Using TRICARE for Drug and Alcohol Treatment
TRICARE is a health benefit for veterans that offers detox and rehab coverage. Learn how to use your TRICARE benefits for detox and rehab here.
Takeaways from this article:
Types of TRICARE plans for veterans
How to check your TRICARE benefits
How to find treatment centers that accept TRICARE
Does TRICARE Cover Detox and Rehab?
TRICARE is a health benefit for active duty and retired service members and their families.1 It covers a wide range of substance use treatment services.2 Depending on your needs, these can include:2–7
- Detox to manage your withdrawal symptoms. Detox is often the first step in treating a substance use disorder (SUD).
- Inpatient treatment, where you stay at a treatment center for the length of treatment.
- Outpatient treatment, where you visit a clinic or office for treatment at set times and go home at night. This can include standard outpatient, partial hospitalization (PHP), or intensive outpatient (IOP).
- Medication-assisted treatment combines medicine and behavioral therapy to treat SUDs.
How to Check Your TRICARE Substance Abuse Benefits
There are three easy ways to check if TRICARE covers drug and alcohol treatment. Options include:
- Log into the web portal.
- Call the number on the back of your card. If you don’t have a card, you can find this number on the TRICARE website.
- Call the treatment center. Most detox and rehab centers can tell you more about your insurance benefits.
How to Use TRICARE for Drug and Alcohol Treatment
If you are a veteran and want to seek treatment, you may not know where to start. Often, the first step is to talk to your doctor. They can help you figure out what type of treatment will fit your needs.
Depending on your needs and the type of treatment you choose, you may need to get a special approval before starting treatment.8 This is called a prior authorization. Your doctor can fill out this paperwork for you.
You’ll also want to talk to the detox or rehab center before starting treatment to make sure you know what is and isn’t covered. Depending on your TRICARE plan, you may still have to pay for part of your treatment. This is called out-of-pocket costs. If you have trouble paying this, some places offer scholarships, grants, or sliding scale fees based on your income. Veterans Affairs (VA) centers may also be able to offer you treatment at veterans’ rehab centers for reduced or no cost.13
TRICARE Inpatient Coverage
If you are having an emergency, you do not need to get prior authorization before going to the nearest hospital.4,8 This also applies to substance use or mental health emergencies, such as life-threatening withdrawal symptoms or suicidal thoughts.4,8 But in non-emergency situations, such as going to inpatient rehab, your doctor may need to complete a TRICARE inpatient authorization form before you start treatment.8
How to Find TRICARE Covered Rehab Facilities
Finding in-network TRICARE drug and alcohol treatment is easier than you think. More than 400,000 providers accept some form of TRICARE, including American Addiction Centers (AAC).14 You can use TRICARE’s online Find a Doctor Wizard to find an in-network treatment center, or call TRICARE customer service. If your first choice isn’t covered, there are many more options to choose from, so don’t give up hope for getting treatment that you can afford.
Does TRICARE Cover Out-of-Network Providers?
TRICARE may offer some out-of-network coverage benefits, depending on which plan you have.9–12 But in general, costs less to attend treatment with an in-network provider.9,10 It is important to know what your plan will and won’t cover before starting treatment so that you can get the most out of your plan.
Are there Special Veterans Rehab Facilities?
There are some in-network TRICARE treatment centers that focus on veterans and their unique recovery needs. One of these centers is Desert Hope Treatment Center, an AAC detox and rehab center in Las Vegas, Nevada. Desert Hope offers a program called Salute to Recovery that addresses SUDs as well as issues such as trauma, mental health issues, anger management, family and couples counseling, pain management, grief and loss, and peer support from other veterans in recovery.
Types of TRICARE Plans
TRICARE offers many different plans for active service members, veterans, and their family members. These include:9–12,15
- TRICARE Prime. In this plan, you choose a primary care provider (PCP) who will refer you to a specialist as needed. Benefits of this plan include low out-of-pocket costs.
- TRICARE Select is similar to TRICARE Prime, but you have more options in who you see and often don’t need referrals. But you may pay higher costs and some services still need prior authorization.
- TRICARE for Life is a program for people who have Medicare Part A (hospital coverage) and Part B (medical coverage). Benefits of this plan include very low out-of-pocket costs and a wide choice of doctors.
- US Family Health Plan offers coverage through networks of non-profit community care systems in some regions of the United States. A PCP will offer all treatment and coordinate referrals to specialists. Benefits of this plan include paying less out-of-pocket and the convenience of getting all your care through one local community system.
Check Your TRICARE Coverage Now
It’s easy to verify your insurance coverage for SUD treatment. Fill out the free and private form below and we’ll send you the results.