Does TRICARE Cover Drug Rehab?
TRICARE is an insurance program that provides healthcare coverage to active duty service members, retired service members, and their families.1 (paragraph 1) Presently, nearly 10 million people around the world receive healthcare coverage benefits through TRICARE.2 A variety of insurance coverage options are available, depending on which plan you have.3 To verify your TRICARE substance abuse treatment coverage, provide your insurance information to a rehab facility or contact the number listed on the back of your card.
This page will help you learn more about:
- TRICARE drug rehab coverage.
- Approved types of TRICARE treatment facilities and services for mental health.
- TRICARE plans that include substance abuse treatment.
- How to find nearby TRICARE-approved residential treatment centers and TRICARE mental health providers.
- How to check whether TRICARE drug coverage will approve medication-assisted treatment.
- How to find out if TRICARE is accepted at rehab facilities.
- TRICARE rehab centers that offer specialized detox and rehab programs for military families.
TRICARE Insurance Drug Treatment Coverage
TRICARE coverage may include a wide range of treatments for substance use disorders.4 Each plan offers different levels of coverage for certain treatments according to the type and severity of substance abuse issues you have. Approval depends on whether you meet certain requirements.5, 6, 7, 8, 9
TRICARE plans that cover substance use disorders may approve the following treatments:4, 5, 6, 7, 8, 9
- Inpatient treatment. This can occur in a hospital or an inpatient facility and may involve detoxification if needed. If you are experiencing an emergency, TRICARE inpatient coverage can be used at the nearest hospital. However, if you are planning your inpatient treatment, you may be required to use an in-network facility.
- Residential treatment. This is community-based treatment that provides housing with around-the-clock support and structured treatment. It is especially helpful for people with co-occurring disorders. Prior authorization is required before beginning a residential program.
- Partial hospitalization programs (PHP). These offer intensive treatment on an outpatient basis, providing a bridge between inpatient care and less intensive outpatient services. They may provide care for substance use treatment only, or also for co-occurring disorders. Prior authorization is not required.
- Intensive outpatient programs (IOP). A step-down treatment from a partial hospitalization program, IOP allows you to receive more intense treatment than in standard outpatient care and eases the transition from higher levels of care. Some plans may require prior authorization before you begin treatment.
- Outpatient treatment. This is the least intensive treatment option. It prepares you to live a sober, independent life. You may need prior authorization to obtain this level of care.
- Medication-assisted treatment (MAT). This is when medication and therapy are combined to help you detox, manage cravings, and maintain sobriety. MAT can be used in various settings, and a number of medications may be used to help you stay sober. MAT generally doesn’t need prior authorization.
Is Mental Health Covered by TRICARE Insurance?
TRICARE mental health coverage includes a variety of services.10 Treatment that addresses co-occurring substance use and mental health disorders—known as an integrated approach—has been shown to be more effective than treating the disorders separately.11 (pe3) TRICARE recognizes that this is the ideal form of treatment when someone has co-occurring disorders.10, 11 (pe3)
TRICARE mental health benefits cover inpatient, residential, partial hospitalization, and the full spectrum of outpatient services, depending on your plan and specific needs.10 Your treatment plan may incorporate individual, group, family, and couples counseling as well as creative arts therapies.10 MAT is also covered as long as the medications are prescribed by an approved TRICARE mental health provider.10
Various TRICARE plans are available to active duty service people, military veterans, and their family members.3, 12 (who can participate), 13 (who can participate), 14 (who can participate)
- TRICARE Prime is a managed care plan for active and retired military service people and their spouses in specific service areas. You receive the majority of your care through your primary care provider and must obtain referrals for specialists.3, 12 (paragraph 1, how it works)
- TRICARE Select is a preferred provider network plan available to active duty service people, retired veterans, and their families. You can get treatment from any authorized provider—in-network or not—and you don’t have to obtain a referral.3, 13 (who can participate, how it works)
- TRICARE For Life is a program that provides secondary coverage to eligible TRICARE members who have Medicare Parts A and B.3, 14 (paragraph 1, who can participate) It allows you to see any authorized provider and will pay for approved services after Medicare has paid their share.3, 14 (paragraph 1, how it works)
TRICARE Covered Rehab
If you are a military service member or veteran seeking treatment, your first question may be whether a particular facility or provider is an in-network TRICARE rehab. Fortunately, if you receive treatment at an in-network rehab program, you can still attend a Veterans Administration (VA) facility. Contact TRICARE at the phone number on the back of your card to determine which facilities are in-network. There is also a website that can help you find an in-network TRICARE alcohol rehab or drug treatment center. Finally, you can contact the facility directly and speak with a staff member who will clarify whether they are in-network with TRICARE.
Desert Hope Treatment Center is a facility in Las Vegas, Nevada, which has a special focus on treating veterans. It offers a full spectrum of treatment services, from detox to outpatient care, and a program designed to help veterans meet the unique challenges they face in treatment. Their Salute to Recovery program, which was designed in conjunction with the VA, specializes in relapse prevention, behavioral therapy, trauma-focused treatment, pain management, coping with grief, and a variety of other complementary therapies. It is designed to help veterans learn to maintain sobriety, manage stress more effectively, cope with trauma or other mental health issues, adjust to civilian life, and improve connections with friends and family.
Rehab Not Covered by TRICARE Insurance Policy
Depending on which rehab center you choose and what type of TRICARE rehab coverage you have, you may be responsible for part or all of the cost of treatment. You will have to pay for the full cost of care if you attend a facility that does not accept TRICARE. In some cases, you may have only a copayment. Receiving treatment right away is important. Don’t delay treatment because of cost—putting it off can have harmful consequences on your physical health, mental health, employment, and relationships with family and friends. Waiting for treatment can also allow your substance use disorder to become more severe and harder to treat. It can create legal problems and even put your life at risk.
If the cost of treatment is an issue, there are some options you may wish to consider. Some programs offer treatment on a sliding scale, according to what you are able to pay. You may be able to break the cost into a payment plan so you can make smaller, more manageable payments over time. Other options include putting the cost onto a credit card, taking a loan, crowdfunding, or borrowing from friends and family.
How to Find TRICARE Covered Rehab?
If you are struggling to find a rehab program that accepts TRICARE, American Addiction Centers can help. Our Salute to Recovery program caters to the unique needs of veterans in recovery so you can live a healthier, sober life. Call our free, confidential helpline 24/7 at 1-888-851-2649 Who Answers? . A staff member can answer any questions you may have and verify your benefits coverage while you’re on the phone. You can also check your information online and immediately see whether you’re covered or not. Don’t wait—reach out and let us help you today.
Let’s verify your coverage for treatment at an American Addiction Centers location. Your information is always confidential.
- (2018). About us.
- (2020). Facts and figures.
- (2021). Health plans.
- (2018). Substance use disorder treatment.
- (2020). Emergency inpatient hospital services.
- (2020). Residential treatment centers.
- (2020). Partial hospitalization (psychiatric and substance use disorder).
- (2020). Intensive outpatient program.
- (2020). Medication-assisted treatment.
- (2020). Mental health therapeutic services.
- Yule, A.M., & Kelly, J.F. (2019). Integrating treatment for co-occurring mental health conditions. Alcohol research: Current reviews, 40(1).
- (2020). TRICARE Prime.
- (2021). TRICARE Select.
- (2018). TRICARE For Life.