Meritain Health Insurance Coverage for Rehab and Detox

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 Rehab 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 Rehab Covered by Meritain Health

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—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 to Use Your Meritain Health Plan for Rehab

People often fear being responsible for a substantial medical bill when they go to treatment. When you receive care, it’s crucial to make sure that your insurance provider and the treatment center are on the same page. You want the peace of mind that comes with knowing that the costs associated with a life in recovery will be at least partially covered. Always check with your insurance provider to verify what services are offered under your plan.

The first step towards using your Meritain Health plan to pay for rehab is checking your benefits. For details on your specific coverage,  You can find specific plan details and the coverage of rehab services provide by either logging into their online portal or by calling them directly.

Once you have checked your benefits with Meritain, the next step will be choosing a treatment center that accepts your plan’s coverage, acquiring any documentation needed, and providing the treatment center of your choice with your insurance details.

Detox and Rehab Centers that Accept Meritain Health

Meritain Health, like Aetna, offers a provider search function on their website. If your plan only offers in-state coverage, your choices may be limited to that state. However, some Meritain Health plans may offer out-of-state coverage. If there is a specific treatment center you are interested in, as mentioned previously, you can contact them directly to see if they accept your plan. Many treatment centers, like American Addiction Centers, operate confidential hotlines dedicated to answering admissions-related questions and can tell you if your plan is accepted within moments. All you’ll need is your policy information.

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

Medicare Part D

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.