TRICARE Drug & Alcohol Rehab Insurance Coverage

Many insurance providers, including TRICARE, will cover the costs of drug and alcohol rehab at The Recovery Village at Palmer Lake.

One of our most important objectives at The Recovery Village at Palmer Lake is making rehab as accessible as possible to as many people as possible. As part of that, we are in-network with most major insurance providers nationwide, including TRICARE.

TRICARE Insurance Overview

TRICARE is a health care program available to active-duty military members, their families and National Guard and Reserve members. Military retirees and their families, survivors and some former spouses of military members can also use TRICARE. TRICARE combines the Military Health System resources, like military hospitals, with a network of civilian providers.

TRICARE Health Plans

There are many different TRICARE health plans available, including:

• TRICARE Prime for active-duty military members. TRICARE Prime has fewer costs out-of-pocket than TRICARE Select, but there’s less freedom in the providers you can choose.
• TRICARE Prime Remote is available in remote areas of the country, and your home and work addresses must be at least 50 miles from a military clinic or hospital.
• TRICARE Prime Overseas is for active-duty service members, activated National Guard/Reserve members and command-sponsored family members of National Guard/Reserve members that are activated. It’s a managed care option available overseas.
• TRICARE Prime Remote Overseas is available in certain remote overseas locations, including Eurasia-Africa, Latin America, Canada and part of the Pacific regions.
• TRICARE Select is a self-managed preferred provider organization (PPO) plan available in the U.S. It’s open to active-duty family members, retired service members, their families and other groups.
• TRICARE Select Overseas provides comprehensive coverage to retired and active-duty military members in all overseas areas.
• TRICARE For Life is Medicare wraparound coverage if you have Part A or B, available regardless of age or where you live.
• TRICARE Reserve Select is a premium-based plan available worldwide for qualified members of Selected Reserve and their families.
• TRICARE Retired Reserve is premium-based for qualified retired Select Reserve members and their families.
• TRICARE Young Adult can be purchased for qualified adult children after regular TRICARE eligibility ends.
• TRICARE Plus is a primary care program at certain military clinics and hospitals.
• The U.S. Family Health Plan is an additional option through the TRICARE program available if you live in certain designated areas of the U.S.

TriWest vs. TRICARE vs. VA Benefits

TRICARE is the U.S. Department of Defense Military Health Care System health care program. TriWest is a third-party administrator for the Community Care programs available by the Department of Veterans Affairs (VA). Typically, veterans would receive care through the VA medical facility network. When they can’t, the VA might rely on community providers for veterans, which is when TriWest becomes relevant. Veterans can otherwise receive care through the VA when enrolled in healthcare through the Department.

Does TRICARE Cover Drug and Alcohol Rehab?

TRICARE health plans meet essential requirements for coverage that the Affordable Care Act outlines. Among the 10 essential health benefits that insurers must cover is addiction treatment for drugs and alcohol. While each person is unique and their treatment plan is as well, some of the specific addiction care TRICARE may cover include detoxification, inpatient rehab and outpatient treatment.

Does TRICARE Cover Medical Detox?

Detox can be an important step toward recovery. Some substances, including alcohol, can cause severe withdrawal symptoms and require medical monitoring for comfort and safety. While a medically supervised detox can be needed, it’s not a replacement for comprehensive addiction treatment. TRICARE will often cover medical detox programs, depending on your plan specifics and where you go for treatment.

Does TRICARE Cover Inpatient Rehab?

Inpatient rehab is residential, so you live onsite for a period of time while receiving addiction treatment. An inpatient program is an important way to step away from your environment of substance misuse and focus entirely on healing and recovery. TRICARE will typically cover at least a portion of the costs of an inpatient rehab program.

Does TRICARE Cover Outpatient Rehab?

Outpatient rehab can vary a lot in terms of the time commitment, intensity and the types of treatments used. Outpatient programs offer flexibility and are often a step down after someone completes a residential program. TRICARE covers many types of outpatient rehab based on your plan and coverage level, specific medical needs and where you receive treatment.

Does TRICARE Cover Therapy & Mental Health Services?

Therapy and mental health services are a critical part of addiction recovery. Many people with a substance use disorder have a co-occurring mental health disorder requiring treatment. As with rehab programs, mental health services are an essential health benefit under the Affordable Care Act. There are various types of therapy and mental health services likely to be covered if you have TRICARE insurance, including cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) therapy that helps heal trauma.

Does TRICARE Cover Medication-Assisted Treatment (MAT)?

While behavioral therapy and counseling are foundational to addiction treatment programs, some people also benefit from medications. Medication-assisted treatment, or MAT, incorporates approved medicines to help reduce substance cravings and withdrawal side effects, improving recovery outcomes. Some medicines are covered by TRICARE that fall under the umbrella of MAT, including Suboxone.

Do Addiction Treatment Centers Need To Be In-Network?

In most situations, TRICARE will provide full coverage for providers with the insurer’s approval. In-network providers will have a set pricing agreement with TRICARE that determines how the cost of addiction treatment services is billed. If you get in-network treatment, you only have a small out-of-pocket responsibility compared to going out-of-network. Certain TRICARE plans allow out-of-network providers, including: 

• Select
• Reserve Select
• Retired Reserve
• Young Adult Select
• Family Health
• Prime Remote 

If you choose an out-of-network rehab center, even with these plans, you might still have to pay a greater percentage of the care costs.

Colorado Rehab That Accepts TRICARE

If you are looking for rehab for yourself or someone you love, The Recovery Village at Palmer Lake accepts TRICARE insurance. You can contact TRICARE directly to learn more about the details of your coverage, or one of our Recovery Advocates can help. You can also complete our insurance verification form to learn about what’s covered and your out-of-pocket expenses.

Contact our Recovery Advocates today if it’s time to take a step toward recovery.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more