Does Meritain Health Cover Inpatient Alcohol and Drug Rehab Centers?

With Meritain Health rehabilitation coverage, you can count on some level of coverage for substance use disorder services. The health plan benefits align with the Affordable Care Act mandates, which specify that members receive mental health and substance abuse treatment coverage.³ Your plan will dictate the exact amount that Meritain pay will pay. However, one plan option provides this mental health and substance abuse coverage guide for an example:⁴

• For people in groups under 50: Outpatient services in-network can attend 40 visits per year, visits apply to the deductible, and 50% coinsurance is covered. If it’s out-of-network, the coinsurance is 30 % covered.
• For groups over 50: Outpatient services in-network follow the plan’s copay, deductible, and coinsurance options are chosen.
• For groups under 50: Inpatient rehab can have 30 days per year, applies to deductible, and 50% coinsurance covered. If it’s out-of-network, the main difference is 30% coinsurance covered.
• For groups over 50: Inpatient rehab can have 30 days per year, follows plan copay, deductible, and coinsurance options chosen.

If you’re wondering more about what is involved with the various treatment programs, here is a breakdown of the main ones you may encounter:⁵

• Inpatient residential treatment rehab—Provides 24/7 care in a hospital-like setting. You can safely detox and receive therapy throughout the day.
• Partial hospitalization program—Similar to an inpatient program, except you return home at night.⁶
• Intensive outpatient program—A more intense outpatient program because you participate in several days and hours of therapy a week.⁵
• Outpatient treatment program and therapy—Eventually, you transition to a standard outpatient treatment, which is about once or twice a week.⁵

Does Meritain Health Cover Mental Health Care?

If you are also concerned about Meritain Health mental health coverage, it is good to treat both substance abuse and mental health together. The reason for this is that these conditions often co-occur.⁷ It’s not uncommon for someone with a substance use disorder to develop a mental health disorder or someone with untreated mental illness to turn to a substance for relief.⁷ Researchers have found that studies support the connection between these two conditions.⁸ About 7.7 million adults are diagnosed with a co-occurring disorder involving substance abuse and mental illness.⁸ It’s vital to treat these conditions together because they play off each other. Researchers don’t know for sure which one may influence the other, but it could work both ways.⁷

Meritain Health rehab covers co-occurring disorders due to the ACA guidance to insurance carriers. These regulations ensure you can receive treatment for both issues at once.

You want to ensure you receive adequate treatment when beginning your recovery journey. The length of time and type of treatment program(s) you participate in might be different from other people on the journey. Each person is unique and needs to continue in Meritain Health for addiction treatment until they feel comfortable with their progress.

There are no exact “right” or “wrong” timeframes, but usually, the longer you are in treatment, the better chance of success you will have. Experts recommend at least three months of detox rehab for best results.⁹ You may stay in outpatient therapy even after your initial detox is completed.

What if my Meritain Health policy does not cover Inpatient alcohol and drug rehab facilities?

Are you concerned about your Meritain Health coverage? Maybe you’re not confident that all of your costs will be covered by your Meritain insurance. In the case that you incur out-of-pocket costs, keep in mind that you have options.

Some drug and alcohol rehab facilities offer financing and payment plans to cover out-of-pocket costs. They may even offer a scholarship or discount. Make sure you ask about other ways to pay for or receive treatment.

It’s vital that you don’t let any setbacks keep you from your goal of treatment. It’s important not to delay your recovery.

As noted above, the Meritain Health network coverage operates through Aetna’s large network of providers. You have access to over 600,000 doctors and providers across the nation.² You benefit from obtaining treatment at a qualified in-network rehab facility. In-network substance abuse rehab facilities offer services at a discounted rate because they have a contract with the insurance provider. This discount is given to you when you select from their pool of facilities and providers. You can verify your insurance when you contact the rehab center.

Meritain Health drug rehab coverage is available for treatment at a substance abuse rehab facility. You can access your policy’s information by visiting the member portal here and choosing which plan you have. Find out more details about what your policy will cover. However, you can quickly and easily verify your insurance now with American Addiction Centers (AAC). Their fast and efficient online system gives an answer almost immediately. At AAC, we are here to answer your questions and make sure you have coverage, so you can begin recovery. Contact our helpline at today for more details.

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1. (2021). Aetna subsidiaries.
2. Meritain Health. (2021). For members.
3. gov. (n.d.). What marketplace health insurance plans cover.
4. National Health Insurance Company. (2017). Benefits available with Meritain, your third-party administrator.
5. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
6. Definition of partial hospitalization. The National Association of Private Psychiatric Hospitals and the American Association for Partial Hospitalization. (1990). The Psychiatric hospital, 21(2), 89–90.
7. National Institute on Drug Abuse. (2018). Comorbidity: substance use disorders and other mental illnesses DrugFacts.
8. Han, B., Compton, W. M., Blanco, C., & Colpe, L. J. (2017). Prevalence, treatment, and unmet treatment needs of US adults with mental health and substance use disorders. Health affairs (Project Hope), 36(10), 1739–1747.
9. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.