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TriWest Healthcare Alliance Insurance Coverage for Drug & Alcohol Rehab Treatment

TriWest Healthcare Alliance provide a variety of health services through health care plans and related services. Those with TriWest Healthcare Alliance insurance may have confusion about what their insurance plan covers when it comes to substance abuse and mental health services. This page is intended to help you figure out what your Alliance healthcare does and does not cover when it comes to drug and alcohol addiction treatment.
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Deciding to begin to work on overcoming addiction takes incredible strength. As you consider how to move forward with addiction rehab, you might wonder if your TriWest Healthcare Alliance healthcare coverage can help you afford drug and alcohol addiction treatment. Fortunately, your TriWest health insurance plan does provide coverage for addiction treatment.

Discover how TriWest Healthcare Alliance health plans will help provide coverage for addiction treatment. This page will guide you through the steps to accessing your healthcare benefits and answer questions you may have about addiction treatment coverage, including what your plan covers, how to use your benefits for rehab, how to pay out of pocket expenses that TriWest doesn’t cover, and how to find in network providers and verify insurance for treatment.

 

What is TriWest?

TriWest Healthcare Alliance provides specialized services for veteran and military communities.1 Due to veterans’ high risk of substance abuse, TriWest Healthcare Alliance takes addiction issues very seriously.2

TriWest has a large provider network with more than 700,000 healthcare professionals nationwide who meet the VA requirements for quality care and standards.11 TriWest serves the in-network providers for CCN Regions 4 and 5.11 If you live in these regions, you have a range of healthcare professionals to serve you.

You may also be able to receive drug and alcohol addiction treatment outside of the network, but you may be responsible for added service fees. Check with your provider to ensure you make the right choice.

What is the Community Care Network (CCN)?

The Community Care Network (CCN) is a program run by the Department of Veteran Affairs that links clients and providers to ensure that people get prompt healthcare solutions. They facilitate tasks such as: 4

  • Consolidating the VA’s community care programs into one streamlined program.
  • Providing better service for veterans.
  • Enhancing partnerships with community providers.

CCN operates in all U.S. states and is available to veterans with TriWest insurance.5 Several services are included within CCN, including behavioral healthcare.5

The CCN network comprises 6 regions.5 You can check here to see which region your state is in.

What is the TRICARE Program?

TRICARE is a federally administered healthcare program for veterans and their families.6 It’s managed by the Defense Health Agency through the Assistant Secretary of Defense.6

TriWest Healthcare Alliance insurance is one of the plans covered by TRICARE.7 The TriWest plan, administered through TRICARE, is for veterans using a VA community program, which is made up of partner providers who provide services to veterans when the VA facilities are not able to fulfill the need.

TriWest Health Insurance Plans and Coverage Levels

TriWest Healthcare Alliance is a third-party administrator (TPA) for the U.S. Department of Veterans Affairs (VA). 1 This means that they are in partnership with the VA and all its programs and plans. The VA staff works with TriWest to ensure patients access the best healthcare solutions for their needs. Your plan type—HMO, PPO, POS, etc.—depends on which program you use. Your healthcare administrator will provide you with more details about the plan specifics.

What Are the Coverage Levels and Plans for TriWest Healthcare Alliance?

TriWest Healthcare Alliance is a third-party administrator (TPA) for the U.S. Department of Veterans Affairs (VA). 1 This means that they are in partnership with the VA and all its programs and plans. The VA staff works with TriWest to ensure patients access the best healthcare solutions for their needs. Your plan type—HMO, PPO, POS, etc.—depends on which program you use. Your healthcare administrator will provide you with more details about the plan specifics.

TriWest and Medicare and Medicaid

TriWest also works with Medicare and Medicaid. These 3 entities are federally funded programs that administer healthcare to veterans.7 Each entity provides a different function by serving a different population.7

For example, Medicare is for adults age 65 and over or for those with certain disabilities.8 Medicaid is administered locally, and you must meet the income requirements to qualify for it.

Does TriWest Healthcare Insurance Cover Addiction Treatment?

TriWest’s behavioral healthcare coverage provides treatment options for substance addiction. Because every person has varying levels of needs, a rehab therapist will help you determine what type of drug or alcohol addiction treatment is necessary for your situation.

The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

Veteran or military professionals have access to TriWest’s wide network of providers, which includes at least 700,000 healthcare professionals. 2 The main types of substance abuse treatment available through TriWest Healthcare Alliance include:3

  • Outpatient treatment, including psychotherapy sessions.
  • Medication management counseling.
  • Inpatient treatment program.
  • Residential treatment.
  • Support group therapy.

What Different Types of Addiction Treatment Does TriWest Cover?

When seeking addiction treatment, you may wonder—does TriWest Healthcare Alliance cover drug rehab? The answer is yes. The Alliance is sensitive to veteran needs and provides coverage for a variety of addiction treatment services.

The specific treatments you may require will depend on the severity of your addiction. The main types of treatment for addiction include:10

  • Medical detox program: 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.
  • Inpatient or residential addiction treatment: 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.
  • Partial hospitalization program (PHP): Partial hospitalization 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 addiction treatment: Individuals who have completed inpatient 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 the treatment facility for therapy and support.

TriWest Mental Health Providers and Coverage?

When an individual needs treatment for a substance use disorder (SUD) and another mental health issue, it is called dual diagnosis. Dual diagnosis treatment is often covered by insurance, at least to some extent, and programs that treat dual diagnosis may include treatment for anxiety, depression, and post-traumatic stress disorder (PTSD).

Types of Therapy Covered by TriWest

While in treatment, you may participate in various types of therapy, including individual and group therapy. In addition, your treatment facility may offer cognitive behavioral therapy and dialectical behavior therapy. TriWest may cover all or some of the costs of therapy during addiction treatment.

Addiction Rehab Centers That Take TriWest Healthcare Insurance

TriWest has a large provider network with more than 700,000 healthcare professionals nationwide who meet the VA requirements for quality care and standards.11 TriWest serves the in-network providers for CCN Regions 4 and 5.11 If you live in these regions, you have a range of healthcare professionals to serve you.

You may also be able to receive drug and alcohol addiction treatment outside of the network, but you may be responsible for added service fees. Check with your provider to ensure you make the right choice.

What Should I Do if TriWest Won’t Cover the Total Cost of Rehab?

There are other ways to help pay for the costs of rehab if certain portions are not covered by insurance. You could speak to the intake coordinator about setting up a financial plan to make payments. In addition, you could see if the facility offers a sliding-scale fee plan. If not, a loan is always an option.

For more information on other ways to pay, visit these web pages:

Don’t wait to begin seeking treatment using your TriWest Healthcare Alliance plan. Talk to an admissions navigator today about verifying your benefits. Start your journey to a brighter future now.

Verify Your TriWest Military Health Insurance Coverage

To verify your TriWest addiction treatment coverage, you can contact one of our admissions navigators at , click here, or fill out the form below.

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