Meritain Health operates as an independent subsidiary of Aetna, offering an array of insurance products, including self-funded plans, traditional provider network plans, value-based benefit designs, and consumer-directed health plans.
Deductibles, coinsurance, copays, out-of-pocket maximum, in-network costs, and out-of-network costs vary based on what plan you have. Meritain Health provides many types of rehab programs with varying levels of coverage.
Drug and alcohol rehab is covered by Meritain Health, but plans vary on what is covered. In this guide, we help you navigate the process of figuring out your benefits and getting the help you need for drug and alcohol addiction.
Meritain drug rehab coverage includes both inpatient rehab and outpatient rehab programs. The amount you pay out of pocket for rehab while covered by Meritain Health insurance depends on your specific policy, the services you are seeking, and other factors.
Some Meritain plans fully cover residential treatment programs, while some offer partial coverage. Depending on your unique policy, Meritain Health will cover all or some of the costs of your stay at a rehab facility. However, Meritain may limit stay in a residential facility to a max amount of days per year. Regardless, Meritain policies offer great coverage for drug rehab and alcohol rehab.
Many Meritain Health insurance plans require policyholders to meet a deductible and pay a coinsurance to seek rehabilitative services for addiction. Some plans may also require the policyholder to get preauthorization to seek certain services. Policyholders can only receive certain rehabilitative services if Meritain decides that those services are medically necessary for the recovery.
The best way to find out about drug rehab coverage is to get a verification of benefits. If you don’t want to go through the pain of figuring it out alone, we can help you if you submit through our verification of insurance form.
Meritain Health provides coverage for alcoholism, prescription drug abuse, street drug abuse, and co-occurring disorders (mental illness and addiction). Several types of treatments are available for any addiction, including inpatient rehab, partial hospitalization, standard outpatient, and intensive outpatient.
The detox process is often the first focus when admitted to drug and alcohol rehab, followed by the second phase of inpatient rehab, and then outpatient.
During inpatient rehab, the patient lives in an addiction rehab facility and participates in intensive therapies such as individual therapy, group therapy, EMDR therapy, and more. The idea is to learn the coping mechanisms necessary to live life on life’s terms and to let go of destructive coping mechanisms.
Group sessions with other members help improve their confidence and interpersonal skills. These groups create an atmosphere of support and foster human connection.
Partial hospitalization programs are often covered by Meritain health. The daily structure and services offered in partial hospitalization programs are fundamental to building and sustaining a solid life in recovery.
People with certain types of addiction require more intensive care than others. Inpatient rehab is best suited for individuals with moderate to severe substance use disorder.
However, outpatient programs are a viable option for many individuals.
Meritain Health alcohol rehab normally has three phases: alcohol detox, inpatient or outpatient programs, ongoing therapy, and aftercare.
Alcohol detox should never be done alone; medically-assisted detox for alcohol addiction is the standard procedure. Medically-assisted detoxification ensures that withdrawal symptoms do not impair the patient’s normal functioning. Some patients may experience severe withdrawal symptoms, which may cause potentially fatal complications if not managed carefully.
Inpatient treatment is recommended for people with severe alcohol abuse problems as such programs involve medical management of both physiological and psychological aspects of alcoholism.
The final phase of Meritain Health alcohol rehab focuses on addressing the psychological aspects of alcohol abuse. Patients take part in one-on-one meetings with their counselors and learn coping mechanisms. The sessions aim to develop healthy routines for patients and help them identify mental patterns that lead to alcohol abuse.
Co-occurring disorders are mental health and substance abuse problems within the same person. Meritain Health insurance covers treatment for co-occurring disorders or dual diagnosis. Over 9 million adults in the United States suffer from co-occurring disorders, according to SAMHSA’s 2018 National Survey on Drug Use and Health.
The first phase of the treatment involves neuropsychological evaluation of the patient to determine their needs, identify their strengths, and figure out potential barriers to recovery. Rehab specialists then use this information to develop an integrated plan of care that addresses the patient’s mental illness and substance use disorder at the same time.
Co-occurring disorders can be complex to treat. It’s important to know that not getting the full necessary treatment can increase a person’s likelihood of either dropping out of rehab or relapsing.
Meritain health insurance is likely to cover dual diagnosis (or co-occurring disorder) treatment.
Recovery is an ongoing process, and people may relapse even after completing rehab. Relapse is an extremely common occurrence in the treatment of substance use disorders but does not indicate total and complete failure.
The National Institute on Drug Abuse reports that relapse rates while in recovery are between 40% to 60%. Relapses can be analyzed and prevention plans changed. Relapses can often help rehab specialists identify what needs to be changed in the patient’s plan of care.
Meritain Health understands that victims of substance use disorders may have to go to rehab more than once to learn to live in true abstinence. Meritain Health will usually pay for rehab if deemed medically necessary, irrespective of how many times you have previously been to rehab.
To find out exactly what your specific Meritain insurance policy covers, you can contact the insurer and gather the information or let us help you. By allowing us to help you, we can see if you are eligible for our substance abuse treatment programs.
Our admissions team will spend time gathering all of the specifics of your policy. We know the right questions to ask, and even better, we can advise you in layman’s terms what your coverage means. Visit our insurance verification page.