TRICARE Insurance for Alcohol & Drug Rehab

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If you or a loved one is struggling with substance use and have TRICARE Insurance, you may be eligible for addiction treatment services in rehab.

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South Coast Behavioral Health’s specialty program for veterans and first responders offers an innovative approach to substance use disorder treatment.

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Navigating the complexities of healthcare and insurance can often feel like a daunting task, especially when seeking treatment for addiction. Fortunately, for military members and their families, TRICARE insurance provides a beacon of hope, offering comprehensive coverage tailored to meet the unique needs of those facing substance use disorders. 

At South Coast Behavioral Health, we seek to guide you through the process of utilizing TRICARE insurance for addiction treatment, shedding light on eligibility criteria, covered services, and how to embark on your journey towards recovery. With an emphasis on compassion and understanding, we’re here to help simplify the intricacies of accessing the care you deserve, ensuring that you or your loved ones receive the support necessary to overcome addiction.

What is TRICARE?

TRICARE, a government health insurance provider for active military members, retirees, and their family members, offers various plans suited to different needs and situations. One of these plans is TRICARE East, also known as Humana Military. This plan covers the eastern region of the United States. TRICARE West, on the other hand, provides insurance coverage for the western region of the United States.

For those who are eligible, TRICARE also offers additional benefits through TRICARE For Life (TFL). TFL is a Medicare wraparound plan that covers out-of-pocket expenses not covered by Medicare. This plan is specifically designed for military retirees and their spouses who are enrolled in both Medicare Parts A and B.

If you’re new to TRICARE or simply struggling to understand your benefits, it can be confusing to understand all the different options and what they cover. Our goal is to help simplify the intricacies of accessing the care you deserve. We understand that navigating through health insurance plans can be overwhelming, especially during a time when you or your loved one may be facing health challenges.

Understanding TRICARE Insurance Policies

Understanding TRICARE policies is the first step in leveraging this valuable resource for addiction treatment. TRICARE, a government health insurance provider for active military members, retirees, and their family members, offers various plans suited to different needs and situations. When it comes to addiction treatment, knowing which services are covered and how to access them can make all the difference in embarking on a successful recovery journey.

Prior to joining treatment, it’s imperative to determine your eligibility and understand which TRICARE plan you’re enrolled in. 

Currently, TRICARE offers the following health insurance plans:

To find out what your TRICARE plan covers, log into milConnect and click on the “Obtain Proof of Health Coverage” option. This is an important first step because your TRICARE policy will affect the type of treatments available to you.

What TRICARE Policies Cover Addiction Treatment?

In 2017, TRICARE started covering addiction recovery treatment. This includes things like alcohol use disorder and opioid use disorder. It also covers various issues that often co-occur with addiction, like PTSD.

The variety of treatments and extent of coverage depends on your TRICARE health insurance plan. For example, TRICARE Prime is a managed care option for active-duty military. For the insured or their beneficiaries, there are no copays or deductibles. On the other hand, TRICARE Select features both copays and deductibles. Therefore, it’s important to know which treatments your plan covers and to what extent.

Understanding your policy and benefits allows you to make informed decisions about your recovery path. If you would like help determining your TRICARE benefits for rehab, please contact our admissions team. They can assist with verifying your coverage, navigating the approval processes, and ensuring that you maximize your benefits while minimizing out-of-pocket costs.

TRICARE Referral for Rehab

To access rehab services, you may need a referral from your primary healthcare provider, especially if you’re under the TRICARE Prime plan. For those with TRICARE Select or other plans offering more flexibility, seeking out an approved provider is crucial without necessarily needing a referral. It’s essential to verify that the chosen facility or provider is authorized by TRICARE by consulting their online directory or contacting them directly.

TRICARE Pre-authorization for Rehab

Pre-authorization may be required for certain treatments or services, which means people often require approval from TRICARE before starting treatment to ensure coverage. Without receiving pre-authorization prior to treatment, people are often denied  coverage by their insurance policy.

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Looking for quality substance abuse treatment that’s also affordable? South Coast accepts most major insurance providers. Get a free insurance benefits check now.

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Rehab Programs Covered by TRICARE Insurance

For those who are eligible for TRICARE insurance and are struggling with addiction, it’s important to know that TRICARE offers coverage for rehab. This means that you or your loved ones can access the care needed to overcome addiction without having to pay exorbitant costs.

Depending on the specific policy, TRICARE may cover levels of care including detoxification, inpatient services, and outpatient programs as well as therapy sessions (individual, group, and family), medication-assisted treatment (MAT), and holistic treatment services.

TRICARE Coverage for Detoxification

Detoxification, or detox for short, is the process of clearing a substance from the body. This is usually in the context of someone ceasing all use of drugs or alcohol. The chemistry of the brain and body changes when an individual develops a substance dependence. Abruptly quitting alcohol without medical assistance can cause abnormalities in the body and brain, disturb fluid balance, cause seizures, or even cause death.

The medical care required to treat these withdrawal symptoms may be covered by TRICARE insurance.

TRICARE Coverage for Residential Treatment

TRICARE covers both emergency and non-emergency residential treatment. Emergency inpatient hospital stays are covered if you have an immediate medical emergency (ex: chest pain, slurred speech, seizures, etc). You’ll receive addiction treatment at the closest facility in your area.

To get TRICARE to approve your inpatient treatment, you’ll need to have a primary diagnosis of substance use disorder with symptoms or potential symptoms that are:

You’ll also need to get pre-authorization. This is when your regional coordinator approves your care. It needs to happen prior to the appointment.

After completing inpatient treatment, TRICARE will cover your stabilization.

TRICARE Coverage for Partial Hospitalization

TRICARE covers authorized partial hospitalization for mental health and substance use disorders.

You may qualify for partial hospitalization if you:

You’ll also need to get pre-authorization. This is when your regional coordinator approves your care. It needs to happen prior to the appointment.

TRICARE Coverage for Intensive Outpatient Treatment

Intensive outpatient treatment is when someone receives therapy in a nearby rehab facility on a part-time basis. A few hours of treatment and support are provided several days a week at this level of care. 

IOP, which focuses on relapse prevention and the incorporation of healthy habits into daily life, is appropriate for those who have a stable home environment and do not require round-the-clock supervision.

TRICARE will cover your IOP if: 

You may or may not need prior authorization to get TRICARE coverage for your IOP. Check with your regional contractor.

TRICARE Coverage for Medication-Assisted Treatment (MAT)

Sometimes, withdrawal symptoms need to be managed with special drugs. This is known as medication-assisted treatment (MAT). It’s often used in conjunction with residential treatment and mental health counseling.

TRICARE will cover MAT if the medications are FDA-approved.

FDA-approved drugs for treatment of alcoholism include:

FDA-approved drugs for the treatment of opioid use disorder include:

These drugs can be used to help with detoxing or for ongoing medical support, such as intensive outpatient treatment.

Using TRICARE for Mental Health Treatment

Mental health is an important aspect of overall wellness and it’s crucial for individuals to seek help when needed. TRICARE offers various options for mental health treatment, making it more accessible and affordable for those who are seeking help for mental illness.

Mental health issues covered by TRICARE include (but are not limited to):

TRICARE will cover the following options for mental health treatment:

Using TRICARE to pay for treatment provides veterans and their families with access to a network of qualified mental health providers. TRICARE has a network of mental health professionals who are trained and experienced in treating a wide range of mental health conditions. This ensures that you will receive quality care from knowledgeable clinicians.

We Are In-Network With Aetna, Anthem, & Cigna Health Insurance Plans

South Coast Behavioral Health is proudly an in-network provider of substance abuse and dual diagnosis treatment services for BlueCross BlueShield Anthem, Aetna, and Cigna health insurance plan members.

Aetna Insurance Logo- We accept Aetna Insurance Plans

We also accept most major insurance providers

Tricare insurance
Providence Health

If you are ready to recover, please reach out to speak with one of our admission coordinators.

Should I Use TRICARE Insurance for Rehab?

It’s important to note that seeking help for addiction and mental health concerns does not make someone weak or flawed. In fact, it takes courage and strength to recognize when one needs help and take steps towards improving their well-being. With TRICARE covering mental health treatment, there’s no reason to suffer in silence or feel ashamed.

If you or a family member is struggling with substance abuse, it’s important to seek help from a qualified and approved provider of TRICARE rehab services.  With TRICARE, you have access to affordable and effective treatment options that can help you on your journey toward recovery today. We encourage you to reach out to our team by calling 866-881-1184 for more information on our treatment services and locations in your area.

Verify Your TRICARE Coverage Now

If you don’t know what your TRICARE covers, we can help. To get started, simply fill out the insurance verification form available on our website. This form is your initial step toward peace of mind, as it allows us to gather the necessary information to verify your insurance coverage for addiction treatment services. 

By providing details such as your full name, date of birth, TRICARE member number, and contact information, you enable our dedicated team to conduct a thorough review of your coverage and get back to you with a clear understanding of the benefits available to you for rehab.

Finding a TRICARE Rehab Near Me in Orange County, California

South Coast Behavioral Health is a TRICARE rehab provider located in Orange County, California. We are proud to offer evidence-based treatment programs for substance abuse and mental health disorders specifically tailored to meet the needs of military service members, veterans, and their families.

Our substance use disorder treatment centers are located in several cities throughout Orange County, California including:

South Coast is honored to provide specialized treatment for veterans and first responders within each of our drug and alcohol rehabs in Orange County, CA. Our Valor Program provides personalized treatment founded on trauma-informed care.

At South Coast’s TRICARE approved rehab facilities, our clinicians understand the unique challenges faced by those who serve our country. Throughout our addiction treatment programming, we provide compassionate care and support throughout the recovery process.

During treatment, veterans gain access to a variety of vital addiction treatment services such as medication management, behavioral therapy, and addiction counseling.

In addition to traditional therapies, we also offer expressive arts therapy which allows clients to explore their feelings through creative outlets. This can be especially beneficial for veterans who have difficulty verbalizing their emotions.

We also provide dual diagnosis treatment for co-occurring mental health and substance abuse disorders, and medication-assisted treatment (MAT) for those struggling with addiction.

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TRICARE Insurance

Paying for Rehab with TRICARE

Remember, recovery is a journey that requires support on multiple fronts. By thoroughly understanding how to utilize your TRICARE insurance for addiction treatment, you are taking a significant step towards reclaiming control over your life and well-being.

South Coast Behavioral Health is here every step of the way to support you through this process with compassion and expertise. To learn more about our veterans rehab program or receive help in paying for rehab with TRICARE, reach out to us at (866) 881-1184.

If you or someone you know is struggling with addiction, please don’t hesitate to reach out to us.

We are here to help because we’ve been there.

The Treatment Experience at South Coast

What Our Alumni Have to Say

This place truly saved my life. I'll be forever grateful for the opportunity to get and stay sober here... Everyone was great. This experience definitely paved the way for a real future for me and for my son. Thank you.

J.C. Alumni of SCBH
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