Tricare Insurance for Rehab

What is Tricare Health Insurance?

Tricare is a health care program for uniformed members of the military, retirees, and their families worldwide. Coverage is available within the USA and overseas. Any region outside the USA is considered overseas by Tricare.

Tricare provides health care for medically necessary expenses as well as prescription drugs, special programs, and offers dental plans.

Does Tricare Insurance Cover Rehab?

Yes, it covers a wide range of services for mental health and substance use disorders. This includes both inpatient and outpatient care.

Drug Rehab Coverage

Tricare may cover:

• Inpatient rehab services
• IOPs (intensive outpatient programs)
• Detox services to manage withdrawal symptoms
• MAT (medication-assisted treatment)
• Mental health therapies
• Office-based opioid addiction treatment
• Opioid treatment programs
• PHPs (partial hospitalization programs)
• Residential substance use disorder treatment

Alcohol Rehabilitation

Tricare may cover the same services as listed in the Drug Rehab Coverage section above, but for alcohol-related issues instead of drug abuse.

Covered Rehab Facilities

Tricare covers different types of rehab facilities for substance use disorder treatment, including:

• Residential Treatment Centers
• Partial Hospitalization Programs
• Intensive Outpatient Programs

Tricare Inpatient Coverage

Tricare covers residential substance use disorder (SUD) rehab in the form of inpatient care at a treatment facility. Services at these facilities include detoxification to manage withdrawal symptoms. Also covered are the services needed to recover from substance use disorders.

Keep in mind that prior authorization is needed before admission. Inpatient substance use disorder treatment is typically approved when the person has a primary diagnosis of substance use disorder.

Also, inpatient substance use disorder treatment may be approved if:

• The person has severe symptoms or potential symptoms that require inpatient care and physician management.
• The person requires full-time monitoring.
• The person’s SUD is causing functioning difficulties in several major life areas.

Service Providers

Tricare health service providers offer care and therapies for drug and alcohol rehabilitation. There are network and non-network providers. A network provider agrees to participate in the Tricare network. A provider who is not a member of the network is called a non-network provider.

A service provider can be a:

• Doctor or Dentist
• Rehab Facility
• Hospital
• Clinic

Check the complete directory of service providers for more information.

Does Tricare Cover Therapy?

Yes, Tricare does cover therapy as follows:

Psychotherapy: Also called talk therapy or counseling, it covers therapy given on an inpatient and outpatient basis. This includes individual, group, and family therapy.

Psychoanalysis: It covers psychoanalysis if the service provider has the proper certification, and you get preauthorization.

Medication Treatment: Psychiatric drugs are covered when an authorized provider prescribes them as part of a treatment plan.

Electroconvulsive Treatment: Electroconvulsive treatment (ECT) may be covered.

Medication-Assisted Treatment (MAT): Covered when prescription drugs are used to treat cravings and prevent relapse from substance use disorders.

Ancillary Therapies: It covers ancillary therapies when they are part of a treatment plan at one of the following rehab facilities:

1. Inpatient facility
2. Residential substance use disorder treatment
3. Psychiatric residential treatment center (for those under age 21)
4. Partial hospital program
5. Intensive outpatient program

Ancillary therapies include:

• Art
• Music
• Dance
• Occupational
• Other ancillary therapies
• Mental Health Coverage

Tricare covers both inpatient and outpatient services under the umbrella of mental health care, including:

Tricare covers both inpatient and outpatient services under the umbrella of mental health care, including:

• Autism Spectrum Disorder
• Applied Behavior Analysis
• Collateral Visits
• Cognitive Rehabilitation Therapy
• Drug Testing
• Disordered Eating Treatment
• Electroconvulsive Therapy
• Family Therapy
• Gender Dysphoria
• Intensive Outpatient Programs
• Inpatient Hospital Services (emergency and non-emergency)
• Management of Withdrawal Symptoms (Detoxification)
• Medication-Assisted Treatment
• Office-based Opioid Treatment
• Opioid Treatment Programs
• Partial Hospitalization
• Psychoanalysis
• Psychological Testing
• Psychotherapy
• Psychotropic Drugs
• Residential Treatment Facility Care
• Substance Use Disorder Treatment
• Therapeutic Services
• Transcranial Magnetic Stimulation

For more information, you can visit the TRICARE website.