How Meritain Health Covers Outpatient Drug and Alcohol Rehab in New Jersey

Meritain Health typically covers a portion of the cost of drug and alcohol rehab at Rubicon Recovery Center, but the amount will depend on your plan and benefits.

Treatment for drug and alcohol addiction can be costly, but insurance can help cover some of the cost. At Rubicon Recovery Center in Watchung, NJ, we provide evidence-based rehab programs for substance use disorders (SUDs). We accept Meritain Health insurance and can assist with insurance verification. Learn more about Meritain’s addiction treatment coverage to understand your benefits and possible out-of-pocket expenses.

Key Takeaways

• Meritain Health generally covers some of the cost of addiction treatment and services, but your level of coverage will depend on your specific plan and benefits.
• To verify your insurance coverage, contact Rubicon Recovery Center for a quick insurance verification. Simply fill out our web form or call us to speak with a professional.
• Out-of-pocket costs through Meritain Health, such as deductibles and copays, will depend on your specific healthcare plan that is provided through your employer.

What Does Meritain Health Typically Cover for Addiction Treatment?

Meritain Health doesn’t sell individual health insurance plans, but it is a Third-Party Administrator (TPA) that manages health benefits for employer-sponsored, self-funded health plans. Meritain is a subsidiary of Aetna and CVS Health, so members typically use Aetna provider networks. If you’re curious whether Meritain Health will cover your drug or alcohol addiction treatment, you should know that the level of coverage will vary based on your specific plan and benefits. However, many Meritain Health plans cover the following, either partially or fully:

Medical Detox Placement

When medically supervised detox is needed to wean someone off substances and manage withdrawal symptoms, it may be covered with Meritain Health. Coverage depends on the plan, but if medical necessity is demonstrated, it will often be partially or fully covered.

Partial Hospitalization Program (PHP)

A Partial Hospitalization Program (PHP) is an intensive outpatient rehab program that offers structured support 5 to 6 days of the week, 6 hours each day. PHPs are often covered by Meritain Health, but the precise amount of coverage will depend on your plan.

Intensive Outpatient Program (IOP)

An Intensive Outpatient Program (IOP) is another type of structured outpatient addiction treatment that runs for 3 to 5 days for 3 hours each day. While you may have to pay some out-of-pocket costs, IOPs are generally covered by Meritain Health when they’re medically necessary.

Outpatient Program (OP)

In an Outpatient Program (OP), substance use treatment is less intensive than in PHPs and IOPs but still provides comprehensive support 2 to 3 times per week for an hour a day. Meritain Health may cover outpatient rehab programs, although you’ll need to confirm by checking your plan details.

Mental Health and Dual Diagnosis Care

Individuals with a substance use disorder and a mental health disorder have what is called a dual diagnosis. Meritain Health typically covers some or all of the cost of dual diagnosis treatment under the Affordable Care Act (ACA) and federal mental health parity laws.

How Can I Verify My Meritain Health Coverage at Rubicon Recovery Center?

To verify that your treatment at Rubicon Recovery Center will be covered, simply contact our Admissions Department at admissions@rubiconrc.com. You can also fill out our web form or call (908)-274-0015 to speak confidentially with a professional. We offer a quick insurance verification, where we’ll take your member ID and determine your coverage, benefits, and the potential out-of-pocket costs you’ll face.

What Do Out-of-Pocket Costs Look Like with Meritain Health?

Since Meritain Health is a third-party administrator, its plans are designed and funded by employers. Therefore, your out-of-pocket costs, which typically include deductibles, copays, and coinsurance, will depend entirely on your specific healthcare plan. You’ll need to review your plan details for further information. However, once you reach your plan’s maximum out-of-pocket limit, Meritain Health will cover 100% of covered medical services.

Explore Drug and Alcohol Rehab Programs Near You in NJ

If you have Meritain Health insurance and are seeking evidence-based treatment for a substance use disorder, turn to Rubicon Recovery Center. We provide whole-person, compassionate care near you in Watchung, NJ, serving individuals from New Jersey, New York, and Pennsylvania, and we accept Meritain Health. We will also help handle your insurance claims, helping make the process as simple and stress-free as possible. To learn more about Meritain addiction treatment coverage, contact us today or call (908)-274-0015 for a free insurance verification.

Frequently Asked Questions About Meritain Health Rehab Coverage

Does Meritain Health cover outpatient rehab in New Jersey?

Yes, Meritain Health often covers outpatient rehab in New Jersey at least partially. However, your specific plan and benefits will determine the level of coverage.

Does Meritain Health cover IOP and PHP at Rubicon Recovery Center?

Meritain Health typically covers a portion of IOP and PHP costs at Rubicon Recovery Center, but the extent of coverage will depend on your plan and benefits.

How do I verify my Meritain Health benefits?

To verify your Meritain Health benefits, contact the Admissions Department at Rubicon Recovery Center by phone or web form for a free insurance verification.

What out-of-pocket cost should I expect with Meritain Health?

Out-of-pocket costs, such as deductibles and copays, will depend on your specific healthcare plan that is provided through your employer.

Does Meritain Health cover dual diagnosis treatment?

Yes, Meritain Health often covers dual diagnosis treatment partially or entirely. This is because federal mental health parity laws and the Affordable Care Act mandate that mental health disorders, including addiction, are treated at the same level as physical health conditions.

Do I need insurance to access treatment at Rubicon Recovery Center?

No, insurance is not required to attend Rubicon Recovery Center. However, treatment costs can be high and prohibitive without insurance.

Does Rubicon Recovery Center accept other insurances?

Yes, we also accept other major insurance providers, including Aetna, Anthem, Cigna, Blue Cross Blue Shield, UnitedHealthcare, and more.