According to Psychology Today, an American general-interest psychology magazine, more than 22 million Americans have a substance abuse problem of some kind. Of those, many are military veterans who have proudly served our country. To further put this into context, 1 in 10 soldiers who served in Afghanistan and Iraq are currently struggling with either drugs or alcohol, according to the U.S. Department of Veterans Affairs. Fortunately, TRICARE can help many of these individuals get their lives back on track. For those who may not be familiar with TRICARE, it is a health insurance plan that is available to current and former military personnel as well as their families. Along with traditional health coverage, Tricare also provides coverage for addiction treatment.
WHAT TYPE OF ADDICTION TREATMENT IS AVAILABLE UNDER TRICARE?
When it comes to addiction treatment services, TRICARE covers many of the same services covered by traditional health insurance, including alcohol rehab, inpatient and outpatient rehab, coverage for sober living houses, and much more. One thing to note, however, is that there may be eligibility restrictions associated with different levels of coverage under TRICARE insurance. Nonetheless, this military insurance is designed to ensure that all military members and their families have access to the care they need to overcome their addiction to drugs or alcohol. That said, let’s take a closer look at some of the treatments covered under TRICARE insurance:
Alcohol rehab – Because many current and former military members are prone to alcoholism, TRICARE insurance covers alcohol rehab programs for those who are ready to begin their journey toward achieving sobriety. Like traditional insurance, TRICARE covers the costs associated with medically-assisted detox, which is a form of treatment used to help lessen the severe withdrawal symptoms that come with alcohol cessation. These plans may also cover counseling sessions with a substance abuse counselor. However, there is a caveat; individuals must be enrolled in an approved inpatient or outpatient facility for these treatments to be covered.
Inpatient rehab – If urgent emergency inpatient care is needed, those treatments will only be covered if an individual is experiencing a medical or psychiatric emergency that requires hospitalization. Non-urgent inpatient rehab is also covered under TRICARE; however, those in need of this type of inpatient treatment will be responsible for finding an approved treatment facility on their own and admitting themselves into that facility.
Intensive outpatient rehab – Like inpatient rehab, TRICARE also covers intensive outpatient rehab; however, there is a caveat in that patients must be struggling with an active addiction that does not require around-the-clock treatment. Also, coverage may be contingent upon patients receiving prior authorization from TRICARE before they can receive the care that they need. That said, TRICARE covers intensive outpatient rehab for those struggling with co-occurring disorders as well as those who are transitioning from an inpatient program.
Sober living houses – Although detox and aftercare are two of the most critical steps in overcoming one’s addiction to drugs or alcohol, they are only the first steps towards achieving long-term sobriety. As such, TRICARE also covers the costs associated with staying at a sober living house, which can help individuals make a successful transition back to the “real” world. To qualify for this coverage, an individual must complete detox and maintain their sobriety while residing in a sober living house.
COVERAGE FOR MEDICALLY-ASSISTED DETOX
Medically-assisted detox is not limited to those trying to overcome an addiction to alcohol. These programs are also available to those who are ready to end their addiction to opioids as well. Medically-assisted detox encompasses both prescription-based medications to help patients cope with severe withdrawal symptoms as well as access to substance abuse counselors who work with patients to help them maintain their sobriety long-term. Like many of the other programs covered under TRICARE insurance, medically-assisted detox may require prior authorization before patients can begin receiving treatment.
HOW TO GET REHAB TREATMENTS COVERED UNDER TRICARE
Most of the substance abuse treatments covered under TRICARE will require individuals to receive prior authorization and be treated at an approved in-network rehab facility. After all, these facilities have agreed to the fee schedule put in place by TRICARE, which makes billing for services rendered a much easier process. Of course, this is not to suggest that patients are not allowed to seek treatment with an out-of-network rehab facility, but they will be responsible for any out-of-network costs associated with those treatments.