Drug Rehab & Detox Coverage from Tricare Insurance
Tricare is the federal health benefits and insurance program for the Department of Defense and the Military. Tricare coverage is generally for active members of the armed forces and their family members.
Tricare insurance covers a number of services related to substance use disorder, which may be more commonly referred to as addiction. The services listed here are meant to be for general information only. For information about what is covered in a specific situation, refer to the policy language or contact the company directly.
Addiction Services Covered by Tricare
The following services may be covered by Tricare. There typically aren’t benefits for the cost of aversion therapy, halfway houses or sober living facilities.
• Emergency Inpatient Services
Tricare will pay for emergency inpatient hospital care for detoxification and stabilization. The company will also pay for services relating to medical complications resulting from substance abuse or a mental health disorder.
Detoxification for substance abuse is covered through emergency inpatient services (listed above), a residential treatment facility or a partial hospitalization program.
• Partial Hospitalization Program
If you have a substance abuse problem that allows you to function, with support in some of the major areas of your life and you don’t need to be hospitalized on a full-time basis, Tricare will cover the cost of a partial hospitalization program.
You may be approved for this type of treatment if you
- Need detoxification services as well as alcohol or drug counseling services
- Require longer treatment sessions than intensive outpatient addiction treatment can provide
- Need some medical support but are well enough to return home each evening
- Have acute medical symptoms which require medical treatment
- Residential Treatment Facility Program
If you have been diagnosed with a severe substance abuse disorder, you may be approved to receive treatment at a residential facility. The company will consider whether your symptoms are severe enough to be treated in a residential treatment program. It will also look at whether your condition needs to be monitored on a 24-hour basis and whether you have difficulty functioning in several major area of your life
• Medication Assisted Treatment
This type of treatment combines mental health and drug therapies. To qualify, you must have been diagnosed with an opioid use disorder.
• Mental Health Therapy Services
Tricare Insurance covers a number of therapy services for people being treated for substance abuse, including:
This category includes individual and group counseling sessions. Family sessions are also covered under Tricare Insurance plans.
• Psychological Assessment and Testing
Where an assessment is needed to diagnose a patient and develop a treatment plan, the insurance company will cover the cost of this service.
• Ancillary Therapies
These forms of therapy include occupational, music and dance. The insurance company will only cover them when they are being provided as part of a treatment plan offered in a residential treatment facility or a partial hospital program.
Tricare Insurance offers a generous level of substance abuse disorder coverage. Before making arrangements to enter any type of treatment program, be sure to check with the company to confirm your coverage and your policy limits.