Covers Addiction Rehab and Substance Use Disorder Treatment.
TRICARE rehab insurance covers active-duty service members, National Guard and Reserve members, veterans, survivors, their families, and select former spouses worldwide. This health insurance offers coverage for medical, dental, and prescriptions, and can used to cover mental health concerns like addiction treatment.
Managed by the Defense Health Agency (DHA), TRICARE operates similarly to a traditional health insurance plan but with specific benefits tailored to military members and their family’s unique needs.
Does TRICARE cover addiction treatment? Yes, TRICARE does cover emergency and non-emergency addiction treatment for those experiencing addiction, including costs associated with rehab for veterans.
If you or someone you care for is struggling with addiction, you are eligible for coverage for several addiction treatment programs.
While some rehabs may accept this insurance policy, TRICARE rehab coverage depends on the specific provider, the individual’s health plan, the length of treatment, and several other factors that affect the rehab cost.
TRICARE has several different program options available to eligible and those who want to purchase TRICARE coverage. Those programs are:
This is a mandatory TRICARE plan for active-duty military members. It covers active-duty, retired, and National Guard members and their families.
This plan is for those who qualify for TRICARE Prime but live and work at least 50 miles from the nearest military hospital. This policy covers most forms of substance misuse (inpatient, outpatient, and detox).
This plan is a self-managed care option offering the most freedom of choice. It is available to most beneficiaries worldwide except active duty service members and select people.
This policy is offered to active-duty and retired military members and their families but has higher costs.
This plan is for people who receive Medicare Part A and B and can cover expenses that Medicare does not.
This coverage is for reserve members not on active duty.
A health plan is available for purchase by qualified Retired Reserve members, their family members, and qualified survivors.
This policy provides coverage for those needing healthcare after their TRICARE coverage ends after age 21 (23 if in college). However, there are requirements for this policy. (Under 26 years old, unmarried, and a child of an eligible TRICARE member.)
TRICARE rehab coverage depends on the statute of the individual’s service and qualifications. In some circumstances and policies, an individual will be required to receive a referral from their doctor before TRICARE insurance covers the cost of treatment.
Choosing between TRICARE East and TRICARE West can be a pivotal decision for military personnel and their families.
While these policies are similar, they have distinct differences that could impact TRICARE rehab coverage.
TRICARE health insurance typically covers all levels of care for drug and alcohol addiction treatment. If you choose to go to TRICARE-approved rehab facilities, your treatment could come at no financial cost.
Depending on your level of care needed and policy, TRICARE may cover:
Several TRICARE plans provide coverage for several types of drug and alcohol detox.1 Depending on your policy, TRICARE rehab coverage can cover detox entirely by your insurance provider.
However, having TRICARE insurance coverage does not mean you will have immediate coverage for drug and alcohol withdrawal/detox. TRICARE detox centers that accept the insurance may require you to pay an out-of-pocket fee based on your policy and meet specific criteria for admission to a detox program set by the insurance provider.
It is important to understand your level of care through an assessment. An admissions team member can verify your insurance and conduct a free assessment today to determine the best level of addiction treatment.
TRICARE offers coverage for different types of outpatient rehabs, like partial hospitalization programs (PHPs), which allow patients to live at home or in sober houses as they undergo addiction treatment.
PHP is a highly structured and intensive outpatient treatment offering evidence-based therapies and care similar to inpatient rehab. While your policy may limit coverage, preauthorize you, and charge you out-of-pocket for PHP treatment, TRICARE offers coverage.
Similar to PHPs, intensive outpatient programs (IOPs) are structured rehabs that allow clients to go home in the evenings and maintain a work or school schedule. They are less intensive than PHP, and the number of sessions is often less than PHP.
TRICARE rehab coverage may cover the cost of IOP, but it depends on your policy and the level of care needed for addiction treatment.
Choosing the right treatment facility for you might involve exploring rehabs that take TRICARE, whether in-network or out-of-network.
Some TRICARE plans, such as TRICARE Reserve Select, TRICARE Young Adult, and TRICARE Prime Remote, allow patients to opt to receive treatment from an out-of-network provider, but the costs are higher than using an in-network provider. Other plans require patients to use an in-network provider.
An in-network provider with TRICARE can offer you the least expensive coverage, as the rates negotiated between a provider and the insurance plan are usually the best possible value.
You may receive higher out-of-pocket costs with a non-network provider, but that may not always be the case.
If you receive care from a provider within the TRICARE network, your financial responsibility is limited to the portion of costs left after TRICARE covers the negotiated rate. However, opting for a non-network provider will result in higher out-of-pocket expenses.
There are payment options avaliable for addiction rehab. You can often arrange a payment plan with the provider to manage these costs.
It is best to talk to your insurance provider or an admissions member at Tree House Recovery, who can help you find the most cost-effective options for your needs.
To verify your TRICARE rehab coverage for Orange County addiction treatment, you must assess the best level of care for your needs. You can do this by speaking with a medical professional or calling a Tree House Recovery admissions team member.
Next, your verification of benefits (VOB) will need to be completed and submitted to see what your TRICARE insurance policy covers. After determining your eligibility for health insurance benefits for your current plan, you will better understand how much addiction treatment will cost out-of-pocket.
To begin the VOB process, you can either speak with our admissions specialist for addiction rehab in Costa Mesa, CA or complete our VOB web form. Your details will help us clarify your coverage, including deductible amounts, co-payments, co-insurance rates, and other key cost-related factors for addiction treatment.
Some TRICARE rehab plans (TRICARE Reserve Select, TRICARE Young Adult, and TRICARE Prime Remote) allow members to receive care from an out-of-network provider.
Still, the costs are usually higher than using in-network rehabs that accept TRICARE.
TRICARE-approved rehab facilities that are in-network will often cover most of the cost of care by your provider.
If you use rehabs that take TRICARE, you may only be responsible for covering the remaining costs after the insurance pays the providers the negotiated rate.
However, selecting out-of-network rehabs that accept TRICARE can result in higher out-of-pocket costs. The easiest way to determine your coverage and rehab cost is to speak with a TRICARE representative or a Tree House Recovery admissions team member to find the best value for you and your situation.
Choosing a drug rehab in Orange County is a big step toward taking your power back from addiction. That’s why Tree House Recovery is here to help you take those first steps toward the life you want to live by finding the best TRICARE rehab coverage your policy offers.
Call our admissions team today at (855) 202-2138 to verify your TRICARE coverage, or visit our admission page.
Substance Use Disorder Treatment. TRICARE. (2024, October 29). https://tricare.mil/CoveredServices/IsItCovered/SubstanceUseDisorderTreatment
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