Meritain Drug and Alcohol Rehab in Ohio

Will Meritain Pay For Rehab?

Yes, at least a portion of drug and alcohol rehab will be covered by your plan. This also depends on your specific coverage and provider choice. Although Meritain itself does not directly pay claims (since it serves as a third-party administrator), it works through your employer’s self-funded health plan to manage benefits and process claims. Because Meritain partners with Aetna, members still receive access to Aetna’s expansive provider network and addiction treatment benefits.

Under federal law, all health insurance plans must cover treatment for substance use disorders as an essential health benefit. However, your coverage and the types of services included can vary based on several factors, such as the substance being misused (e.g., opioids, alcohol, benzodiazepines), how often and how long it has been used, and the health risks linked to your condition.

These factors all play a role in determining whether medical detox, inpatient rehab, or outpatient treatment is medically necessary, and therefore covered by your plan. Your plan type will also influence the amount of any copays, deductibles, or coinsurance you may owe out-of-pocket.

Type of Meritain Plans And Effect On Addiction Services

Your Meritain plan type directly determines which addiction services are covered, how you access care, and what you’ll pay out of pocket. Understanding the differences between plans can help you make informed decisions about where to seek treatment and how to minimize costs. Here’s how each Meritain plan type works when it comes to substance use and Meritain alcohol rehab coverage:

• HMO (Health Maintenance Organization): These plans require you to stay within a defined network of providers. If you or a loved one is seeking Meritain Health rehab in Ohio, you’ll need to choose an in-network facility like OARC to receive coverage.
• PPO (Preferred Provider Organization): PPO plans offer greater flexibility, allowing you to receive care from both in-network and out-of-network providers. However, staying in-network will significantly reduce your out-of-pocket expenses. If you choose a rehab center that is out of network, you may be responsible for a larger share of the costs..
• POS (Point of Service): POS plans blend features of HMOs and PPOs. You can go out of network, but you’ll typically need a referral from your primary care provider. These plans offer a good balance for people who want flexibility while still prioritizing coordinated care.
• EPO (Exclusive Provider Organization): These plans are less common but operate similarly to HMO plans, requiring members to stay within a specific provider network. However, EPOs tend to offer a broader selection of in-network providers than HMOs. Meritain generally does not cover out-of-network services unless it’s an emergency.
• HDHP (High Deductible Health Plan) / HSA (Health Savings Account): HDHPs require you to pay a higher deductible, $1,600 or more for individuals in 2024, before insurance coverage begins. Many families use HSAs, which are tax-free savings accounts, to help cover addiction treatment costs under these plans.

Why Should I Choose A Meritain In-Network Rehab in Ohio?

Choosing an in-network rehab center that accepts Meritain Health ensures you’ll receive not only more affordable care but also high-quality, regulated services. In-network facilities like OARC undergo regular oversight from both Meritain and its parent company, Aetna. This ensures adherence to evidence-based treatment practices, ethical standards, and regulatory compliance. Contrary to the misconception that out-of-network providers offer superior services, in-network treatment centers must meet stringent guidelines and maintain quality care in order to retain their insurance partnerships. Opting for in-network care means reduced financial burden, streamlined pre-approvals, and confidence in the standard of treatment being delivered.

Meritain Coverage at Ohio Addiction Recovery Center

As one of the rehab centers that accept Meritain Health, we offer a full continuum of evidence-based services, including detox, residential treatment, outpatient programs, and dual-diagnosis care. Our goal is to remove financial obstacles while supporting long-term recovery through compassionate, individualized treatment. From your first call, our team will help verify your insurance, explain your coverage, and guide you toward the right level of care. Our covered services include:

Medical Detox Accepts Meritain

Medical detox is often the first step toward recovery, especially for substances that cause physical dependence or life-threatening withdrawal symptoms. At our detox center in Columbus, Ohio, we offer 24/7 medical care in a comfortable, home-like setting to support clients withdrawing from alcohol, heroin, prescription opioids, fentanyl, benzodiazepines, and more. Because detox is considered medically necessary, Meritain Health often covers this service as part of your behavioral health benefits. 

Inpatient Rehab Accepts Meritain

Our inpatient rehab program offers a structured, residential setting where clients can focus fully on recovery without outside distractions. This 30-to-45-day program includes therapy, medication management, relapse prevention, and holistic services tailored to each person’s needs. Clients participate in individual and group sessions, 12-step facilitation, and recreational therapy, all designed to address the root causes of substance use. As a Meritain Health rehab in Ohio, your insurance can help reduce the cost of this comprehensive level of care.

Outpatient Rehab Accepts Meritain

OARC provides two main levels of outpatient care, both of which are typically covered by Meritain Health depending on your plan. Our PHP offers full-day treatment with clients returning home or to sober living in the evenings. The IOP provides a flexible schedule, usually three sessions per week, ideal for those transitioning back to daily responsibilities. These programs support continued recovery while offering more flexibility than inpatient rehab.

Mental Health Services

As a dual-diagnosis treatment provider, we address both substance use disorders and co-occurring mental health conditions. Our clinical team offers psychiatric assessments and therapy tailored to each individual. These services are typically covered by Meritain Health under behavioral health benefits, ensuring clients receive whole-person care.

Compare Costs With Meritain Health

If you’re looking to compare treatment providers and understand your coverage options, Healthcare Bluebook™ is a helpful tool available to Meritain members. This online platform allows you to find rehab centers that accept Meritain Health, review average costs for services, and compare provider quality ratings. It’s a smart way to ensure you’re making a cost-effective and informed decision about treatment.

That said, every plan is different, and your best next step is often to speak directly with a treatment provider like OARC, who can verify your benefits and explain exactly what your plan covers.

Start Your Recovery With a Meritain Health Rehab in Ohio

Getting help for addiction or mental health challenges can feel overwhelming, especially when navigating insurance coverage. But you’re not alone, and Ohio Addiction Recovery Center is here to support you every step of the way. As a trusted Meritain Health rehab in Ohio, we offer compassionate care, evidence-based treatment, and help you understand your insurance benefits.To take the first step toward healing, contact our admissions team or call 800-481-8457. We’ll help you verify your Meritain benefits, explain any out-of-pocket costs, and guide you or your loved one into the right level of care with clarity and compassion.