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TRICARE Insurance Coverage for Drug and Alcohol Rehab

Dealing with an addiction or substance abuse issue requires a treatment plan that will get you on the road to recovery. This article provides you with information about TRICARE insurance coverage for drug and alcohol rehabilitation, how you can access your TRICARE plan, and how to use the insurance to begin the journey to sobriety. American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers' addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.
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Does TRICARE Cover Addiction Treatment?

TRICARE does cover substance abuse treatment, just as all insurance providers do. The extent of what is covered depends on your plan’s specifics. Everyone who experiences a drug or alcohol addiction issue will face a host of different problems that require personalized treatment options. Understanding how TRICARE insurance coverage works is a critical part of moving forward and getting the help you need.

Types of Approved TRICARE Substance Misuse Treatment

Everyone has unique needs when it comes to drug and alcohol treatment. For some people, inpatient residential care is the best option for their addiction problems, while others thrive from regular intensive therapy sessions.

Although coverage varies depending on the specifics of your plan, you can count on some type of addiction treatment coverage from TRICARE. Here are some of the particular programs and treatment services you may be eligible for under TRICARE’s healthcare coverage:4-6

TRICARE Inpatient Rehab

Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.

Medications for Addiction Treatment (MAT)

Medications for Addiction Treatment (MAT), also known as Medication-Assisted Treatment, involves the use of medications along with counseling and behavioral therapies. The goal is to provide treatment that addresses the entire person in connection to their substance use disorder.

TRICARE-Approved Drug and Alcohol Detox Facilities

In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms. Read more: Detox Facilities Near You.

Partial Hospitalization Program (PHP)

Partial hospitalization programs, sometimes known as day treatment programs, give you the opportunity to live at home while attending treatment during the day.

Intensive Outpatient Program (IOP)

Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.

Outpatient Treatment Centers

Individuals who have completed inpatient addiction treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at a treatment facility near you for therapy and support.

Does TRICARE Cover Dual Diagnosis Treatment?

TRICARE insurance may also help individuals cover the cost of dual diagnosis treatment for addiction and co-occurring mental health disorders. While costs will vary from person to person, mental and behavioral health disorders treatment are considered essential benefits under the Affordable Care Act (ACA). As such, health insurance plans, like TRICARE plans, are required to provide some degree of coverage for the medically-necessary treatment of mental health disorders.

Some common types of mental health disorders include:

Additionally, TRICARE may cover various types of different therapies, such as:

How to Check Your TRICARE Rehab Coverage

You may wonder if TRICARE covers drug and alcohol rehab, and the only way to really have the answer is to check your TRICARE health plan coverage. Knowing exactly what TRICARE plans cover can give you peace of mind while you or your loved one is in a rehab facility. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles.

TRICARE offers healthcare insurance for active duty and military veterans. Coverage is available in 2 main regions:2

West Region: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding the Rock Island Arsenal area), Kansas, Minnesota, Missouri (excluding the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (only the southwestern corner, including El Paso), Utah, Washington, and Wyoming.

East Region: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island Arsenal area only), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area only), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding the El Paso area), Vermont, Virginia, West Virginia, and Wisconsin.

New active-duty service members are eligible for these plans:3

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas

National Guard or Reserve members qualify for one of the following plans:3

  • Line of Duty Care
  • TRICARE Reserve Select

Other military personnel may qualify for the following plans:3

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Select
  • TRICARE Select Overseas
  • TRICARE for Life
  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult
  • US Family Health Plan

Do Addiction Treatment Centers Need to Be In-Network?

When going to a substance abuse rehab facility, it’s most helpful to stay in-network, where providers have a contract with the treatment center.1 There are several benefits to using an in-network addiction rehab. You won’t have to pay as much in out-of-pocket costs when you go to one of TRICARE’s providers.2

TRICARE has Eastern and Western regions of network providers you can check with to see if the treatment facility you’re considering is listed. Also, you can verify your healthcare benefits by contacting the rehab center or calling the number on the back of your card.

What Should I Do if TRICARE Won't Cover the Total Cost of Rehab?

TRICARE may cover some, and possibly all, of your drug and alcohol rehab treatment. However, you may be responsible for paying some out-of-pocket costs or deductibles. What should you do in this instance? You can seek out alternative ways to pay for substance abuse treatment. Some options include:

  • Payment plans: Rehab programs may offer payment plans where you arrange to spread out the total cost over regular payment installments, to make the financial burden more manageable. Be sure to look at interest rates and other details of the plan.
  • Sliding fee scale: Programs may offer a sliding fee scale, where the treatment costs will vary based on the individual’s income—if you make less money, you will have lower costs. This may only be an option if you pay entirely out-of-pocket.
  • Scholarships: Programs may offer rehab scholarships where you can potentially receive treatment at a discounted cost or no cost at all.
  • Signing up for Medicare or Medicaid if you’re eligible.

Make sure to do thorough research when looking for a rehab facility so that you can find one that meets your financial needs.

Here are additional resources that provide more information about other ways to pay for rehabilitation with or beyond what TRICARE covers:

Whatever addiction issues you’re facing, TRICARE does offer some assistance with insurance coverage. You can take the first step in your recovery today by calling one of our admissions navigators today.

How to Find Rehabs that Accept TRICARE

The task of looking for rehab may seem daunting, but there are resources and steps you can take to make things go quickly and smoothly. For example, one may consider first reaching out to their doctor. They may be able to help diagnose medical conditions like substance use disorder and may be able to refer individuals to suitable rehabs.

Additionally, you may also take advantage of the Rehabs.com directory. Our directory is a powerful tool that can help connect our readers with TRICARE-approved facilities from around the country.

Sources

  1. TRICARE. (2020). Network providers.
  2. TRICARE. (2021). TRICARE regional offices.
  3. TRICARE. (2021). Health plans.
  4. TRICARE. (2018). Covered services: Substance use disorder treatment.
  5. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
  6. Substance Abuse and Mental Health Services Administration. (2021). Medication-Assisted Treatment (MAT).
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