Alcohol And Drug Rehabs That Accept TRICARE
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
April 5, 2019
Seeking help for a drug or alcohol addiction is the best decision you can make. Many insurance companies, including TRICARE, provide partial or full coverage for addiction treatment services.
TRICARE is an insurance company that caters to military personnel, their families, and veterans. TRICARE operates as part of the United States Department of Defense Military Health System.
There are two types of TRICARE insurance available: TRICARE Standard and TRICARE Extra. Both forms of insurance offer coverage for a number of different treatment services.
As with other insurance plans, how much coverage a person will receive will depend on his or her TRICARE plan. When planning your recovery program, understanding your insurance benefits is an important first step.
Does TRICARE Cover Addiction Treatment?
TRICARE offers coverage for a number of different addiction treatment programs and services. Most TRICARE plans offer coverage for addiction treatment for three benefit periods in a person’s lifetime. This means that someone can receive coverage three different times as long as they are not in the same benefit period.
While TRICARE covers most treatment programs, prior authorization is often required to receive coverage. This means that proof of medical necessity must be given to TRICARE before they will provide insurance coverage for treatment.
Speaking with a TRICARE representative can help you better understand your treatment options and the coverage you are eligible for.
Drug And Alcohol Addiction Services Covered By TRICARE
TRICARE may provide coverage for a number of different drug and alcohol addiction services. The services covered by TRICARE must be medically necessary and considered proven. Your plan will determine if you will have any out-of-pocket expenses and what they will be for.
Common addiction services covered by TRICARE include:
- mental health therapeutic services
- office-based opioid treatment
- family therapeutic services
- intervention programs
- medication-assisted treatment
- treatment for dual diagnosis
TRICARE also offers coverage for intensive types of drug and alcohol addiction treatment. For example, if deemed medically necessary, TRICARE may cover inpatient or outpatient treatment.
Inpatient Rehab Programs
TRICARE covers residential substance use disorder treatment if a number of conditions are met. For example, a person must be under the age of 21 or have a condition that interferes with normal functioning.
TRICARE will cover both emergency and non-emergency addiction treatment. Emergency treatment is when a person has a medical or psychiatric emergency and requires immediate medical attention. TRICARE will cover the detoxification, stabilization, and any medical complications.
Non-emergency treatment is when someone decides to seek treatment on his or her own. This requires prior authorization from TRICARE before they will provide coverage. Coverage usually includes both detoxification and stabilization. It may also include any diagnosis or complications that arise from long- or short-term drug or alcohol abuse.
Inpatient treatment is the most intensive type of drug and alcohol addiction treatment. This type of program requires individuals to live at a treatment facility for an extended period. How long a person will stay in inpatient treatment will depend on his or her condition and TRICARE plan.
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Patients must meet their plans’ qualification requirements before TRICARE will cover outpatient treatment. A person must be active in addiction but not in need of hospitalization or around-the-clock care.
There are several types of outpatient treatment. These include standard outpatient programs, intensive outpatient programs (IOP), and partial hospitalization programs (PHP).
Standard outpatient treatment is the least intensive form of outpatient treatment and only requires people to attend therapy once or twice a week. IOP is more intensive and consists of therapy several days a week. PHP is the most intensive outpatient treatment and involves daily treatment that lasts four to eight hours.
Using TRICARE To Cover Drug And Alcohol Addiction Treatment
Understanding your TRICARE plan and what it will or will not cover is an important aspect to planning your recovery.
You may first want to speak with a treatment specialist to determine the treatment options that best suit your needs and condition. With that in mind, speaking to a TRICARE representative can help you determine what is required, if anything, for you to receive coverage for treatment.
You will also want to ensure that the treatment facility or program you plan on attending is part of TRICARE’s network. Not all facilities accept TRICARE, so calling ahead to ensure that one does can help prevent unwanted costs.
Questions To Ask Before Using TRICARE For Addiction Treatment
Seeking addiction treatment is the best decision you can make regarding your recovery from a substance use disorder. However, there are several questions you should know the answer to before attending a rehab program.
These questions include:
- Does TRICARE cover outpatient treatment? If so, what types of outpatient treatment are covered?
- Does TRICARE cover detoxification and inpatient treatment?
- What addiction programs and services require prior authorization to be covered?
- How long of an inpatient stay will be covered by TRICARE?
- Are medications and medication-assisted treatment (MAT) covered by TRICARE?
- What will I be required to pay out-of-pocket?
- What are the copays or deductibles for the treatment program(s) I plan to pursue?
Finding A Rehab Program That Accepts TRICARE
Speaking to a treatment specialist can make the planning of a program of recovery much easier. A treatment specialist can verify your benefits and can answer many of the questions you may have.
Additionally, speaking directly with a TRICARE representative can also help you better understand your benefits. A representative can also tell you of any prior authorizations needed before coverage will be provided for treatment.
He or she will also be able to match you with an in-network treatment program that best suits your needs. The representative should also be able to inform of any out-of-pocket expenses or copays that may be required.
* Disclaimer: RehabCenter.net is not affiliated with or endorsed by TRICARE. Details about TRICARE’s coverage are intended for informational purposes only. The specific details of your plan may vary and the specific treatment services you require may or may not be covered.Article Sources
TRICARE - Substance Use Disorder Treatment
Addiction Campuses - TRICARE Insurance Coverage For Drug And Alcohol Rehab