Some Meritain Health-administered plans may include out-of-network addiction-treatment benefits, but the exact rules depend on the employer’s plan design. Trinity Behavioral Health accepts Meritain-administered benefits when the specific plan provides applicable coverage. Meritain explains that out-of-network care may have different coverage and costs, and some plans include transition or continuity-of-care processes for qualifying situations.
Verify your Meritain out-of-network benefits before admission.
Does every Meritain plan include out-of-network coverage?
No. Meritain administers different employer plans and network configurations. The member’s plan documents determine whether out-of-network behavioral-health care is covered and how claims are processed.
Can out-of-network care cost more?
Yes. Meritain advises members that out-of-network providers may not have contracted rates, which can affect allowed amounts, deductibles, coinsurance, and reimbursement.
Can precertification still be required?
Yes. Network status and precertification are separate questions. If the plan requires authorization for a treatment service, that requirement may still apply when out-of-network benefits are available.
What should I verify?
- The employer plan and applicable network
- Whether out-of-network behavioral-health benefits exist
- Trinity’s network status
- Precertification or prior authorization
- Allowed-amount and reimbursement rules
- Deductible and coinsurance
- Any transition or continuity-of-care options
For carrier-level information, see Meritain Health rehab benefits. Depending on clinical need, Trinity offers residential rehab, PHP, and IOP.
Verify Your Meritain Out-of-Network Benefits
Authoritative resources
- Meritain Health — In-Network vs. Out-of-Network Care
- Meritain Health — Member Resources and Transition/Continuity Forms
- Meritain Health — Precertification
Exact benefits vary by plan and should be verified directly. Out-of-network access does not guarantee coverage, authorization, reimbursement, or payment.