Most insurance plans will cover either all or a portion of the treatment.
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Navigation:
- Overview
- What Kinds of Addiction Treatment and Support Services Does Meritain Health Cover?
- How Much of My Treatment Is Covered?
- What If My Plan Doesn’t Cover All of My Treatment?
- Find Treatment Centers That Take Meritain Insurance
Overview
Meritain insurance plans cover a wide variety of substance abuse treatment services to make care more affordable and accessible. Offering a nationwide network of treatment providers and coverage for multiple tiers of addiction rehab, it can make getting help for drug and alcohol abuse more manageable, while giving you or your loved one more options.
If you or a family member is struggling with alcohol or drug addiction, and is covered by a Meritain Health policy, you may be able to have all or part of your treatment paid for by your insurance. Here’s a little bit of what to expect from your Meritain Health policy.
What Kinds of Addiction Treatment and Support Services Does Meritain Health Cover?
While the exact scope of coverage depends on variables like group size, state of residence, plan tier, and other factors, Meritain typically covers essential treatment services covered under the Affordable Care Act (ACA) and Mental Health Parity laws.
These include, but are not limited to, the following:
- Assessment and Screening – Initial evaluation from trained and experienced mental health professionals to determine medically appropriate care. These assessments help to identify core clinical needs and ensure patients are routed to the proper treatment models.
- Inpatient and Residential Treatment – If patients’ assessments determine that they are candidates for inpatient treatment, Meritain may cover inpatient treatment, which lasts an average of 28-30 days. During inpatient treatment, patients stay at their facility while getting help so they can heal in a comfortable, supportive, and distraction-free environment. Meritain policies typically cover around 30 treatment days per year, but plans may vary.
- Outpatient and Intensive Outpatient Treatment – Outpatient treatment consists of daily treatment programming, such as behavioral rehab, counseling, and supplemental therapies, at the end of which patients return home every day. These programs vary in duration but often consist of three to five daily treatment sessions per week, lasting anywhere from four to eight hours. Depending on group size and other plan factors, Meritains may cover up to 40 outpatient sessions per year.
- Detoxification and Withdrawal Management – Medically supervised management of acute physical and psychological withdrawal symptoms. This includes care from experienced doctors and nurses. Detox typically lasts around three to seven days to ensure that patients’ systems are medically stabilized and ready to pursue behavioral rehab. Coverage varies depending on plan type and patients’ ongoing care needs, but plans usually cover the entire process.
- Medication Management – This includes meds for co-occurring mental health issues, such as depression, anxiety, bipolar disorder, and others, as well as FDA-approved opioid maintenance medications, such as Suboxone, Vivitrol, Methadone, and Sublocade. Restrictions apply, depending on plan type.
- Partial Hospitalization Programs (PHPs) – These programs can serve as an alternative option to inpatient treatment or as a transition from residential programs. They provide the structure and in-depth treatment needed for more critical patients, while also providing the flexibility patients need to stay present in their careers, families, and other areas of their lives that need ongoing nurturing. PHP programs are often designed based on each patient’s individual needs.
Your Meritain policy may also cover therapy and counseling, as well as other support services. Treatment elements may be offered as part of one comprehensive program or as separate components of care.
How Much of My Treatment Is Covered?
The exact scope of coverage will vary depending on what kind of plan you have, the size of your group that’s covered with you, your state of residence, and other factors. The best way to find out exactly how much of your treatment will be paid for is to contact your Meritain Health representative. They will help to coordinate an assessment so you can find out exactly what kind of treatment you need, based on your substance use history, associated medical needs, co-occurring mental health disorders, and other variables.
What If My Plan Doesn’t Cover All of My Treatment?
After speaking to your Meritain services representative, you can talk to an admissions coordinator at the facility you’re considering to find out if they have other means of payment to make treatment more affordable. They may be able to work with you by offering sliding-scale payment options that allow you to pay what you can afford, financing agreements, or even scholarship programs to cover the remainder of your care.
Find Treatment Centers That Take Meritain Insurance
We’ve created a nationwide directory of rehab centers that accept Meritain Insurance. Use our directory to find trusted addiction treatment programs covered by your Meritain plan.
