Does TRICARE Cover Suboxone Treatment?

Last Updated: Nov 20th 2020

Reviewed by Brittany Polansky

Does TRICARE Cover Suboxone Treatment?

If you, or a dependent, is struggling with an opioid addiction and have TRICARE health insurance, Suboxone treatment is covered.

TRICARE Suboxone Treatment Coverage Details

TRICARE buckets Suboxone treatment coverage under Medication Assisted Treatment (MAT) — which includes the coverage of services that combine drug and mental health therapies to treat substance abuse. However, not all physicians that prescribe buprenorphine (the generic name for Suboxone) are covered by TRICARE; they must be authorized. Prescribers have to have completed training and certification set forth by the Department of Health and Human Services (HHS), the U.S. Drug Enforcement Administration (DEA), and state and local government. TRICARE MAT coverage includes two types of opioid substance abuse programs that typically include the use of Suboxone; opioid treatment programs and office-based substance use disorder treatments.

Opioid Treatment Programs

Opioid treatment programs (OTP) are covered by TRICARE when an authorized provider deems it necessary for a patient to be enrolled in a comprehensive detox program that is supported by medication therapy and mental health services. Covered OTP treatment can include both opioid detoxification and medically managed withdrawal from maintenance medications. OTP care is generally only covered and available for TRICARE members based in the U.S. and U.S. territories.

Office-Based Substance Use Disorder Treatment

Office-based Suboxone treatment programs are covered by TRICARE when the providers have been authorized according to TRICARE requirements. These are generally covered for members based in the U.S. and overseas — pending compliance with the host country’s specific licensure or certification requirements for providers. 

Talk to a TRICARE representative to determine referral and prior authorization requirements, which may vary depending on your specific plan, location, and other factors.

How Do I Start Taking Suboxone?

TRICARE requires that Suboxone treatment is accompanied by mental health therapy. SAMHSA (Substance Abuse and Mental Health Services Administration) reports that the combination of medication and therapy has proven to be effective for people suffering from opioid use disorders. 

Generally, a physician will evaluate your situation and will determine the best course of action. He may recommend that you enter medically managed detox to ensure you are as safe as possible while the drug leaves your body. The doctor will also work with you as you transition from your current opioid drug to Suboxone and manage your continued use of Suboxone. 

You’ll take the first dose of Suboxone between 12 and 48 hours after your last dose of an opioid drug, or when you begin to experience mild to moderate withdrawal symptoms. Starting Suboxone too early can trigger severe withdrawal symptoms. 

Withdrawing from Suboxone

With the use of Suboxone as an effective opioid addiction treatment, there’s always the concern of what to do when withdrawing from the drug. Ideally, you don’t want to be on Suboxone forever, and when the time comes to remove Suboxone from your addiction treatment plan, there’s typically two ways to withdrawl; through a taper or through a direct detox.

Through a taper, most people begin with a daily dose of Suboxone, gradually decreasing to a dose every other day. Depending on your needs, you may stay on this dosage or gradually move to a monthly maintenance dose. Suboxone isn’t intended for “as needed” or occasional use.

If you come to First Step for Suboxone, we will discuss all options as we curate your specific addiction treatment program plan. 

1st Step Accepts TRICARE Coverage, but We Don’t Offer Medication-Assisted Treatment

At First Step Behavioral Health, we accept TRICARE health insurance but we do not offer Suboxone treatment programs.

We do take a holistic approach to care, and screen all our clients for dual diagnosis to make sure we’re treating any mental or behavioral health issues along with drug addiction. We offer a variety of different types of substance abuse programs including drug detox, residential treatment, partial hospitalization, inpatient rehab, outpatient rehab, and mental health services. 

For more information about 1st Step Behavioral Health treatment options or to make an appointment to talk to one of our compassionate, knowledgeable counselors, please call (855) 425-4846 or contact us online

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.