Meritain Health is a third party administrator of self-funded health insurance plans for companies nationwide. It is a subsidiary of Aetna Insurance and its parent company CVS. A self-funded plan refers to insurance that an employer fully pays for as a benefit to company employees. The employer doesn’t pay a premium to an insurance company, instead they cover the cost of employee medical care themselves.
A third-party administrator sets up and manages the healthcare benefits for the employees, processes insurance claims and manages billing and payments for services to providers. They can also connect a self funded plan with a provider network if they need one.
Meritain Health has been in business since 1983 and has more than 1.5 million members. Most company employers purchase the Aetna Choice POS 11 plan to offer their employees because it gives them access to Aetna’s national network of 1.6 million healthcare providers and more than 350,000 behavioral health providers.
Meritain Health is the only third party administrator that can offer access to this Aetna network.
While examining treatment pathways or confirming insurance coverage, you can learn more about rehab options to review centers that match your plan.
By Rita Milios
Rita Milios, The Mind Mentor, is a recently retired psychotherapist, freelance author (recovery, mental health, spiritual growth), seminar leader, and podcaster from Kissimmee, FL. She provided counseling in rehab facilities in Ohio and Florida, as well as in her private practice. Rita also served as a DOT Substance Abuse Professional (SAP) consultant.
Medically Reviewed by Dr Jillian Foglesong Stabile
Jillian Foglesong Stabile is a board-certified Family Physician who enjoys the full scope Family Medicine, including obstetrics and women’s health, along with caring for children and adults of all ages. She manages a number of health conditions, including mental health and those with a history of substance abuse.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
My experience at All In Solutions exceeded my expectations. I was treated with respect, honor and dignity. I was kept comfortable while detoxing.
Timothy Snow
1 week ago
My wife completed residential treatment here for alcohol addiction and the change has been remarkable. Family therapy sessions helped all of us understand how to support her moving forward.
Rosalind Actongale
2 weeks ago
Attentive medical staff during detox, comfortable rooms, board-certified providers who explain everything clearly.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private insuranceSelf-Pay Options
The clinical building being separate from the housing is a detail that sounds small but makes a big practical difference. You go there to work, and you come back to somewhere calmer when the day is done. That separation gave the whole experience a clearer shape.
Brian Saunders
2 weeks ago
Friday afternoons they bring in alumni speakers. Sitting in a room listening to someone who's been through it and come out the other side is different from any group session with a counselor. It was one of the parts of the week I genuinely looked forward to.
Thomas Navarro
2 weeks ago
The weekly family group, held online so family can join from wherever, is something I wasn't expecting. My family had been through a lot and being able to include them in the process, even from a distance, changed how I felt about what I was doing here. Recovery doesn't happen in a bubble and a program that actually acknowledges that is worth noting.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
This is a great facility and great program a lot of great people work here that care about helping others !!!!!
Jarrett Alfieri
1 week ago
This place was awesome. The staff was very helpful and who knew rehab could be a great time. I am forever grateful for this place ! <3
Gabriela Martinez
2 weeks ago
I had my phone the whole time. For anyone coming from a detox program where everything gets locked away, that's worth knowing. Being able to stay in contact with family and handle things in my life while doing the program made it feel sustainable, not like I'd put everything on pause.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
I absolutely love All in Solutions. They've played a large role in developing me into the person I am today. The staff is great! Especially the counselor, Mrs. Hepzibeth!! She's been the sweetest, and I've created an unbreakable bond with her. She will always hold a special place in my heart. l love y'all and am forever grateful for everything!!
Fleniecia Caldwell
1 week ago
For anyone dealing with opioid or fentanyl dependency specifically, the medical detox with 24-hour clinical supervision is the detail that matters most early on. Withdrawal management done properly makes everything that comes after it more possible.
A Google User
2 weeks ago
The alumni support program is something I don't see mentioned enough when people talk about what makes a rehab worth considering. Getting through treatment is one thing. Having some kind of structured support afterward is a completely different conversation, and it matters.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Loving this app easy to do things are nice to work out and they also give you leads and show you places that help them work with treatment and they’re also nonjudgmental with the marijuana
Scott Gadd
1 week ago
It works, they are professionals, & they care!!!!
Jennifer M
1 month ago
10 out of 10 highly recommend for the busy person that wants to make addiction a priority but restriction is time or Transportation not anymore not with this program everything is done from the comfort of wherever you choose still private can get one-on-one or group feedback the qualifications and steps are easy and if you have insurance it's a walk in the park before I head insurance I would have given it for three stars just because it was very expensive $75 a week plus the cost of prescription otherwise their time out of 10 amazing and they will try and find a way to work with you when it comes to payments if you're in that position I did not ask enough questions when I was in that place so don't let that deter you#wedorecover
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
El mejor lugar para tratar la adiccion de un ser querido. Un excelente grupo de profesionales que hacen mas q su trabajo, es su vocacion. Recomendado al 100% El mejor centro en Puerto Rico. Mi agradecimjento a Josefina q fue la persona contacto en Puerto Rico, quien con mucha paciencia y amor nos facilito llegar a este lugar maravilloso
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
ICFR was just what I needed to learn about my addiction and learn about ways to recover successfully. The clinical staff and support staff are outstanding in every way. The accommodations are comfortable and they do everything they can to address your needs.
Michael Pritchard
5 days ago
Great place would recommend to anyone in need.
Joseph Hickman
3 weeks ago
Really changed my life. Feel like a completely different person leaving than when I first got here. The group facilities are fantastic and really are able to help you on a deep level. The community overall is phenomenal and recommend it to anybody who is struggling
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Mountainside showed me that there is more to life than isolating in addiction. The people in this facility saved my life and I’m eternally grateful.
Josh Reeve
4 days ago
Mario is truly an amazing recovery coach. He goes above and beyond to support, encourage, and inspire me and my recovery. His compassion, patience, and genuine dedication make a lasting difference. Mario doesn’t just help me through recovery—he believes in me and reminds me of my strength every step of the way.
Matt O
1 month ago
I had the privilege of working with Mario Cocozza as my recovery coach, and I can’t recommend him highly enough. Mario meets you where you are — no judgment, no scripts, just genuine care and real accountability. He checked in consistently, celebrated the wins, and helped me stay grounded through big life transitions.
What sets Mario apart is that he actually walks alongside you; he’s invested in your success as a person, not just a client. My recovery is stronger because of the work we did together. If you’re considering Mountainside and get the chance to work with Mario, take it.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
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Frequently Asked Questions
Does Meritain Health Cover Addiction Treatment?
Self funded employer plans are not required to cover addiction or mental healthcare, but if they do, they must follow the Mental Health Parity Act and cover it at the same level as other medically necessary services.
Your employer’s plan may include mental health and rehab coverage, but it may not, so it’s very important to check with your company’s benefits manager before you commit to a treatment program. You may also need to stay within a specific provider network in order to use your employer coverage.
What Inpatient Rehab Options Does Meritain Health Cover?
If your insurance plans covers inpatient rehab, you may have coverage for services like medical detox and inpatient or residential care.
Detoxification that removes drugs from the body may involve the use of medication assisted treatment (MAT) medications to treat and reduce withdrawal symptoms. Methadone, naltrexone, and buprenorphine are often used as MAT medications. The goal of medical detox is to give you a clean start and help you stay safe and as comfortable as possible during the process.
With inpatient rehab, you are treated in a clinic or hospital; with residential rehab treatment, you are treated in a non hospital facility that usually has a home like setting. Both inpatient and residential treatment options offer 24/7 supervision and care.
Inpatient treatment will often last two weeks or fewer, although some hospitals have longer term programs. Residential treatment typically lasts 28 to 30 days, and possibly longer. Patients who have a dual diagnosis, with both substance abuse and another mental illness being present together, require integrated care that addresses both their mental health and substance use.
Does Meritain Health Cover Outpatient Treatment?
Your insurance plan may include a variety of outpatient treatment options. For example, there are partial hospitalization programs, intensive outpatient programs, and regular outpatient programs.
Partial hospitalization programs (PHP), also called “day treatment,” usually involve at least 20 hours of treatment per week, with sessions held 4-5 days per week. There are no overnight stays. A typical length for PHP treatment is three to four weeks, but it can last up to several months.
Intensive outpatient substance abuse rehab treatment typically involves nine to 20 hours of treatment per week, and these hours are spread over three to five days. Ninety days of IOP treatment are most often recommended.
In general outpatient programs, group addiction education and counseling sessions usually take place in a clinic or rehab setting once or twice a week. Individual sessions are usually offered as needed, on a selective basis.
Does Addiction Treatment With Meritain Have to Be In Network?
The Aetna Choice POS (Point of Service) II plan, used by about 90% of Meritain insurance members, allows patients to use either the Aetna network of service providers or out of network providers.
Sometimes, an out-of-network option makes sense because an in-network provider may not be nearby or convenient, or there may be an urgent need.
However, out-of-network providers will generally cost more, and you may have to pay the additional cost yourself. Unlike in-network services, claims and billing related to out-of-network providers are not handled by Meritain.
Also, while approval for coverage of some services may be required when using either an in network or out of network provider, an out of network provider would not automatically process your request for approval. You would likely have to handle that on your own.
When using an in network provider, your primary care doctor would process your request for approval when needed.
Are There Special Features Available from Meritain Health?
Employers who choose the popular Aetna Choice® POS II network can offer employees a variety of specialized services. These tools help support your overall health and therefore have an impact on your mental health and triggers for substance use disorder. For some services you may need pre certification performed by the medical management team.
Your physician must pre certify certain services that go beyond a standard physician office visit. This can include non emergency admissions or elective ambulatory surgery. It may also include diagnostic procedures and continuing care services for conditions like substance use disorders and mental health conditions. The medical management team will review the treatment plan against standard guidelines to ensure the procedure or treatment is medically necessary. Your member’s services booklet has a list of all services that require pre certification.
The Aetna Choice® POS II network has over 776,000 physicians across more than 6,100 hospitals to provide specialized care for nearly every concern. Aetna has an Institutes of Quality and Institutes of Excellence programs throughout their facilities. The Institutes of Excellence program offers access to a network of high performing hospitals that help improve patient outcomes. The Institutes of Quality is a designation for healthcare providers that meets certain quality standards.
Within this network of Institutes Aetna has identified high levels of care in bariatric care and cardiac care along with orthopedic care and behavioral health. The Institutes of Quality Network for Behavioral Health provides beneficiaries with specialized treatment for substance use and mental health conditions. Your benefits can also include virtual and in person behavioral health care to help address mental health conditions like depression and anxiety disorders.
Your insurance benefits may include a telemedicine service available to you 24/7/365. You’ll have access to qualified physicians over the phone and online as well as through an app. Telehealth and virtual primary care options provide help when you’re unable to see your primary physician in person or you are traveling or live in rural areas without a large network of physicians. The Aetna Choice® POS II network also includes Minute Clinic and Health Hub walk in locations available seven days a week so you can receive urgent care when you need it. These often have a lower cost than most urgent care facilities.
Aetna also provides wellness programs including the Healthy Merits program with resources to focus on fitness and nutrition along with financial wellness and social and emotional health. Employers can fully customize the Healthy Merits program based on the needs of their employees. They have over 400 unique wellness activities and challenges and others that can be developed. The program supports employees working from home using an accessible online or mobile app that easily integrates with wearable fitness trackers.
Aetna offers core benefits for self funded plans including an online health assessment tool to help you set health goals and identify potential health risks. The Informed Health Line offers 24/7 health information from registered nurses so you can quickly get your questions answered. Members also have access to discounts on products and services for fitness and natural therapy along with weight management and nutrition. You may also have access to Nurse Health Coaching and support services that help manage chronic conditions such as diabetes and heart disease and management for other complex situations like fertility.
Finally when you have questions about your insurance benefits or coverage you can access 24 hour support to member services. You may use the online member portal or Meritain Health app along with printed resources and customer service to get your questions answered about your health insurance benefits.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.