Meritain Drug and Alcohol Rehab in Ohio

Will Meritain Pay For Rehab?

Generally, yes, if you have a Meritain Health plan, at least a portion of drug and alcohol rehab will be covered by your plan. Out-of-pocket expenses will depend on the specifics of your policy and the provider you choose. 

Because Meritain is a TPA, they do not pay for addiction treatment services directly. Claims are instead processed by your employer’s health fund. However, like its parent company Aetna, you’ll still have access to the same benefits and a large network of providers. Meritain simply offers management of the plan and administration of claims and services.

Thanks to federal law, health insurance plans are required to offer addiction treatment services as an essential health benefit. That means anyone with health insurance will receive at least some coverage for drug or alcohol rehab. However, Meritain Health does have the freedom to identify providers and the level of care that will be covered. 

Like other health conditions, which type of services are covered will depend on the severity of your diagnosis. This can include:

• Which substances are being used
• Length and frequency of use
• Past or predicted health consequences of the addiction.

Lastly, out-of-pocket expenses will depend on your Meritain plan type. Meritain Health plans emulate the types of plans offered through Aetna.

Type of Meritain Plans And Effect On Addiction Services

There are various types of Meritain employee health plans designed to match the healthcare needs and budget of its members. Some plans offer lower out-of-pocket costs for treatment services with higher monthly premiums, while others offer lower premiums in exchange for higher costs at the time of service. Plans include:

HMO – Meritain HMO plans have a defined network of providers. This means you will have to choose an in-network addiction treatment center to receive coverage.

PPO – With out-of-network coverage, Meritain PPO plans offer more flexibility when choosing a provider. However, choosing an out-of-network treatment center will result in higher out-of-pocket costs, which can be thousands of dollars.

POS – Like PPO plans, Meritain POS plans do offer out-of-network benefits but usually require a referral from your primary care physician.

EPO – A less common plan, Meritain EPO is similar to an HMO plan with no out-of-network benefits. However, EPO offers a larger network of providers.

HDHP / HSA – HDHP is a high-deductible health plan, which means you will be responsible for covering your annual deductible when you are admitted to an addiction treatment center. As of 2024, a high deductible plan is considered anything over $1,600 for individuals. Many families enroll and invest in a health savings account (HSA) to cover future services under a high-deductible health plan. 

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

Some individuals mistakenly assume out-of-network facilities offer premium services due to higher out-of-pocket costs. This cannot be further from the truth. Because Meritain is contracted with its network providers, rehabs that are in-network with Meritain are held to additional oversight by Aetna, the nation’s third-largest health insurance provider.

Meritain in-network treatment centers are held to a standard of care regulated by both the insurer and federal law. This oversight reduces negative health outcomes compared to out-of-network care. Aside from saving money, choosing an in-network rehab will ensure you or a loved one are receiving the highest level of care.

Meritain Coverage at Ohio Addiction Recovery Center

Ohio Addiction Recovery Center is proud to offer a full continuum of addiction healthcare that is in-network with Meritain Health, along with other major insurance plans. Our covered services include:

Medical Detox Accepts Meritain

Medical detox is often the first phase of addiction treatment. Our inpatient detox center in Columbus, Ohio specializes in the safe and comfortable management of drug or alcohol withdrawal symptoms. Because withdrawal can produce life-threatening symptoms, Meritain plans help cover detox services as an essential health benefit. Our detox center offers:

• Alcohol detox
• Heroin or prescription opiate detox
• Fentanyl detox
• Benzo detox, such as Xanax, Valium, Ativan, Klonopin, etc
• Sedative sleep medications, such as Ambien

For substances that do not produce chemical dependency, such as marijuana or stimulants, Meritain may cover an alternative level of care.

Like a hospital, detox includes 24-hour nursing care, medications, and physician oversight. However, unlike a hospital, our facility offers a comfortable residential environment with various amenities and recreations. Learn more about our detox center in Columbus, OH.

Inpatient Rehab Accepts Meritain

Residential rehab, also called inpatient rehab, is an intensive 30-45 day program designed to treat the psychological component of addiction and the underlying causes of substance abuse. In residential treatment at OARC, clients receive an individualized treatment plan and engage in individual therapy, group therapy, relapse prevention planning, aftercare planning, educational classes, 12-step facilitation, holistic therapies, and more.

Learn more about our inpatient rehab in Columbus, OH. Our residential program is also in-network with Meritain Health.

Outpatient Rehab Accepts Meritain

OARC also offers various outpatient aftercare options so clients can continue their treatment utilizing their Meritain Health coverage. These include:

Partial Hospitalization (PHP): PHP offers a similar intensive program as residential, where clients engage in treatment full-time. However, unlike residential, they return home or to sober living for the evening.

Intensive Outpatient (IOP): IOP is the next phase of care after residential or PHP. Clients engage in treatment for 3-hour sessions three days per week. This allows them to begin their transition back to work, school, and/or home life.

Mental Health Services

Ohio Addiction Recovery Center is a dual-diagnosis treatment center, which means we also treat any co-occurring mental health conditions, such as depression, trauma, or anxiety. Psychiatric services are also covered by Meritain Health.

Compare Costs With Meritain Health

Want to find other rehabs in-network with Meritain? Healthcare Bluebook™ is a preferred partner with Meritain, where members can find in-network providers and compare costs and quality of services. 

Understanding Your Meritain Health Plan

We understand navigating addiction treatment options and insurance coverage can be overwhelming. We’re committed to offering transparent, confidential, and judgment-free assistance to anyone who reaches out to us for help. Our insurance experts would be happy to help verify your benefits online or over the phone at 800-481-8457. We can help you understand what is covered by your plan and any out-of-pocket costs associated with treatment.

• Sources
  1. Meritain Health – About Us
  2. Meritain Health – Getting To Know Your Network Options
  3. Healthcare Bluebook