Meritain Health Coverage for Rehab

Overview

• Meritain Health coverage can assist in covering costs for drug or alcohol rehab.
• Meritain is an in-network provider with Principles Recovery Center.
• Verification of specific plan coverage is necessary.

Key Questions

• Does Meritain cover inpatient treatment?
• What are out-of-pocket expenses for treatment?
• What is not covered in rehab?

Understanding Your Plan

• Coverage can vary based on the specific health plan.
• Bronze plan: ~60% coverage, 40% out-of-pocket.
• Gold plan: ~80% coverage, higher premiums.
• Importance of choosing an in-network treatment center to reduce expenses.

Types of Treatments Covered

• Detox: Medically supervised detox programs typically covered.
• Partial Hospitalization Program (PHP): Intensive daytime treatment, typically covered.
• Intensive Outpatient Programs (IOP): Offers intensive therapy while living at home.
• Dual Diagnosis Treatment: Coverage for both substance abuse and co-occurring mental health disorders.

Covered Services

• Assessments, evaluations, exams, detox, medications, therapy.
• Inpatient and outpatient treatments depending on the plan.

Addictions Covered

• Alcohol, cocaine, methamphetamines, opioids, benzodiazepines, ADHD medications, other prescription drugs.

Exclusions

• Out-of-Network Providers: May not be covered or result in higher costs.
• Non-Medically Necessary Treatments: Not typically covered.
• Experimental Treatments: Often excluded from coverage.
• Certain Therapies and Pre-existing Conditions: Coverage may be limited or excluded.

Payment Process

• Review your coverage: Understand limits, deductibles, and pre-authorization requirements.
• Contact treatment center: Confirm they accept Meritain Health and discuss covered services.
• Verify insurance benefits: Treatment facility can assist in verifying coverage.
• Authorization for treatment: Ensure necessary paperwork is completed for pre-authorization.

Duration of Coverage

• Varies based on medical necessity, plan limitations, treatment progress, and required pre-authorization.
• Coverage supports continuum of care from inpatient to outpatient treatment.

Best Practices for Addiction Treatment

• Seek professional treatment and enter a structured program.
• Build a support network and address underlying issues.
• Develop healthy coping skills and structure daily routines.
• Avoid triggers and practice mindfulness.
• Set realistic goals and remain committed to recovery.

Insurance Verification Process

1. Contact Principles Recovery Center.
2. Provide insurance information.
3. Complete verification form.
4. Verify insurance.
5. Review coverage details.
6. Follow up as needed.

Starting Recovery

• Contact Principles Recovery Center to explore treatment options and benefit from Meritain Health Insurance to reduce out-of-pocket costs.