TRICARE Insurance Coverage for Alcohol Abuse and Addiction Rehab Treatment

Does TRICARE Insurance Cover Alcohol Detox and Rehab?

If you or a loved one is struggling with drug or alcohol addiction, going to rehab may be a natural next step on the path to recovery. Alcohol rehab and drug rehab is a common type of addiction treatment, but it comes at a cost. Fortunately, many U.S. health insurance plans help to cover some or all the costs associated with treatment.

If you have a TRICARE health insurance plan, this may hold true for you. Every TRICARE plan is different, though, and your coverage may vary based on the TRICARE plan you have, whether your provider is in-network with your plan, and where you live.

The number of rehab centers that are in-network with TRICARE plans will vary based on your location and the type of plan. The best way to find in-network treatment centers near you is to call the number on the back of your insurance card to speak to a TRICARE representative who can help you learn more about your benefits and coverage.

What Does TRICARE Insurance Cover for Alcohol Treatment?

What TRICARE insurance plans cover in terms of alcohol addiction treatment may vary based on your specific plan. There are many different types of treatments that may be available to you in alcohol rehab, which can include:

• Screenings, interventions. Alcohol rehab screenings are used to help identify whether a patient has an alcohol use disorder or addiction.¹ It helps assess alcohol consumption and behaviors, as well as other alcohol-related problems.¹
• Detox. Medically supervised detoxification is the process in which the body is rid of substances, such as drugs or alcohol.^{2, para 2} Detox is typically done in a medically supervised setting to help mitigate potentially life-threatening side effects of withdrawal from not using substances.^{2, para 2}
• Inpatient. Inpatient alcohol rehab refers to treatment programs where patients stay at the facility for the duration of their care.^{3, (How are behavioral therapies used to treat drug addiction?)} Inpatient programs can range from days to weeks to months and involve 24/7 round-the-clock care.^{3, (How are behavioral therapies used to treat drug addiction?)}
• Outpatient. Outpatient alcohol rehab refers to treatment programs where patients attend a facility for their treatment sessions but return home after treatment is received. Care may involve attending one or two meetings a week for patients, which could involve therapy or group meetings.^{3, (How are behavioral therapies used to treat drug addiction?)}
• Behavioral therapies. Behavioral therapies for alcohol treatment typically involve methods designed to help engage those in treatment. They also may provide incentives for patients to modify their attitudes and remain sober and teach them skills to help cope with triggers without using alcohol.⁴
• Treatment for co-occurring disorders. A co-occurring disorder is what it is called when someone experiences both a substance use disorder and mental illness at the same time.⁵ Because the two conditions often influence each other, treating both at the same time is often the recommended treatment program.^{5 “What should I do?”}

There are 11 different types of TRICARE health plans, and plan availability depends on who you are and where you are located.⁶ It is available in all 50 states, as well as additional territories or locations across the country. The number of alcohol rehab centers across the nation that may accept TRICARE will depend on the type of TRICARE plan you have. To verify your benefits and coverage, call the number on the back of your TRICARE plan.

What TRICARE Does Not Cover for Alcohol Treatment?

Depending on your TRICARE plan, there may be various types of alcohol treatment that are not covered under your plan. Some aspects that may not be covered include:

• Non-medical amenities.
• Holistic care services.
• Recreation programs.
• Food delivery.
• Private treatment services.
• Alternative therapies.

Call the number on the back of your TRICARE health plan card to check whether any of the above treatment methods are covered by your specific plan.

What Is TRICARE Insurance?

Iterations of TRICARE insurance have been around since the 1960s.⁷ Early iteration of TRICARE was called the Civilian Health and Medical Program of the United States, or CHAMPUS.⁷ CHAMPUS was a fee-for-service health insurance plan that required cost-sharing for members but no premiums or enrollment fees.⁷ In the 1990s, the Department of Defense was directed by Congress to consider a health maintenance organization (HMO) model approach to health care, and TRICARE was created.⁷

TRICARE is a health insurance program available to uniformed service members, veterans, and their families around the world.⁸ Pharmacy and dental plans may also be offered through TRICARE.⁷ TRICARE plans are managed by the Defense Health Agency, and all plans meet the minimum essential coverage requirements set forth by the federal Affordable Care Act (ACA).⁸ TRICARE is available to eligible enrollees all over the world.⁹

TRICARE plans are managed in three global regions, with two located in the U.S. (East and West) and the third overseas, covering Eurasia, Africa, Latin America, Canada, and the Pacific area.⁹ Each region is managed by its own regional contractor.⁹ Where you live dictates what regional TRICARE plans may be available to you.

How Much Does Alcohol Rehab Cost?

How much alcohol rehab costs under your TRICARE insurance plan will vary. Contributing factors to the cost of alcohol rehab include the plan that you have, the facility itself, the type and duration of rehab services you receive, and various amenities offered by the facility. It’s recommended that you work with a TRICARE representative or the rehab facility itself to check what treatment methods may be covered and at what level they may be covered. Doing so can help you prepare for medical bills you may receive following treatment.

Cost of Inpatient Alcohol Rehab

Due to the variety of available TRICARE plans and how many global inpatient rehab facilities there are, there’s no set average cost of inpatient alcohol rehab. The specific TRICARE plan that you have and where you seek care will influence the total cost of your inpatient alcohol rehab stay. However, because inpatient alcohol rehab involves overnight stays and round-the-clock care, it tends to be more expensive than outpatient alcohol rehab services.

Cost of Outpatient Alcohol Rehab

The average cost of outpatient alcohol rehab services will depend largely upon what type of TRICARE plan you have, as well as whether the facility or provider from which you receive care is in- or out-of-network. An in-network provider is one that is contracted with TRICARE plans to participate in the TRICARE program and accept the TRICARE negotiated rates as payment in full.¹⁰

Non-network providers, or out-of-network providers, are those that aren’t authorized to provide care to you, which means that care received from non-network providers may not be fully or partially covered.¹⁰ Choosing an in-network outpatient alcohol rehab provider could help you keep your care costs low.

Cost of Alcohol Partial Hospitalization Programs (PHP)

The average cost of alcohol partial hospitalization programs (PHPs) will vary. The type of and extent of your TRICARE plan’s specific coverage will largely affect the cost of your PHP treatment. The length of treatment and the facility you attend will also affect the overall cost of your treatment. If your TRICARE plan doesn’t fully or partially cover the cost of PHP alcohol treatment, you can ask the facility whether they offer scholarship or financing options to help offset the costs of treatment.

Cost of Medication-Assisted Treatment (MAT)

MAT involves using a combination of medications and behavioral or counseling therapies to help patients overcome alcohol and other substance use disorders.¹¹ While it is primarily used to help treat opioid addiction, it may also be used to treat alcohol use disorders.¹¹ The average cost of MAT will depend upon the TRICARE plan that you have, as well as the type of medications that may be prescribed to you.

Alcohol Rehab vs. the Cost of Alcohol Addiction

Beyond the nation’s economic costs of drinking, alcohol use disorder raises the odds that a person may become incarcerated or develop serious health issues.¹² Becoming incarcerated can cause you to lose income, as well as potentially experience negative social and familial side effects.¹²

Additionally, according to the World Health Organization, alcohol contributed to more than 200 diseases and injury-related health conditions.¹² As you can see, the upfront costs of attending rehab may seem more expensive, but the overall costs and risks of continuing alcohol addiction are far more serious.

What Length of Alcohol Rehab Does TRICARE Cover?

The length of time your TRICARE insurance will cover alcohol rehab will depend upon where you seek care, the type of care you need, and the TRICARE plan that you have. Despite your insurance coverage details, which you can look up on the back of your insurance card, it’s important to prioritize remaining in rehab for an adequate length of time. In fact, good rehab outcomes are contingent upon remaining in rehab for long enough.¹³

While every person’s path to recovery is unique, it’s often recommended that residential and outpatient treatments last at least 90 days to maintain positive outcomes and stop or reduce drug use.¹³

Choosing Between TRICARE Inpatient vs. Outpatient Alcohol Rehab Centers

While one type of alcohol rehab center is not inherently better than the other, one may be better than the other for your specific needs. Inpatient alcohol rehab provides round-the-clock, medically supervised care and often a sober setting to help you overcome your alcohol addiction. As such, it is a more focused environment with supervision and accountability. There is also an inherent level of support as others around you are also working toward recovery. Be sure to work with your provider to determine the best type of treatment for your situation.

How to Use TRICARE Insurance for Alcohol Rehab?

The specifics surrounding how to use your TRICARE insurance plan for alcohol rehab may vary based on the plan type you have. Be sure to call your TRICARE plan representative to learn more about how to use your specific plan. However, the process for using your insurance typically involves determining where you can seek rehab care based on your plan (i.e., military hospital and clinic or a civilian network provider).

After you’ve found a suitable rehab program, you can check with TRICARE or the rehab center directly to determine whether your plan is accepted at the facility. If it is, they may facilitate all claims submissions and insurance benefits on your behalf. You may be billed for your portion of the services rendered, depending on your plan.

How to Find Alcohol Rehabs That Accept TRICARE Insurance?

Finding alcohol rehab centers near you that accept TRICARE insurance doesn’t have to be difficult. You can work with American Addiction Centers and its team of experienced admissions navigators.

AAC staff will help you learn more about addiction and treatment and can even help you check your benefits right while you’re on the phone. They can also help you find a rehab that accepts your insurance so you can become one of many across the country who finances rehab through TRICARE coverage. They can match you with local facilities, as well as in-network AAC facilities that may be near you. Call AAC’s helpline to learn more.