Recreate Life Counseling provides partial hospitalization (PHP) and intensive outpatient (IOP) treatment for substance use and mental health in Boynton Beach, Florida. If your health plan is administered by Meritain Health, this page explains how Meritain plans work, what they typically cover for addiction treatment, what you can expect to pay, and how to check your benefits before you start.
Our admissions team verifies Meritain benefits for free. Because every Meritain plan is designed by a different employer, network status and cost vary more than with most insurers, so we confirm both and give you a written estimate before you commit to anything.
What Meritain Health is
Meritain Health is not a traditional insurance company. It is a third-party administrator for self-funded employer health plans. In a self-funded plan, your employer pays the claims with its own money and hires Meritain to run the plan: processing claims, handling authorizations and giving members access to a provider network.
Meritain has been part of Aetna since 2011 and part of CVS Health since 2018. Many Meritain plans use the Aetna network, but not all do. Your employer chooses the network, so two Meritain members can have very different networks and benefits.
One practical consequence: your plan document, often called the summary plan description, is the final word on what is covered. It is written by your employer, not by Meritain.
Does Meritain cover addiction treatment?
In most cases, yes. Self-funded employer plans are governed by federal law, and the Mental Health Parity and Addiction Equity Act applies to them: if a plan covers mental health and substance use treatment, it cannot limit that coverage more strictly than medical or surgical care. Most Meritain plans cover behavioral health and substance abuse treatment when it is medically necessary.
Coverage usually depends on:
- Medical necessity, shown by a clinical assessment that uses ASAM criteria.
- Precertification for higher levels of care such as partial hospitalization.
- The network your employer chose, and whether the plan pays anything out of network.
Levels of care, and what Recreate provides
Recreate provides the outpatient part of treatment. If you need detox or residential care first, we refer you to a partner program and bring you into ours when you are ready to step down.
| Level of care | What it is | At Recreate |
|---|---|---|
| Medical detox | Supervised withdrawal management, usually several days | Referral to a partner detox |
| Residential treatment | Live-in care with 24-hour support | Referral |
| Partial hospitalization (PHP) | Treatment most of the day, five days a week. You go home or to recovery housing at night. | Yes |
| Intensive outpatient (IOP) | Several hours a day, several days a week, built around work or school | Yes |
| Dual diagnosis treatment | Addiction and a co-occurring mental health condition treated together | Yes |
| Aftercare | Ongoing support and alumni programming after discharge | Yes |
PHP is a day program. You attend treatment at our facility and live elsewhere, either at home or in a separate recovery residence if you need a substance-free place to stay.
In-network vs. out-of-network with Meritain
Network status drives cost. An in-network provider has a contract that sets the rate and limits what you can be billed. With an out-of-network provider, the plan pays less, or nothing, and the provider can bill you the difference.
Because your employer designs the plan, out-of-network rules vary. Some Meritain plans pay out-of-network care at a lower rate with higher co-pays and deductibles. Others pay nothing outside the network. We confirm which applies to your plan, and whether Recreate is in network, during the benefits check.
What you will pay
Your share is set by your employer’s plan design:
- Deductible: what you pay each year before the plan pays.
- Copays and coinsurance: your share per day or per session after the deductible.
- Out-of-pocket maximum: the most you pay in a plan year for covered in-network care.
If part of your care is not covered, ask admissions about self-pay rates and payment options. A health savings or flexible spending account can also cover deductibles and copays.
How to verify your Meritain benefits
- Have your Meritain ID card ready. The back usually shows which provider network your plan uses.
- Call us or complete the confidential form on this page.
- We contact Meritain to confirm active coverage, network status, deductible and copays, and precertification requirements for PHP or IOP.
- You get a written estimate before you agree to anything.
- If you move forward, we complete a clinical assessment, request precertification and schedule your start date.
Your employer’s HR or benefits department can also share the summary plan description, which spells out what the plan covers for behavioral health.
Questions to ask before you start
Self-funded plans leave more room for surprises than standard insurance, so a few direct questions up front can save you a bill later. Ask us, and ask your plan:
- Which network does my Meritain plan use, and is this program in it?
- Does my plan pay anything for out-of-network behavioral health care?
- Is precertification required for PHP, IOP or both, and who requests it?
- How much of my deductible and out-of-pocket maximum is left this plan year?
- What happens if the plan stops approving care before my clinicians think I am ready?
Beyond coverage, check the program itself. Look for Joint Commission or CARF accreditation, a current state license, licensed therapists, and a clear answer about which conditions the program treats and which it refers out. A program that is vague about cost or wants you to commit before verifying benefits is a warning sign.
Treatment at Recreate
Inside PHP and IOP, treatment combines individual, group and family therapy with evidence-based approaches: cognitive behavioral therapy, dialectical behavior therapy and trauma-focused work such as EMDR. We plan around your job and family commitments where we can, and you leave with a relapse prevention plan and an aftercare plan.
Recreate Life Counseling is accredited by The Joint Commission and licensed by the Florida Department of Children and Families.
Frequently asked questions
Is Meritain the same as Aetna? Meritain is an Aetna company, but it administers self-funded employer plans rather than selling Aetna insurance. Many Meritain plans use the Aetna network. If your card says Aetna, see our Aetna page.
Does Meritain cover mental health treatment without a substance use problem? In most plans, yes, under the same behavioral health benefit.
Will my employer find out? Your employer funds the plan but is not allowed to see your treatment details. Health information is protected under HIPAA, and substance use treatment records have added protection under 42 CFR Part 2.
What if Meritain denies coverage? You can appeal. Our admissions team can explain the next step and support it with clinical documentation.
Written by: The Recreate Life Counseling Editorial Team
Published on: March 31, 2019
Updated on: November 11, 2026
