Drug & Alcohol Rehab with TRICARE
TRICARE offers coverage to military servicemembers (both active-duty and retired, as well as family members) and is split up into two regions: east and west.1 TRICARE West operates in Nevada and surrounding states in the Western region of the U.S.2 TRICARE beneficiaries in the Western region may have coverage for substance use disorder treatment at Desert Hope.
How Does TRICARE West Coverage Work?
If you have a TRICARE plan and live in the TRICARE West region, your benefits will be managed by Health Net Federal Services, the contractor for TRICARE West.2,3
If you have TRICARE coverage in any of the states below and are curious if TRICARE West covers rehab at Desert Hope, you can verify your TRICARE coverage online in just minutes with our .
Types of TRICARE Plans
TRICARE coverage is available in many forms for active-duty military, retired servicemembers, and military families. Each TRICARE plan is unique and has specific eligibility requirements, which you can view in detail on the TRICARE website. See below for a basic introduction to TRICARE plans.
This managed care plan requires an assigned primary care manager (PCM) to coordinate most of your treatment.4
Servicemembers on active duty must enroll in TRICARE Prime. Other servicemembers (including retired military and family members) may be eligible for TRICARE Prime granted they have not yet become eligible for Medicaid based on their age.4
PRIME plan options include:4
- Prime Remote (for members in remote areas of the U.S.).
- Prime Overseas.
- Prime Remote Overseas.
TRICARE Select replaced TRICARE Standard and Extra in 2018. This preferred provider plan option eliminates the primary care manager requirement and lets you manage your own care without referrals from a PCM.5 With an annual deductible and coinsurance (cost-share) for covered services, this plan functions in a similar vein to a private marketplace healthcare plan. TRICARE Select Overseas is also available for those outside the U.S.6
TRICARE Reserve Select
TRICARE Reserve Select is a premium-based plan available globally for eligible Select Reserve members and their families.7
This plan, like TRICARE Select, does not require referrals from a PCM, and you can schedule your own appointments with TRICARE-authorized care providers. This plan, like TRICARE Select, is similar to a private marketplace plan with annual deductibles, and coinsurance (cost-share) for covered services. It also requires the payment of a monthly premium.7
TRICARE Retired Reserve
This plan has all of the same elements as TRICARE Reserve select but is available for qualifying Retired Reserve members and their families.8
TRICARE Young Adult
TRICARE Young Adult coverage is available for unmarried young adults whose regular eligibility for TRICARE has ended (at 21 years old, or if enrolled in college, at 23). Both Prime and Select plans are options for young adults, but eligibility criteria and costs differ between plans.
Does TRICARE Cover Addiction Treatment?
Yes. TRICARE offers coverage for many forms of substance use disorder treatment. In order for TRICARE to cover these services, however, they must be considered medically necessary.9
How much you pay for covered services will depend on the specific TRICARE plan that you hold.
What Types of Substance Abuse Treatment Are Covered by TRICARE?
With a TRICARE plan, you may have coverage for a variety of mental and behavioral healthcare services including:10
- Withdrawal management (detox).
- Inpatient substance use disorder treatment.
- Outpatient substance use disorder treatment, including:
- Partial hospitalization programs (PHPs).
- Intensive outpatient programs (IOPs).
- Therapy and counseling.
- Medication-assisted treatment (the use of FDA-approved medications with therapy to treat substance use disorders).
How to Use TRICARE West for Drug & Alcohol Rehab
Depending on which TRICARE plan you hold, you may be able to schedule specialty services (such as rehab or therapy) with a TRICARE-authorized provider yourself, or you may need to get your primary care manager to provide a referral.
Staying in the TRICARE network will lower your costs and may make your life easier in that the treatment provider will file health claims on your behalf. While some plans allow you to go out of network, you may pay significantly higher costs and you may have to submit your health claims on your own.7 If you do prefer an out-of-network provider, you can explore flexible options for covering the cost of treatment such as loans or financing.
In most cases, you’ll need prior authorization from Health Net (the healthcare contractor for TRICARE West) for specialty services prior to starting treatment, or services may not be covered.11
For immediate in-person help, you can call to speak to an admissions navigator who can check your TRICARE benefits for you and confirm whether you’re covered for care at Desert Hope.
Verify Your Benefits Online
We can help you begin the process of accessing high-quality, lifesaving care at Desert Hope by verifying your benefits for you in just minutes. You can complete the form below by inputting some very basic information including your plan name and member ID, and we’ll email you results in just minutes.
Benefits of TRICARE for Addiction Treatment
TRICARE provides coverage for many forms of behavioral health and substance abuse treatment so that you don’t have to continue to suffer if you’re living with addiction. Substance abuse impacts many residents of Nevada. In fact, in 2020, Nevada was put on a “red alert” after the over opioid overdose deaths rose by more than 50% in just a few months.12
If you’re a TRICARE beneficiary struggling with substance abuse in Nevada, Desert Hope can help. You don’t have to wait and suffer. Contact us today to discuss using your TRICARE West benefits to get help.