TRICARE Insurance for Drug and Alcohol Rehab

For those with Tricare Insurance who need to attend addiction rehab, it’s important to know the level of coverage for treatment, as well as how to make the most of this health insurance plan.

Last Edited:

09/22/2022

There are many health insurance companies that offer addiction treatment coverage. TRICARE rehab coverage is one such option. This insurance provider offers insurance coverage to military personnel and their family members. Different TRICARE plans provide:

  • Medical coverage
  • Mental health coverage
  • Dental coverage
  • Prescription coverage
  • Special program coverage

If you are an active duty or retired member of the military or have a family member in the service and need drug or alcohol addiction treatment coverage, TRICARE may be able to provide it. There are many treatment options for addiction. Whether you need to control your withdrawal symptoms, undergo detox, or utilize medication assisted treatments, TRICARE may provide assistance.

Just like other insurance providers, TRICARE offers varying levels of insurance coverage and has different eligibility requirements. Researching the TRICARE rehab network may help you receive the assistance you need.

Alcohol and Drug Detox and TRICARE

Does TRICARE pay for drug rehab? People who need addiction recovery assistance can find such help from professional centers that offer alcohol and drug detox services. People can do this with TRICARE rehab insurance.

Medications and medical care provided by alcohol and drug detox programs are typically categorized as detox procedures if they are used to manage the symptoms of drug or alcohol withdrawal. TRICARE often covers alcohol or drug detox procedures for people who are enrolled in approved outpatient or inpatient care centers. Partial hospitalization and residential treatment at medical centers may also qualify for detox service coverage.

Inpatient Coverage and TRICARE

When people meet certain conditions, TRICARE will offer coverage for non-emergency and urgent inpatient addiction treatment. For example, if TRICARE clients are experiencing medical or psychiatric emergencies related to addiction and need hospitalization immediately, they meet the requirements for urgent care.

For most TRICARE enrollees, their insurance provider will provide coverage for stabilization and detox processes. Additionally, TRICARE covers the diagnosis and treatment of short-term and long-term complications that occur due to alcohol and drug addiction.

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Intensive Outpatient Rehab Coverage and TRICARE

Are you looking for TRICARE mental health insurance? If so, you will be happy to learn that TRICARE often covers programs at intensive outpatient rehab centers.

Clients who meet certain requirements may receive coverage. They must currently have active addictions and be using alcohol and/or drugs but do not require around-the-clock hospital supervision or care. TRICARE clients do not need to obtain prior authorization before they receive care from intensive outpatient treatment centers.

Those who have substance use disorder disorders may also receive intensive outpatient treatment when they are transitioning out of inpatient treatment center programs. If you are looking for TRICARE mental health coverage, you can receive it for a range of mental health conditions. The programs help address underlying issues related to addictions. They also teach clients the relapse prevention skills they need to live long, healthy lives in recovery.

Consider contacting your administrator or checking the TRICARE website for general information or to see if your plan has changed recently. Such information can help you find the addiction treatment assistance that you deserve. Eligibility for the plans depends on people’s ages, locations, service, health care coverage, and other factors[/vc_column_text]

TRICARE plans

TRICARE is not one type of insurance, but several. There are multiple TRICARE plansTRICARE plans include:

TRICARE Prime – A plan for active duty and retired service members, National Guard members, and other current and former members of the military and their families who live in prime service locations.

TRICARE Prime Remote – AA plan for active duty service members, some military family members, and some survivors of active duty service members. People in this plan live fifty miles or more from military hospitals or clinics.

TRICARE Prime Overseas – AA plan for active service members, active members of the National Guard and National Guard, and the command-sponsored families of both groups. People with this plan live near military clinics and hospitals.

TRICARE Prime Remote Overseas – AA plan for active service members, active members of the National Guard and National Guard, and the command-sponsored families of both groups. It covers people living outside of the United States.

TRICARE Select – AA plan that charges fees for services for active duty and retired service members, National Guard members, and other current and former members of the military and their families.

TRICARE Select Overseas – A A plan that provides coverage for overseas active duty and retired service members, National Guard members, and other current and former members of the military and their families.

TRICARE For Life – AA plan that provides coverage for military-affiliated people who have Medicare Part A and B coverage.

TRICARE Reserve Select – A A plan for some members of the military reserve forces and their families who do not have other types of coverage.

TRICARE Retired Reserve – AA plan for some retired members of the military reserve forces and their families who do not have other types of coverage.

TRICARE Young Adult – AA plan for unmarried young adult children of some members of the military who do not qualify for other forms of TRICARE or other health care coverage.

US Family Health Plan – AA plan for military family members, National Guard and National Reserve members, some military retirees, and other people affiliated with the military.

Where you live may also help determine your addiction treatment coverage:

  • West Region – Covers the western part of the United States. The regional contractor for this plan is Health Net.
  • East Region – Covers the eastern part of the United States. The regional contractor for this plan is Humana Military.
  • Overseas –  Covers areas outside of the United States.

AIf you have a TRICARE plan or want to enroll in one, please contact a TRICARE administrator. The administrator can help you determine how certain plans will cover drug and alcohol addiction treatment and other needs.

Medication-Assisted Treatment (MAT) Coverage and TRICARE

If people are TRICARE enrollees and have diagnosed opioid abuse disorders, they may qualify to receive medication-assisted treatment (MAT). Such treatment may include various mental health treatments in addition to medications used for easing withdrawal symptoms and reducing the risk of relapses.

Clients might not need pre-authorization to receive medication-assisted treatments. Their chosen alcohol or drug rehab facilities need authorization from the Drug Enforcement Administration (DEA) to prescribe and monitor medication usage. Such facilities may be methadone or Suboxone treatment centers or other facilities or programs.

Sober Living House Coverage and TRICARE

After people leave rehab facilities, there may also receive TRICARE coverage to attend sober living houses. This type of coverage relates to partial hospitalization center programs. If people have addictions to alcohol or drugs and enter into recovery, they may be able to receive these support services.

While sober houses do not provide around-the-clock care, they still provide sober living environments for recovering addicts. The environments promote sobriety and give recovering addicts more time to hone their relapse prevention skills.

Recovering people staying in sober living house must show that they can become and stay sober through outpatient services. If they are going to live in sober living houses, they must actively participate in recovery programs as well.

Out-of-Network Care, In-Network Care, and TRICARE

TRICARE plans often cover treatments and procedures that are medical necessities. Clients may choose in-network providers that are covered through TRICARE. In-network providers have agreements with TRICARE for billing addiction rehab treatment services. Clients who receive such services will only have to pay part of the total cost.

Some clients who are enrolled in plans such as Prime Remote, Young Adult, Retired Reserve, and Reserve Select are allowed to use out-of-network providers. If they choose these providers, they may have to pay higher out-of pocket amounts.

Out-of-network service may cost more than what is allowable through TRICARE in-network providers. In some instances, people with TRICARE may have to pay the entire cost of a treatment and ask for reimbursement through their insurance providers after receiving services.

Consider contacting your preferred center or program to see if it accepts TRICARE. You may also contact TRICARE to see which rehab centers, sober living houses, and other addiction-related assistance it covers.

Finding Alcohol and Drug Rehab Centers That Work with TRICARE

There are various ways to find alcohol and drug rehab centers that work with TRICARE. The first thing you can do is contact the addiction rehab center to ask if it accepts that form of insurance. You can also contact TRICARE to determine which rehab centers it prefers.

Find out more about finding the addiction treatment help you need today. It may help you overcome your addiction and learn to recover in healthy ways. Addiction rehab may not be easy, but you can ask for the help you need and receive it. Make that first call toward improving the rest of your life today.

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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