Uniformed military service members and their family members are usually covered under the TRICARE insurance coverage option. They may serve in any branch of the armed forces to use this medical coverage. People who are covered under TRICARE may receive multiple medical, dental, and other health benefits through their military service or if they are family members of people who are serving in the military.
Learning more about TRICARE, how it helps, and what it covers ensures that you make an informed decision regarding its substance abuse assistance. It may help you learn more about coverage of TRICARE for drug rehabs as well as any other medical coverage the program provides.
What Is TRICARE?
TRICARE is health coverage for members of the United States military. The program offers numerous healthcare plans and coverage options to different members of the military. Such options provide an expansive list of coverages that depend on individual members and what they need.
Some TRICARE offerings include:
- Prescription coverage
- Medical coverage
- Dental coverage
- Special programs
This program was developed to provide the coverage to those who are serving the United States and require medical, dental, and prescription coverage and types of health care.
What Health Plans Are Available Through TRICARE?
As with other medical insurance plans, there are many options available to those that have TRICARE coverage. All of the plans available either meet or exceed the standards established by the American Care Act (ACA) to ensure that people have the quality health insurance options they require.
While each plan has a comprehensive list of what it covers and what it does not cover, there are essentially eight different programs available:
- TRICARE Prime – Available in specific geographical locations that are considered prime locations
- TRICARE Prime Remote – Available in more remote areas in the United States as well as some overseas areas
- TRICARE Standard and Extra – This requires a fee to use and it does not require members to enroll to receive its service
- TRICARE Standard Overseas – Comprehensive coverage for people serving overseas
- TRICARE for Life – Medicare coverage option to provide additional help for people who have Medicare Part A and B
- TRICARE Reserve Select – Covers qualified reserve service members and family members
- TRICARE Retired Reserve – A plan for retired reserve members and their families
- TRICARE Young Adult – A plan for young adult children who do not qualify for other TRICARE coverage
Individuals’ coverage will depend on the nature of their service and their qualifications.
There are also three different regional divisions of TRICARE. The regional divisions aim to provide better and more comprehensive insurance coverage to those using the TRICARE program, and each is affiliated with a different insurance company plan:
- TRICARE East – Humana Military
- TRICARE West – Health Net
- TRICARE Overseas – International SOS
How to Check for TRICARE Coverage
Check your eligibility for TRICARE coverage through the branch of military that you or a family member serve. You may verify your coverage through the specific branch office through the branch representative. This verification may help you determine which TRICARE services are available to you and your family members.
It is important to ask about substance abuse treatment options and availability. If you have a TRICARE membership card, you may call a number on the back of the card to learn more about coverage options and the availability of specific plans.
Also remember that some services may require prior authorization from your physician. This process is also known as preauthorization or precertification. Without prior authorization, treatment may be denied if it is not considered medically necessary or if the need is not great enough. This decision can be made at the discretion of TRICARE. As part of the intake process of any treatment facility, staff members at the facility will check your coverage availability and let you know what is covered and what is not covered under the specific TRICARE coverage you have.
Other medical coverage may also provide substance abuse assistance for those who are struggling to overcome their addiction. It is best to ask your specific insurance company if it covers the costs of substance abuse treatment options. Finding help, regardless of coverage type, is important for everyone. You may want to ask about financing. People should not be denied treatment just because they cannot pay.
It is important to speak with treatment centers to learn more about payment options and plans available. We have professionals that can speak with you about this and ways to check for coverage availability if you need substance abuse assistance.
What Does TRICARE Cover Regarding Substance Abuse?
According to the terms of the Afforable Care Act (ACA) , insurance companies are required to provide coverage for a variety of mental health issues. Substance abuse is one of those conditions. TRICARE for drug rehabs is something that can be used in approved treatment centers.
Some of the substance abuse coverage options are outlined below:
Treatment and assessments for the most effective substance abuse treatments are covered under TRICARE. This includes psychological or physical assessments or exams that are required to obtain necessary treatment assistance.
- Certain medication-assisted treatments (MATs) for substance abuse are covered under TRICARE for those that are suffering from opiate addictions.
- Residential treatment options are covered for people who require inpatient services. Certain stipulations state whether people receive this type of coverage, including if they have been classified as having particular types of addiction or if they require immediate medical attention due to addiction.
- Partial hospitalization services may also be covered if the person requires help to function normally, medical detox is required, the person requires stabilization, or the person does not require 24-hour supervision.
- Withdrawal management treatment is often provided to people who require this type of help with different addictions and in different addiction situations. This treatment is also known as medical detox and it is usually performed in medical facilities for safety purposes.
- Different types of emergency medical substance abuse help are covered for individuals who require the help from medical facilities for their substance addiction. Many types of detox, stabilization, and medical emergency facility assistance are covered under the coverage options provided through TRICARE.
TRICARE for drug rehabs is a valuable resource. The program provides substantial coverage to people who are dealing with substance abuse issues.
TRICARE does not cover substance abuse treatments such as:
- Behavioral health services
- Specific therapy services
- Sexual dysfunction therapy
- Treatments for developmental disorders
- Aversion therapy
- Unproven treatments
- Treatments deemed not medically necessary
It is important that people with this medical coverage know that not everything is approved for services. Only those medically necessary services are provided, and some of them may not be approved based on the tests and other diagnostic tools used to determine elegibility and treatment plans. Such assessments are often performed in physicians’ offices or other health care facilities.
TRICARE for substance abuse is a comprehensive coverage plan. Since many substance abuse issues are arising across the country, having this coverage is important. Many people may obtain the help they need to overcome the addictions they fight. The Affordable Care Act ensured that drug and alcohol addiction had coverage options available for people who face those conditions.