TRICARE is the healthcare program for military service members, retirees, and their families. It covers medical care in the United States and abroad. Rehab under TRICARE means treatment for substance use, alcohol addiction, and mental health conditions.
Many military families look for clear information about what TRICARE covers for rehab. At Arkview Behavioral Health, specialized addiction treatment for veterans is available for military families seeking these services.
- Inpatient rehabilitation, which involves staying at a treatment facility.
- Outpatient programs, where care is provided during the day but patients return home.
- Detoxification services, which involve medical support during withdrawal.
- Mental health treatment, including therapy for conditions that occur alongside addiction.
TRICARE coverage is available for active duty service members, retirees, National Guard and Reserve members, and eligible family members. All services are provided by authorized TRICARE providers and require a medical determination of necessity.
Does TRICARE Cover Substance Abuse Treatment?
TRICARE covers substance abuse treatment if a qualified healthcare provider determines it is medically necessary. Medically necessary means the treatment is required to diagnose or treat a covered medical or psychological condition. Substance abuse remains a concern in military communities, so coverage for treatment is available.
Covered services include individual therapy, which is one-on-one counseling with a professional. Group therapy allows individuals to participate in support sessions with others who have similar challenges. Family therapy includes family members in the treatment process, and medication-assisted treatment uses prescription medications to help manage addiction.
TRICARE covers both inpatient (residential) and outpatient (non-residential) substance abuse programs. There are typically fewer limits on the number of sessions than with some other insurance plans. Covered conditions include drug addiction, prescription drug misuse, and other substance use disorders.
Who Is Eligible for TRICARE Rehab Centers?
TRICARE rehab centers are available to a specific group of people. Eligibility includes active duty service members from all military branches. Military retirees who have served at least 20 years are also eligible.
National Guard and Reserve members are eligible when they are called to active duty. Military dependents, such as spouses and children under the age of 26, are included. Survivors, which means widows, widowers, and orphans of service members, qualify as well. Medal of Honor recipients have a special eligibility category.
Coverage for dependents also extends to children up to age 21, or up to age 23 if they are full-time students. If a dependent child has a disability, coverage may continue past these ages. Eligibility does not change when families move between duty stations.
What Are Drug Treatment Centers That Accept TRICARE?
| Provider Type | Cost Share | Authorization Required | Coverage Level
|
| In-Network | Lower copays | Sometimes | Full coverage |
| Out-of-Network | Higher costs | Often required | Partial coverage |
The TRICARE provider directory is available online for anyone seeking in-network rehabilitation centers. In-network providers have agreed-upon rates with TRICARE, so families usually pay less when choosing these facilities.
Before starting treatment, it is important to check if the program is included under the specific TRICARE plan. Each plan has its own rules for copayments and deductibles, which can affect the total cost.
Some addiction treatment programs, such as those for co-occurring mental health conditions, long-term residential care, or unique therapy types, may need additional approval from TRICARE. Verification with TRICARE is sometimes required for these specialized services.
How To Access TRICARE Outpatient Rehab and Detox Centers?
Outpatient rehabilitation services allow a person to live at home while attending therapy sessions at a facility. TRICARE outpatient rehab covers intensive outpatient programs (IOP), partial hospitalization programs (PHP), and standard outpatient counseling. Detox centers that accept TRICARE offer medical supervision to help people safely withdraw from substances.
Accessing these services can involve several steps. Some services require a referral from a primary care manager, and some may also require pre-authorization. The process for accessing outpatient rehab or detox services can vary depending on the region and the details of the TRICARE plan.
A referral from a primary care manager is often required for outpatient addiction treatment. There are situations where certain services can be accessed without a referral, depending on the specific TRICARE plan.
Some outpatient programs, including IOP and PHP, require pre-authorization before starting treatment. Approval for pre-authorization usually takes between a few days and a week.
It is important to confirm whether the specific outpatient program—such as IOP, PHP, or counseling—is included in the TRICARE coverage before beginning treatment. Each plan outlines which services are covered.
Is TRICARE Alcohol Rehab Included?
TRICARE includes several types of alcohol rehab services. These include alcohol detoxification, which is medical supervision during withdrawal from alcohol. Residential alcohol treatment in Pennsylvania involves staying at a facility for a period between 30 and 90 days for structured care. Alcohol counseling is available and can be done one-on-one or in group settings. Relapse prevention services offer continued support after initial treatment to help with long-term recovery.
Does TRICARE Cover Rehab for Dependents?
TRICARE covers rehab services for eligible dependents, such as spouses and children of military members. Eligible dependents include unmarried children under age 21, children under age 23 who are full-time students, and children of any age who are diagnosed with a disability. When eligible, dependents can access the same types of rehab services that are available to the service member.
For minor children, parental consent is usually required before they can receive treatment. If a military family moves to a new location, TRICARE coverage for dependents continues without interruption. Rehab insurance coverage for dependents includes treatment for both substance use disorders and mental health conditions.
What To Know About Claims and Costs for TRICARE Rehab Coverage?
TRICARE rehabilitation services include some out-of-pocket costs. These costs may include deductibles, copayments, and cost-shares, which align with typical methods of paying for rehab. A deductible is an amount paid before TRICARE begins to pay for services. A copayment is a set amount paid for each service. A cost-share is a percentage of the total cost paid by the patient. The exact amounts depend on the type of TRICARE plan and whether services are received from in-network or out-of-network providers.
In-network providers usually have agreements with TRICARE to bill directly and require lower payments from patients. Out-of-network providers may charge higher prices, and patients may need to submit claims themselves. Plan details outline the specific costs for each service.
1. Deductibles and Copayments
The amounts for deductibles and copayments are set by each TRICARE plan. Deductibles often apply to TRICARE Select and Reserve Select plans for certain rehabilitation services. Copayments are set amounts for each visit or service.
2. Out-of-Network vs. In-Network
In-network rehabilitation providers have contracts with TRICARE, which usually result in lower costs for patients. Out-of-network providers do not have these contracts, so patients may pay more and may need to handle more paperwork, such as submitting claims themselves.
Moving Forward with Arkview BH
Arkview Behavioral Health provides support for military families facing substance use or mental health challenges. The organization recognizes that service members and their loved ones often experience unique stressors and transitions. The team offers individualized, evidence-based care for those seeking recovery.
Arkview Behavioral Health collaborates with military families to understand their needs and create a safe, welcoming environment for treatment. To learn more or to begin the process, contact us. The organization is dedicated to partnering with those who have served and their families throughout their recovery journey.
FAQs About TRICARE Rehab
TRICARE provides coverage for emergency rehab services when a person is stationed overseas. Routine rehab care outside the United States may not be available in every location, depending on local providers and resources.
TRICARE rehab coverage continues during permanent change of station (PCS) moves and changes in duty status. Access to rehab services is not interrupted during these transitions.
Some addiction treatment services under TRICARE require a referral from a primary care manager. Emergency care for addiction does not require a referral.
Pre-authorization for rehab services under TRICARE usually takes between a few days and one week. The exact time can depend on the type of service and the region.
TRICARE covers treatment for individuals who have both mental health and substance use disorders at the same time, also known as dual diagnosis treatment.
