Does Tricare Cover Drug and Alcohol Rehab?

TRICARE is a government-run healthcare program for active-duty service members, veterans, and their dependents. Run by the Department of Defense, TRICARE plans that cover drug rehab vary in design and cost, but they all provide some level of coverage1 including mental and behavioral health to all beneficiaries and dependents.2 According to the Military Health System, […]

TRICARE is a government-run healthcare program for active-duty service members, veterans, and their dependents. Run by the Department of Defense, TRICARE plans that cover drug rehab vary in design and cost, but they all provide some level of coverage1 including mental and behavioral health to all beneficiaries and dependents.2

According to the Military Health System, 9.6 million people receive coverage for various healthcare services — including substance use disorder treatments — through TRICARE.3 Active-duty service members or veterans who are struggling with substance use disorders and need drug rehab may be able to receive the help they need at little to no out-of-pocket cost. TRICARE benefits may cover all or part of the cost of rehabilitation treatment, depending on the plan and treatment facility selected.

All American Addiction Centers (AAC) facilities can help you or a loved one verify your TRICARE benefits and coverage levels before you enter treatment. You can also call the number on the back of your insurance card or contact your local VA to learn more about your TRICARE coverage.

Tricare Insurance Drug Treatment Coverage

The Affordable Care Act (ACA) mandates coverage for mental health and substance abuse services as essential health benefits.4 This means TRICARE plans must cover treatment for substance abuse or substance use disorders, including drug rehab treatment, in some capacity. Per their website, TRICARE plans may cover the following drug rehab treatments:5

  • Emergency and non-emergency inpatient services (e.g., detox and residential programs)
  • Outpatient programs (e.g., therapy, office-based opioid treatment, etc.)
  • Medication-assisted treatments
  • Partial hospitalization
  • Certain telehealth services

Your benefits depend on your selected plan and location. It’s important to check whether a treatment or facility will be covered before seeking treatment. Call the number on the back of your insurance card to verify your benefits.

Is Mental health Covered by Tricare Insurance?

As an essential health benefit under the ACA, mental and behavioral health treatments are covered in some capacity under all TRICARE insurance plans. It’s important to note that there is no single approach to treating mental health disorders. Many active-duty service members and veterans experience co-occurring disorders, meaning they have a mental illness and substance use disorder simultaneously. In fact, according to the VA, between 11% and 20% of post-9/11 veterans struggle with PTSD and depression, which can lead to increased substance abuse.6

Because substance use and mental health disorders often occur together, it’s important to treat them with an integrated approach—where both disorders are treated at the same time—for a successful outcome.7

AAC-accredited facilities take this integrated approach when helping veterans and active-duty service members recover and enter rehab. In many cases, TRICARE plans may provide coverage for treatment at these facilities. Be sure to verify your benefits with an AAC representative or with your insurance company.

Tricare Plans

A variety of TRICARE plans is available to veterans and eligible dependents of veterans or active-duty service members. Current active-duty members are eligible to enroll only in TRICARE Prime plans. Depending on your status and plan selected, you may need to contribute to the cost of coverage.

Here’s a list of all the TRICARE plans currently offered by the Department of Defense. Please visit the TRICARE site to view eligibility requirements for each plan type.

  • TRICARE Prime — This plan is similar to traditional health maintenance organization (HMO) plans.8 Covered members work with a primary care physician who then coordinates care, which includes drug rehabilitation. While you typically have less flexibility with TRICARE Prime, most of your treatment will be covered because it will be in-network.
  • TRICARE Select — This plan functions similarly to a preferred provider organization (PPO) plan in that you can coordinate your care and choose where and from whom you receive it.9 With this plan type, it’s your responsibility to use in-network providers to keep your costs down. Out-of-network providers may not be covered, and if they are, they will be covered at a lower rate, which means higher out-of-pocket costs for you.
  • TRICARE For Life — Medicare-eligible retirees and their families can use TRICARE For Life plans that are accepted wherever Medicare is accepted. However, you must have Medicare Part A and B and pay Part B premiums.10
  • TRICARE Reserve Select — Only certain people are eligible for this TRICARE plan. It operates like a PPO with preferred networks, cost-sharing requirements, and deductibles.11
  • TRICARE Retired Reserve — This TRICARE plan is designed specifically for veterans and operates similarly to the TRICARE Reserve Select plan.12
  • TRICARE Young Adult — Adult dependents of veterans or active-duty service members who are not eligible to remain on their parents’ TRICARE plan can use this plan. Enrollees need to pay premiums and are subject to cost-sharing requirements like copays and deductibles.13
  • US Family Health Plan — Available to families located within 6 US areas, the US Family Health Plan provides coverage through community-based care. Families with this plan cannot receive services at military facilities, but their care is coordinated via a primary care physician.14

For more information about any of these plans, including eligibility requirements and pricing, visit the TRICARE Health Plans site.

Tricare Covered Rehab

If you are looking into drug rehab facilities for yourself or a loved one, you may be wondering whether a facility is covered under your insurance. There is not a general answer to this question, unfortunately, because every insurance plan is different. You can verify whether a treatment facility is an in-network provider under a TRICARE plan by calling the number on the back of your TRICARE card and talking to a representative. Alternatively, you can verify your coverage with the facility directly.

AAC’s Desert Hope Treatment Center, located in Las Vegas, NV, offers a recovery program specifically designed for veterans and first responders called Salute to Recovery. This program provides treatment for co-occurring disorders. Desert Hope is part of the VA’s community care network, which means you may be partly or fully covered for treatment there under your TRICARE plan.15

Rehab Not Covered by Tricare Insurance Policy

Depending on your plan or location, your TRICARE insurance policy may not cover the cost of your treatment and you may have to pay for services out-of-pocket.

Be sure to ask the facility if they have financing options or scholarship opportunities to help offset the financial burden of receiving treatment. Remember that getting the care you need as soon as possible is the right solution — don’t delay care any longer.

How to Find Tricare Covered Rehab?

If you’ve decided that now is the time to get the care you need, you may be wondering how you can go about finding a TRICARE-authorized rehab center. American Addiction Centers has many accredited rehab facilities located across the country and we can verify your coverage quickly. Fill out the form below and see immediately whether your TRICARE plan will cover treatment at one of our facilities.

If you’d rather talk to a person or have questions, please call our helpline. One of our representatives will be happy to assist you.

Let’s verify your coverage for drug addiction treatment at an American Addiction Centers location. Your information is always confidential.

Sources

  1. (2021). Health Plans.
  2. About Us.
  3. Military Health System. (2020). Beneficiary Population Statistics.
  4. Gov. Essential Health Benefits.
  5. (2018) Substance Use Disorder Treatment.
  6. S. Department of Veterans Affairs. (2018). How common is PTSD in veterans?
  7. Brouselle et al. (2010, Jul-Sep). Integrating services for patients with mental and substance use disorders: What matters?
  8. (2020). TRICARE Prime.
  9. (2021). TRICARE Select.
  10. (2018). TRICARE for Life.
  11. (2020). TRICARE Reserve Select.
  12. (2020). TRICARE Retired Reserves.
  13. (2016). TRICARE Young Adult.
  14. (2018). US Family Health Plan.
  15. Desert Hope Treatment Center. Salute to Recovery.
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