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TRICARE is a government-sponsored health insurance program for active duty, reserves, retired military members, and eligible family members.
In 2017, TRICARE started covering substance abuse treatment. This includes treatment for alcohol use disorder (AUD). It also covers treatment for various mental health issues that often co-occur with AUD.
The variety of treatments and extent of coverage depends on your TRICARE health insurance plan. For example, TRICARE Prime is a managed care option for active-duty military. It features no copays or deductibles for the insured or their beneficiaries.
On the other hand, TRICARE Select does have both deductibles and copays. Therefore, it’s important to know which treatments your plan covers and to what extent.
TRICARE offers the following health insurance plans:
Log into milConnect and click on the “Obtain Proof of Health Coverage” option to find out what your TRICARE plan covers.
TRICARE offers a wide variety of substance abuse and mental health treatment options, including:
Detoxification (detox) is when a person quits drinking alcohol to remove toxins from their body. This also applies to certain drugs.
When the body becomes dependent on alcohol, brain and body chemistry change. The body depends on alcohol to keep some body systems running. Stopping alcohol suddenly without medical support can result in brain and body malfunction, fluid balance upset, and even seizures and death.
Similar occurrences may occur when a person’s body becomes dependent on other drugs.
Detox leads to alcohol withdrawal, which is dangerous and often requires medical assistance. This is known as a medically-assisted detox.
TRICARE insurance can provide coverage for the medical care you need to manage these withdrawal symptoms.
TRICARE covers both emergency and non-emergency inpatient treatment. Emergency inpatient hospital stays are covered if you have an immediate medical emergency. You’ll receive substance abuse treatment at the closest hospital in your area.
If you have an alcohol use disorder (AUD) or mental health issue, TRICARE will cover:
Intensive outpatient treatment is when someone requires therapy on a part-time basis at a local rehab center. Sometimes partial hospitalization is also required in these situations.
Unlike inpatient treatment, the person returns home at night after outpatient treatment finishes. Treatment may also be part-time rather than full-time.
TRICARE will cover your alcohol rehab on an outpatient basis if:
TRICARE will also cover any accompanying mental health issues on an outpatient basis.
Sometimes, alcohol withdrawal symptoms and cravings need to be managed with medication. This is known as medication-assisted treatment (MAT). It's often used in combination with inpatient treatment and mental health therapy.
TRICARE will cover MAT for alcohol rehab if the medications are government-approved.
These drugs can be used to help with detoxing or for ongoing medical support, such as intensive outpatient treatment.
Referred to by TRICARE as Mental Health Therapeutic Services, TRICARE will cover the following:
They can also be done in conjunction with other approaches, such as medication-assisted treatment (MAT).
TRICARE also covers:
TRICARE won’t cover aversion therapy or any “unproven treatments.” Aversion therapy is the use of an unpleasant sensation to correct behavior issues.
“Unproven treatments” simply refers to treatments that are not evidence-based.
An example of this would be electroshock therapy. This shouldn't be confused with electroconvulsive therapy, a treatment for bipolar disorder.
A variety of evidence-based treatments can be used in alcohol rehab.
According to the National Institute on Drug Abuse (NIDA), these include:
If you use providers who are part of the TRICARE Network, then you only pay any remaining charges after TRICARE has paid their negotiated rates.
You can also use secondary health insurance to pay the remainder.
Note: If you choose a provider that's out-of-network, your cost may be 15 to 20% higher.
To find out more details on your TRICARE coverage, speak to a TRICARE representative.
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