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Using TRICARE Insurance for Drug and Alcohol Treatment

Whether you’re an active-duty service member or a veteran, you may be eligible for health care coverage under a government-run and regionally managed health care program called TRICARE. Managed by the Department of Defense, TRICARE is designed to be used by eligible veterans or service members (and sometimes their dependents) if they cannot receive treatment at a VA or other military facility. 1 In some cases, you may be able to use a combination of Medicare, Medicaid, VA benefits, and TRICARE coverage to receive the care that you need, depending on your eligibility.

Does TRICARE Cover Detox or Rehab?

You can use TRICARE health plans cover some or all of the costs of medical services, including drug and alcohol treatment. What your exact plan will cover may vary based on plan selection, location, and facility choice. That’s why it’s recommended that you verify your benefits and coverage before seeking drug rehab services.

The Affordable Card Act (ACA) mandates that all health plans cover some degree of mental and behavioral healthcare.3 This means that those enrolled in a TRICARE health plan may be able to use it to cover some or all of the costs of drug or alcohol rehab.  The extent to which a specific service is covered under your specific plan may vary based on your plan chosen and where you seek care. It’s important to reach out to your TRICARE representative in order to determine the extent of your coverage before committing to treatment.

Types of Addiction Treatment Covered by TRICARE

Generally, TRICARE plans may cover the following types of drug rehab treatment:4

This list is just an example of common types of covered treatment—it is not a list of what exactly your TRICARE plan will cover. Be sure to check with your plan to verify your benefits and coverage. It’s also important to note that TRICARE plans do not provide coverage for unproven substance use disorder treatments, including aversion therapy.3

How to Check Your TRICARE Coverage

Verifying your benefits and coverage may seem complicated, but it’s an essential step to take to avoid any surprise medical bills. To check your coverage, you can sign in to your TRICARE member portal and review your summary of benefits and coverage. You can also call the number on the back of your insurance card to speak to a representative who can explain your coverage. In some cases, you can also call the detox or rehab center directly and ask whether they accept your TRICARE plan. There are also many online resources for you to check your coverage online.

Detox and Rehab Centers That Accept TRICARE Insurance

TRICARE is available all over the world, and is managed in three separate regions:2

  1. West—Western half of the United States.
  2. East—Eastern half of the United States.
  3. Overseas—All covered areas outside the United States.

Your specific TRICARE plan will dictate where you can go to receive addiction treatment. In the majority of cases, the most cost-effective option for seeking detox or rehab is to go to an in-network provider. Fortunately, because the TRICARE network is available in all 50 states and overseas, there are a wide variety of in-network providers where you can seek rehab care.

American Addiction Centers is well-known for its commitment to helping veterans and active-duty servicemembers on their path to recovery. AAC also is familiar in working with TRICARE insurance plans. The facilities at Desert Hope and Recovery First treatment centers are world-renowned programs for veterans seeking to overcome their addiction. To check whether your TRICARE plan is accepted at either of these facilities, be sure to call a TRICARE representative today.

Types of TRICARE Insurance Plans

There are a variety of TRICARE plans that you may be able to choose from upon enrollment. These plans are briefly outlined below:

  • TRICARE Prime. Prime plans are similar to health maintenance organization plans (HMOs). This is because a primary care manager facilitates all care, meaning that there is often less flexibility in where you can receive care and the doctors you can see.5
  • TRICARE Select. This relatively new plan type replaced the TRICARE Standard and TRICARE Extra plans in 2018.6 It is similar to a preferred provider network (PPO) health plan in that there is a network of preferred providers from whom to seek care at a lower rate. While you’re not required to see providers within the network, seeing one outside of the network may result in higher health care costs or lower levels of coverage.

Based on your status, you may be eligible for other TRICARE plans that function similarly to the two outlined above.

Sources:

  1. TRICARE. (n.d.). About Us.
  2. TRICARE. (n.d.). Region.
  3. healthcare.gov. (n.d.) Essential Health Benefits.
  4. TRICARE. (2018). Substance Use Disorder Treatment.
  5. TRICARE. (2020). TRICARE Prime.
  6. TRICARE. (2021). TRICARE Select.
  7. Department of Health and Human Services. (2019). Does the Affordable Care Act Cover Individuals with Mental Health Problems?
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