab as part of the behavioral health services coverage. Patients will need to check their insurance plan to learn what their specific out-of-pocket expenses will be for outpatient rehab services, but preauthorization is not usually required. Outpatient rehab facilities can also perform a verification of benefits to determine coverage.

In an outpatient addiction treatment program, a patient will receive the same therapies provided during inpatient programs, but with the ability to return home or to a sober living home each evening. This can be an excellent choice for patients with financial constraints or patients who have a milder addiction.

For many people, outpatient rehab is the third step in treatment after detox and inpatient treatment. Both intensive outpatient and partial hospitalization treatment protocols fall into this category. With the right preauthorization and referrals, most Meritain Health insurance plans will cover outpatient treatments.

Does Meritain Health Cover Medication-Assisted Treatment?

When a patient’s doctor thinks that medication will assist their recovery, Meritain Health insurance coverage may pay for a portion of the cost of these prescriptions. All plans include a prescription drug card, and members are responsible for a deductible as well as copays for their prescriptions. Copays vary depending on the medication and which insurance plan the individual has but can be anywhere from $15 for generic prescriptions to 50 percent for non-preferred prescriptions.

For patients dealing with an opioid addiction, medications like methadone (Diskets) and buprenorphine (Suboxone) can reduce the risk of relapse. These medications help to prevent withdrawal symptoms and reduce cravings.

People struggling with alcohol addiction can benefit from naltrexone (Vivitrol) treatment. Naltrexone helps reduce an individual’s desire for alcohol. As part of a full treatment plan, this medication can help improve the chances of successful recovery.

Does Meritain Health Cover Sober Living Houses?

Sober living houses are not typically covered by insurance, including Meritain Health policies. While insurance policies may cover residential treatment centers, they do not typically cover sober living houses.

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Sober living houses offer a drug- and alcohol-free environment for a patient to live in for the first months after treatment. This safe residential facility helps reduce the chances of relapse.

Patients who can benefit from a sober living house should contact their preferred facility to learn more about options for payment outside of insurance. Payment plans and careful budgeting can make it possible for patients to afford this important step in their recovery, even without insurance coverage.

In-Network Vs. Out-Of-Network Costs

Meritain Health plans include access to the extensive network of Aetna providers. However, some patients may choose a rehab facility that is out of the plan’s network. Out-of-network care is allowed on many of the Meritain Health plans, but patients will pay a higher deductible and copay amount for out-of-network care.

How To Find Drug And Alcohol Rehab Centers That Accept Meritain Health

  1. Contact Addiction Campuses for an immediate verification of benefits. Addiction Campuses can answer questions about insurance and addiction treatment and perform a no-obligation verification of insurance benefits on your behalf.
  2. Contact the insurance provider by using the phone number on the back of the insurance card or by visiting the provider’s website. A representative will be able to match you to an in-network drug and alcohol rehab center.
  3. Call the treatment center you or your loved one is interested in. The treatment center’s admissions team can answer questions about covered services.

Aetna - https://www.aetna.com/insurance-producer/behavioral-health/behavioral-health-benefits.html

Meritain Health - https://www.meritain.com/Products-services/Meritain-Advantage-members

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