Will Tricare Substance Abuse Detox Cover Inpatient Programs?

If you’re an active military member or veteran that has a problem with drugs or alcohol, you will be happy to know that health insurance can absorb some of the costs associated with seeking help for your addiction. The passing of two federal laws, which include the Affordable Care Act (ACA) passed in 2010, and the Mental Health Parity and Addiction Equity Act passed in 2008, mandates that all health insurance providers include coverage for mental health and substance abuse treatments. TRICARE insurance, which is available to military members and their families, is no exception in that they proudly offer health plans that cover a wide range of substance abuse treatments, including inpatient and outpatient rehab, medically-assisted detox, sober living homes, and much more.

TRICARE AND SUBSTANCE ABUSE TREATMENTS

While it is possible to quit drugs or alcohol cold turkey, doing so can intensify withdrawal symptoms and increase the risk of relapse. Addiction recovery at a licensed rehab facility is a great way to minimize severe withdrawal symptoms and also improve your chances of achieving long-term sobriety. This general premise is what guides TRICARE insurance when it comes to the substance abuse treatments that they cover. That said, there are a few caveats worth noting; the extent of coverage offered under a TRICARE policy can vary depending on the type of policy you have. Also, some substance abuse treatments may require a letter of medical necessity from a physician as well as prior authorization from the health insurance provider.

WILL A TRICARE POLICY COVER INPATIENT TREATMENTS?

For those struggling with severe addiction or a substance abuse problem coupled with a mental health disorder, many TRICARE health plans will cover the cost of treatment at an inpatient facility. That said, it is important to speak with a TRICARE representative to confirm coverage and also to discuss copays and other out-of-pocket costs that may apply to treatment at these facilities. Substance abuse treatments at most inpatient programs include 24-hours access to physicians and medications, which makes getting through detox slightly easier. More than that, they also provide round-the-clock access to substance abuse counselors to help individuals who may be struggling with the psychological aspect of overcoming their addiction.

IS THERE MORE THAN ONE KIND OF INPATIENT PROGRAM AVAILABLE?

When it comes to inpatient treatment, there is no such thing as a one size fits all approach as everyone responds to addiction recovery differently. And depending on the nature of the addiction, some programs may be better than others. That being said, TRICARE will cover treatment costs associated with either urgent or non-urgent care. Urgent care is covered if an individual has a medical or psychological emergency stemming from the abuse of drugs or alcohol that requires hospitalization. Non-urgent care, on the other hand, will require a physician referral and prior authorization under most TRICARE policies. There are also some restrictions and limitations associated with non-urgent care as well. For example, most inpatient programs can last for 30 days or more. And substance abuse coverage under most TRICARE policies will put a cap on how many days will be covered.

INTENSIVE OUTPATIENT CARE

For some people, going through detox is not enough to break the cycle of addiction. In fact, some may need to transition from an inpatient program to an intensive outpatient program before they can finally return to the “real” world. If this is something that resonates with you, you will be happy to know that these treatments are also covered by TRICARE. These programs are a good fit for those struggling with a mild addiction or those needing the flexibility of being able to return home after undergoing their substance abuse treatments. Those who opt for this form of addiction recovery will have access to either an intensive outpatient program or partial hospitalization, both of which can aid in their recovery.

SOBER LIVING HOUSES AFTER INPATIENT AND OUTPATIENT CARE

Even after completing detox in an inpatient program and transitioning to an outpatient program, some individuals may still not be quite ready for life after rehab. A sober living home provides individuals with not only housing but also access to medical treatments and other resources. TRICARE substance abuse coverage for sober living homes fall under partial hospitalization. Therefore, if your TRICARE policy covers outpatient treatments, sober living homes will most likely be covered as well.

BOTTOM LINE

TRICARE insurance covers inpatient treatments and several other treatments critical to addiction recovery. To learn more about substance abuse treatments covered by TRICARE, you’re encouraged to speak with one of our associates today at 877-027-9048.

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