Tricare Insurance Benefits for Addiction Treatment

Author: Robert Rynfield | Clinical Reviewer: Emily Meyers, LPC | Editorial Policy Updated: June 14, 2024

Longbranch Recovery is a Leading Rehab Center Accepting Tricare Insurance

Are you or a loved one struggling with addiction while serving in the military or as a veteran? You’re not alone. Substance abuse is a prevalent issue among active-duty personnel and veterans, with many facing unique challenges that can make seeking help feel overwhelming. But there is hope. Tricare, the health insurance provider for the U.S. military, offers coverage for addiction treatment, ensuring that you can access the care you need to overcome substance abuse and reclaim your life.

What is Tricare and How Does it Work with Rehab Centers?

Tricare is a comprehensive health insurance program designed to serve active-duty military members, veterans, and their families. It provides coverage for a wide range of medical services, including mental health and addiction treatment. When it comes to rehab centers, Tricare works closely with approved facilities to ensure that beneficiaries receive the highest quality care possible.

Tricare-approved rehab centers, like Longbranch Recovery, meet strict standards for treatment excellence and are staffed by experienced professionals who understand the unique needs of military personnel and veterans. These facilities work hand in hand with Tricare to provide covered services, making the process of seeking addiction treatment more accessible and affordable for beneficiaries.

Types of Tricare Insurance Plans

Tricare offers several insurance plans to meet the diverse needs of its beneficiaries. The main plans include:

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  • Tricare Prime: A managed care option that provides comprehensive coverage with low out-of-pocket costs.
  • Tricare Select: A fee-for-service plan that allows beneficiaries to choose their own healthcare providers.
  • Tricare Reserve Select: A plan designed for members of the Selected Reserve and their families.
  • Tricare for Life: A plan that provides coverage for Medicare-eligible beneficiaries.

Each plan has its own set of benefits, deductibles, and copayments, so it’s essential to understand your specific coverage when seeking addiction treatment.

Eligibility Requirements for Tricare Coverage

To be eligible for Tricare coverage, you must be one of the following:

  • An active-duty service member
  • A retired service member
  • A National Guard or Reserve member
  • An immediate family member or dependent of an eligible service member
  • A survivor of a deceased service member

If you meet one of these criteria, you may be eligible for Tricare coverage for addiction treatment. It’s crucial to verify your benefits with Tricare directly or with the help of a Tricare-approved rehab center like Longbranch Recovery to ensure that you have a clear understanding of your coverage.

Substance Abuse Treatments Covered by Tricare

When you’re ready to take the first step towards recovery, it’s essential to know that Tricare is there to support you. Tricare insurance covers a wide range of substance abuse treatments, ensuring that you have access to the care you need to overcome addiction and build a foundation for lasting recovery.

How Tricare Covers Drug and Alcohol Rehab

Tricare recognizes that addiction is a complex disease that requires comprehensive treatment. As such, the insurance provider covers various levels of care for drug and alcohol rehab, including:

  • Inpatient rehab: Intensive, residential treatment where you live at the facility and receive round-the-clock care and support.
  • Outpatient rehab: Less intensive treatment that allows you to live at home while attending therapy sessions and support groups at a rehab center.
  • Partial hospitalization programs (PHP): A structured, day treatment program that offers a higher level of care than outpatient rehab but allows you to return home in the evenings.

The specific coverage for each level of care may vary depending on your Tricare plan and individual circumstances. However, Tricare generally covers medically necessary services, such as detoxification, therapy, and medication-assisted treatment, when provided by a Tricare-approved rehab center like Longbranch Recovery.

Does Tricare Cover Drug and Alcohol Detox?

Detoxification is a critical first step in the addiction recovery process, as it helps your body safely eliminate drugs or alcohol from your system. Tricare understands the importance of detox and offers coverage for medically supervised detox services.

If you require detox as part of your addiction treatment plan, Tricare will typically cover the following:

  • Medical monitoring and support during the detox process
  • Medications to help manage withdrawal symptoms and cravings
  • Nutritional support and hydration
  • Transition planning to help you move seamlessly into the next phase of your treatment

It’s important to note that detox alone is rarely sufficient for achieving long-term recovery. Tricare encourages beneficiaries to continue with a comprehensive rehab program after completing detox to address the underlying causes of addiction and develop the skills necessary for lasting sobriety.

Tricare Coverage for Co-Occurring Disorders

Addiction rarely occurs in isolation. Many individuals struggling with substance abuse also face mental health challenges, such as depression, anxiety, or post-traumatic stress disorder (PTSD). These co-occurring disorders can complicate the recovery process, making it essential to address both issues simultaneously. 

Fortunately, Tricare recognizes the importance of treating co-occurring disorders and provides coverage for comprehensive, integrated care.

What Are Co-Occurring Disorders?

Co-occurring disorders, also known as dual diagnosis, refer to the presence of both a substance use disorder and a mental health condition in an individual. For example, someone may struggle with alcohol addiction and depression, or opioid dependence and PTSD. 

These disorders often interact with and exacerbate one another, creating a complex web of challenges that can be difficult to untangle without professional help.

Common Co-Occurring Disorders Among Military Personnel and Veterans

Military service members and veterans face unique stressors that can contribute to the development of both substance abuse and mental health disorders. Some of the most common co-occurring disorders among this population include:

  • PTSD and substance abuse: Exposure to traumatic events during military service can lead to PTSD, which may drive individuals to use drugs or alcohol as a coping mechanism.
  • Depression and alcohol addiction: The challenges of military life, such as extended deployments and separation from loved ones, can contribute to depression, which may be exacerbated by excessive alcohol use.
  • Anxiety disorders and prescription drug abuse: The high-stress environment of military service can trigger anxiety disorders, leading some individuals to misuse prescription medications in an attempt to manage their symptoms.

Tricare-approved rehab centers like Longbranch Recovery are well-equipped to handle the unique needs of military personnel and veterans with co-occurring disorders, offering specialized programs that address both addiction and mental health concerns.

Does Tricare Insurance Cover Mental Health Treatment?

Yes, Tricare insurance provides coverage for mental health treatment, including services related to co-occurring disorders. When you seek addiction treatment at a Tricare-approved rehab center, your coverage will typically include:

  • Mental health assessments and evaluations
  • Individual and group therapy sessions
  • Medication management for mental health conditions
  • Family therapy and support services
  • Aftercare planning to ensure continuity of care for both addiction and mental health needs

By addressing co-occurring disorders in an integrated manner, Tricare aims to provide beneficiaries with the comprehensive support they need to achieve lasting recovery and improved overall well-being.

Inpatient Rehab at a Tricare-Approved Treatment Center

When addiction has taken a significant toll on your life, inpatient rehab at a Tricare-approved treatment center can provide the intensive, focused care you need to break free from substance abuse and build a strong foundation for recovery. These residential programs offer a safe, supportive environment where you can fully dedicate yourself to the healing process, away from the stressors and triggers of everyday life.

The Difference Between Inpatient and Outpatient Programs

Inpatient rehab, also known as residential treatment, involves living at the rehab center for the duration of your program. This immersive approach allows you to receive round-the-clock care and support from a team of addiction specialists, including medical professionals, therapists, and peer support staff. Inpatient programs typically offer a structured daily schedule filled with therapy sessions, group meetings, and other healing activities.

In contrast, outpatient programs allow you to live at home while attending treatment sessions at the rehab center on a regular basis. While outpatient care can be effective for individuals with less severe addictions or strong support systems, inpatient rehab is often recommended for those with long-standing or complex addiction issues, co-occurring disorders, or a history of relapse.

Specialized Addiction Treatment Programs at Tricare-Approved Rehab Centers

Tricare-approved rehab centers like Longbranch Recovery offer a range of specialized addiction treatment programs designed to meet the unique needs of military personnel, veterans, and their families. These programs may include:

family contemplating the sunset
  • Trauma-informed care: Many individuals struggling with addiction have experienced traumatic events, whether related to their military service or other life experiences. Trauma-informed care recognizes the impact of trauma and provides a safe, supportive environment for healing.                                         
  • Evidence-based therapies: Tricare-approved rehab centers employ a variety of evidence-based therapies, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR), to help individuals develop coping skills and address the root causes of their addiction.
  • Holistic approaches: Complementary therapies, such as mindfulness meditation, yoga, art therapy, and equine-assisted therapy, can enhance the recovery process by promoting stress reduction, self-awareness, and emotional regulation.

Tricare Coverage for Medically Assisted Treatment (MAT) in Inpatient Rehab

Medically Assisted Treatment (MAT) is an evidence-based approach that combines medication with behavioral therapies to treat substance use disorders. Tricare recognizes the effectiveness of MAT and provides coverage for these services within inpatient rehab programs.

Common medications used in MAT include:

  • Buprenorphine and methadone for opioid addiction
  • Naltrexone for alcohol and opioid addiction
  • Acamprosate and disulfiram for alcohol addiction

When combined with the comprehensive support of an inpatient rehab program, MAT can help individuals manage withdrawal symptoms, reduce cravings, and focus on building the skills and strategies necessary for long-term recovery.

Outpatient Rehab Options with Tricare Insurance

For some individuals, outpatient rehab may be a more suitable option for addiction treatment due to work, family, or other personal obligations. Tricare insurance understands the need for flexibility and provides coverage for a range of outpatient rehab programs, ensuring that beneficiaries can access the care they need in a way that fits their lifestyle.

Intensive Outpatient Programs (IOP) Covered by Tricare

United States flag waving

Intensive Outpatient Programs (IOP) offer a structured, concentrated approach to addiction treatment while allowing participants to live at home and maintain their daily responsibilities. Tricare covers IOP services, which typically include:

  • Group therapy sessions focused on addiction education, coping skills development, and relapse prevention
  • Individual therapy to address personal challenges and co-occurring mental health concerns
  • Family therapy to help rebuild relationships and create a supportive home environment
  • Drug screenings to ensure accountability and monitor progress

IOPs usually require a significant time commitment, with participants attending treatment sessions several times a week for a few hours each day. This intensive approach provides a strong support system and helps individuals build a solid foundation for ongoing recovery.

Partial Hospitalization Programs (PHP) and Tricare Coverage

Partial Hospitalization Programs (PHP) offer a higher level of care than IOPs but still allow participants to return home in the evenings. Tricare provides coverage for PHP services, which are designed for individuals who need more structure and support than an IOP can provide but do not require 24-hour residential care.

PHPs typically involve:

  • Full-day treatment programming, often five to seven days a week
  • Comprehensive assessments and individualized treatment planning
  • Intensive group and individual therapy sessions
  • Medication management and monitoring
  • Skill-building workshops and psychoeducational classes

The goal of a PHP is to help participants stabilize their condition, develop essential coping skills, and prepare for a step-down to less intensive outpatient care or a successful transition back to independent living.

Length of Stay and Continuum of Care in Tricare-Approved Rehab Centers

When considering addiction treatment, it’s important to understand that recovery is a journey, not a one-time event. Tricare recognizes the importance of a comprehensive continuum of care, providing coverage for varying lengths of stay in rehab and supporting individuals as they transition between levels of care.

How Long Does Tricare Cover Rehab?

The length of time that Tricare covers rehab depends on several factors, including the severity of the addiction, the presence of co-occurring disorders, and the individual’s progress in treatment. In general, Tricare will cover medically necessary services for as long as they are deemed appropriate by the treatment team.

Some common lengths of stay in Tricare-approved rehab centers include:

  • 30-day programs: These short-term programs are designed to provide intensive treatment and help individuals establish a strong foundation for ongoing recovery.
  • 60-day programs: Longer programs allow for more in-depth exploration of underlying issues, skill-building, and relapse prevention planning.
  • 90-day programs: Extended stays in rehab can be beneficial for those with severe or long-standing addictions, as well as those with complex co-occurring disorders.

Ultimately, the most appropriate length of stay will be determined by the individual’s unique needs and progress in treatment. Tricare works closely with rehab centers like Longbranch Recovery to ensure that beneficiaries receive the care they need for as long as necessary to achieve lasting recovery.

Transitioning from Inpatient to Outpatient Care with Tricare

As individuals progress in their recovery, they may step down from inpatient rehab to less intensive outpatient programs. This transition is an essential part of the continuum of care, allowing individuals to gradually reintegrate into their daily lives while still receiving ongoing support and guidance.

Tricare covers a range of outpatient services to support this transition, including:

  • Intensive Outpatient Programs (IOP) for those who need a structured, concentrated approach to ongoing care
  • Partial Hospitalization Programs (PHP) for individuals who require more support than an IOP but are not in need of 24-hour residential care
  • Individual and group therapy sessions to address ongoing challenges and reinforce coping skills
  • Medication management and monitoring to ensure continued stability and progress

By providing coverage for a seamless transition between levels of care, Tricare empowers beneficiaries to maintain their hard-earned progress and continue building a strong, sustainable recovery.

Tricare In-Network vs. Out-of-Network Rehab Centers

When seeking addiction treatment with Tricare insurance, it’s essential to understand the difference between in-network and out-of-network rehab centers. Choosing an in-network provider like Longbranch Recovery can help ensure that you receive the maximum coverage available under your plan, minimizing your out-of-pocket expenses and streamlining the admissions process.

Do Treatment Centers Need to Be In-Network with Tricare?

While it is not strictly necessary for treatment centers to be in-network with Tricare, choosing an in-network provider offers several significant advantages:

  1. Lower out-of-pocket costs: In-network rehab centers have pre-negotiated rates with Tricare, which means you’ll typically pay less for your treatment than you would at an out-of-network facility.
  2. Simplified billing and claims process: When you choose an in-network provider, the rehab center will handle most of the insurance paperwork and claims filing on your behalf, reducing the administrative burden on you and your family.
  3. Assurance of quality care: Tricare carefully vets its in-network providers to ensure they meet strict standards for quality, safety, and effectiveness. By selecting an in-network rehab center, you can be confident that you’ll receive evidence-based, high-quality care.

Does Tricare Insurance Offer Out-of-Network Benefits?

man smoking a cigarrete

In some cases, Tricare does offer out-of-network benefits, allowing beneficiaries to receive coverage for addiction treatment at non-contracted rehab centers. However, it’s important to note that out-of-network care typically comes with higher out-of-pocket costs and more complex billing processes.

If you choose to seek treatment at an out-of-network rehab center, you may be responsible for:

  • Higher deductibles and copayments
  • A larger percentage of the total treatment costs
  • Submitting your own insurance claims and paperwork

Before opting for out-of-network care, it’s crucial to carefully review your Tricare plan’s specific out-of-network benefits and consider the potential financial implications. In many cases, choosing an in-network provider like Longbranch Recovery can provide a more streamlined, cost-effective path to high-quality addiction treatment.

Steps to Seek Addiction Treatment with Tricare Coverage

Taking the first step towards addiction recovery can be daunting, but understanding the process of seeking treatment with Tricare coverage can help you feel more prepared and empowered. By following these key steps, you can begin your journey to a healthier, more fulfilling life with the support of Tricare and a trusted rehab center like Longbranch Recovery.

Verifying Your Tricare Benefits for Rehab

Before beginning the admissions process, it’s essential to verify your Tricare benefits and understand the specific coverage available for addiction treatment. You can do this by:

  1. Contacting Tricare directly: Reach out to your regional Tricare contractor to ask about your plan’s coverage for inpatient and outpatient rehab, as well as any pre-authorization requirements or out-of-pocket expenses you should expect.
  2. Consulting with a Tricare-approved rehab center: Many in-network providers, such as Longbranch Recovery, have experienced admissions staff who can help you navigate your Tricare benefits and provide guidance on the most appropriate level of care for your needs.

By taking the time to verify your benefits upfront, you can make informed decisions about your treatment options and avoid unexpected financial surprises down the road.

The Admissions Process: How to Get Started

Once you’ve verified your Tricare benefits and identified a rehab center that meets your needs, you can begin the admissions process. This typically involves the following steps:

  1. Initial assessment: You’ll speak with an admissions specialist who will gather information about your substance use history, mental health concerns, and treatment goals to determine the most appropriate level of care.
  2. Insurance verification: The rehab center will work with Tricare to verify your benefits, obtain any necessary pre-authorizations, and provide you with a clear understanding of your financial responsibilities.
  3. Medical evaluation: Before beginning treatment, you’ll undergo a comprehensive medical evaluation to assess your physical health, identify any co-occurring conditions, and ensure that the rehab center can safely meet your needs.
  4. Treatment planning: Based on the information gathered during the assessment and evaluation process, the rehab center’s clinical team will develop a personalized treatment plan designed to address your unique challenges and goals.

By working closely with a Tricare-approved rehab center like Longbranch Recovery, you can navigate the admissions process with confidence and begin your journey to recovery with the support of a dedicated, experienced team.

Longbranch Recovery: A Tricare-Approved Rehab Center

At Longbranch Recovery, we understand the unique challenges faced by military personnel, veterans, and their families when it comes to addressing addiction and mental health concerns. As a Tricare-approved rehab center, we are committed to providing the highest quality care to those who have served our country, ensuring that they have access to the support and resources they need to achieve lasting recovery.

Comprehensive Addiction Treatment Programs at Longbranch Recovery

Our team of experienced clinicians and addiction specialists has developed a range of comprehensive treatment programs designed to meet the diverse needs of our clients. These programs include:

  • Medically supervised detox to help clients safely navigate the withdrawal process
  • Inpatient rehab with 24-hour support and a structured daily schedule of therapy, group sessions, and holistic activities
  • Intensive Outpatient Programs (IOP) for those who need a focused approach to treatment while maintaining work or family responsibilities
  • Partial Hospitalization Programs (PHP) for clients who require more support than an IOP but do not need inpatient care
  • Aftercare planning and support to help clients transition back to daily life and maintain their recovery

By offering a full continuum of care, Longbranch Recovery ensures that clients receive the appropriate level of support at each stage of their journey, maximizing their chances of long-term success.

Specialized Care for Veterans and Military Personnel

We recognize that veterans and military personnel often face distinct challenges when it comes to addiction and mental health, including combat-related trauma, post-traumatic stress disorder (PTSD), and the difficulties of transitioning back to civilian life. That’s why we have developed specialized programs tailored to the unique needs of this population.

Our veteran-specific services include:

women from the military with her daughter
  • Trauma-informed care that acknowledges and addresses the impact of past experiences on current well-being
  • Evidence-based therapies such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR) to help clients process trauma and develop healthy coping skills
  • Group sessions with other veterans and military personnel to foster a sense of camaraderie and shared understanding
  • Family support and education to help loved ones better understand the challenges of addiction and recovery in the context of military service

By providing a safe, supportive environment where veterans and military personnel can heal alongside others who share their experiences, Longbranch Recovery aims to help clients build a strong foundation for lasting recovery.

Family Support and Involvement in Treatment at Longbranch Recovery

At Longbranch Recovery, we believe that addiction is a family disease, affecting not only the individual struggling with substance abuse but also their loved ones. That’s why we place a strong emphasis on family support and involvement throughout the treatment process.

Our family services include:

  • Family therapy sessions to help repair relationships, improve communication, and build a stronger support system
  • Educational workshops to help family members understand the nature of addiction and their role in the recovery process
  • Support groups for loved ones to connect with others who are navigating similar challenges
  • Ongoing resources and guidance to help families maintain healthy boundaries and support their loved one’s recovery journey

By involving family members in the treatment process, Longbranch Recovery aims to create a more comprehensive, sustainable approach to addiction recovery, one that recognizes the importance of a strong support network in achieving long-term success.