If your health benefits come through your job, there’s a good chance you’ve seen the name Meritain Health on your insurance card or claim statements. What you may not know is how that coverage works when it comes to addiction or mental health treatment, or how much help it could actually provide.
The short answer: potentially a lot. Depending on how your employer has designed your plan, Meritain Health can cover up to 100% of your treatment at Wolf Creek Recovery. Here’s what makes Meritain plans a little different and how to find out what yours includes.
What Is Meritain Health?
Meritain Health is one of the largest third-party administrators (TPAs) in the country and part of the Aetna and CVS Health family. Instead of selling insurance policies the traditional way, Meritain manages health plans on behalf of employers who choose to fund their employees’ health benefits themselves. This setup is called a self-funded plan.
With a self-funded plan, your employer pays for covered care, while Meritain handles the rest:
- Processes claims
- Manages provider networks
- Coordinates pre-authorizations
- Answers member questions
Your Employer Shapes Your Benefits
Because self-funded plans are designed by each employer, no two Meritain plans are exactly alike. Your company makes the decision on:
- Your deductible
- Your copays and coinsurance
- Your out-of-pocket maximum
- Which provider network you use
Many Meritain plans rely on the Aetna network, though some employers choose a different insurer. This flexibility works in your favor more often than you might think.
Employer-sponsored plans are typically required to cover mental health and substance use treatment in a similar way as other types of medical care. Many employers build strong behavioral health benefits into their plans on purpose, as they know that supporting employees through recovery is beneficial for them and the workplace.
If you’d like to dig into the details yourself, your Summary Plan Description, often called an SPD, spells out exactly what your plan covers. You can usually find it through your HR department or your Meritain member portal.
Will My Employer Know I’m in Treatment?
This is one of the most common worries we hear from people with employer-funded plans, and it’s completely understandable. Here’s what’s important to know: your health information is protected by federal privacy laws, including HIPAA, and substance use treatment records carry additional confidentiality protections. Self-funded plans are required to keep members’ health information separate from employment decisions.
If you need time away from work for treatment, you may be eligible for protected leave under the Family and Medical Leave Act, and many employers offer confidential Employee Assistance Programs (EAPs) that can help you explore your options. At Wolf Creek, protecting your privacy is part of how we care for you.
The Care Your Meritain Benefits May Help Cover
Wolf Creek Recovery offers a full spectrum of care, and Meritain plans may help with each phase of treatment.
- Medical detox. When detox is needed, medically supervised withdrawal management gives you a safe, comfortable start.
- Residential care. Our residential treatment program offers luxury accommodations in the peaceful surroundings of Prescott, giving you a comfortable, supportive setting where you can focus on rest and recovery.
- Dual diagnosis treatment. For anyone who’s using substances to self-treat anxiety, depression, or trauma, our dual diagnosis program treats both conditions together with individualized therapy and psychiatric support.
- Holistic therapies. Yoga, meditation, recreational activities, and physical movement support clinical care and help you connect with yourself. It also teaches you new, healthy ways to spend your time.
- Step-down care. When you’re ready to transition home, outpatient programs like partial hospitalization, intensive outpatient, and outpatient care ensure you receive the right support.
Let Us Check Your Benefits for You
Since every Meritain plan is built differently, the fastest way to know what’s covered is a benefits check. Our admissions team will contact Meritain on your behalf to confirm your network, deductible, out-of-pocket costs, and any pre-authorization requirements, all free of charge and with no obligation. In many cases, we can give you answers the same day you call.
Your Benefits Are There for a Reason
You earned your health benefits, and using them to get well is exactly what they’re for. At Wolf Creek Recovery, we pair luxury accommodations with individualized dual diagnosis care and holistic healing, all in a peaceful Arizona setting built for lasting recovery. We’ll take care of the insurance details so you can focus on you.
Have Meritain Health through your employer? Contact Wolf Creek Recovery today for a free, confidential benefits check and take the first step toward recovery.
Finding purpose in pain is what Jonathon does best. He is a strong advocate for those suffering from substance use disorders. As a person in recovery, Jonathon knows how important it is to receive empathy and compassion. He recognizes that each person comes from a different set of circumstances and deserves to be valued and respected.
With a fresh perspective and compassionate attitude, Jonathon works closely with clients to help them let go of the past and know when to take necessary risks. The recovery process is ongoing, which means people need to move forward while applying the skills learned in treatment. Jonathon is a great motivator when it comes time for this!
Jonathon also places emphasis on the family unit and how it can make or break the recovery experience. Individuals with active, supportive families have far better outcomes. Jonathon realizes that it’s impossible to move mountains overnight, but with the right support team and positive attitude, anything is possible.
