TRICARE Drug Rehab Coverage

drug and alcohol rehab with Tricare Insurance

Drug & Alcohol Rehab With TRICARE

TRICARE is a health care program that serves active-duty service members, National Guard and Reserve members, retirees, and their families. If you’re covered by a TRICARE health insurance plan, and you or a dependent is struggling with substance abuse, it’s important to know that TRICARE offers coverage for addiction and mental health treatment services. TRICARE’s drug rehab network allows veterans who are struggling with addiction to get the help they deserve.

Does TRICARE Cover Drug Rehab?

Yes, TRICARE insurance covers addiction treatment and mental health services. Like other insurance companies, the extent of your coverage depends on the specific plan you have, your deductible, or other factors.

Types of treatment TRICARE may cover include:

Detox

Drug detox can range from mild to severe, and it usually comes with unpleasant symptoms. Depending on your needs, you can detox at a treatment center, detox clinic, or in a hospital. It’s smart to have medical help, even if it’s not an emergency, to keep you safe and comfortable. Quitting on your own at home, especially if you’re alone, isn’t a good idea.

Fortunately, your TRICARE insurance will cover medical detox services as well as the medications used. TRICARE covers emergency services that include detoxification and stabilization, including any medical complications from your substance use disorder. Emergency services do not need prior authorization, but you do need approval for continued treatment.

Inpatient treatment

Inpatient (residential) treatment is best for people with severe or long-term addictions. It is also useful for people with unstable home situations or those who also need help for depression, anxiety, or other mental health issues. If you enter inpatient treatment, you’ll be in a more structured environment than outpatient treatment. You receive more counseling and therapy, as well as housing, meals, medical care, and certain recreational activities.

TRICARE offers non-emergency coverage that includes the diagnosis and treatment of mental health and substance use disorders on an inpatient basis. Private psychiatric hospitals as well as local, state, or federal government psychiatric hospitals are typically included in coverage. However, non-emergency inpatient services do require prior authorization before entering a residential treatment program. You also have to be under the age of 21 and have already been diagnosed with a co-occurring mental health disorder.

Partial hospitalization programs (PHP)

PHP is designed for people who have substance use or mental health problems but don’t need inpatient or full-time rehab. Partial hospitalization programs also work well for people who have completed inpatient treatment but aren’t yet stable enough to meet the demands and stresses of everyday life.

With TRICARE, prior authorization is not needed to enter a PHP, but you must seek treatment in the U.S.

Intensive outpatient programs (IOP)

IOP is often recommended for people who don’t require rehab full-time but need more care than they would receive from regular outpatient treatment. Intensive outpatient treatment typically involves at least three visits per week. It is often a middle step for people who have just completed residential treatment but aren’t quite ready for regular outpatient.

With TRICARE, you need to check with your regional plan advisor for whether or not a prior authorization is needed for IOP services. They do offer coverage for those transitioning into IOP from other types of substance abuse treatment programs, like inpatient rehab

Medication-assisted treatment (MAT)

MAT is an integrated approach that combines regular therapy and counseling with certain medications. TRICARE may cover both standard and office-based opioid treatment but requires providers to be authorized and certified by the Drug Enforcement Administration (DEA) to prescribe buprenorphine.

With TRICARE, Prior Authorization is not needed for MAT TRICARE coverage, but First Step Behavioral Health does not offer MAT.

TRICARE does not provide drug and alcohol rehab coverage for aversion therapy (a form of behavior modification that can sometimes trigger anxiety, anger, and hostility), or treatment programs that have not been medically proven and backed up by research.

Understanding Your TRICARE Rehab Coverage

TRICARE typically covers evidence-based treatments for substance use disorders, such as cognitive-behavioral therapy, medication-assisted treatment, and counseling. However, coverage may have specific limits in terms of the duration of treatment and the number of sessions or days covered. These limits can vary based on the specific TRICARE plan or option you have.

It’s essential to seek treatment from TRICARE network providers to maximize coverage benefits. Out-of-network providers may result in higher out-of-pocket costs. The availability of drug rehab facilities and the specific services covered may vary based on your location and the TRICARE plan you have. As a result, it’s important to check with TRICARE or your regional contractor for specific details and options available to you.

addiction treatment program for veterans

TRICARE-Covered Rehab in Florida With 1st Step Behavioral Health

First Step Behavioral Health in South Florida is happy to accept patients who are covered by TRICARE. Our substance abuse treatment providers can work with you to find the right drug rehab program for you, and make sure every step of your treatment is looked at so that you can feel at ease that the services are covered.Contact us online, or give us a call or text at (855) 425-4846 to get your journey to recovery started.

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