TRICARE Insurance Coverage for Drug and Alcohol Rehab Treatment

Does TRICARE Cover Drug or Alcohol Rehab?

TRICARE health insurance typically covers drug and alcohol rehab treatment. If you are in need of TRICARE substance abuse treatment, you are eligible for coverage at a wide range of treatment programs, including American Addiction Centers. There are many rehabs that accept TRICARE, but TRICARE rehab coverage depends upon the specific provider at hand, the member’s specific health plan, and a few other variables.

At American Addiction Centers (AAC), we offer treatment for substance abuse and co-occurring mental health conditions in states across the country. To learn more about AAC’s treatment options and TRICARE drug rehab give us a call at , or you can verify your insurance by filling out the form below.

Please note: American Addiction Centers strives to provide you with the most updated information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.

Does TRICARE Cover Drug and Alcohol Detox?

TRICARE plans provide coverage for several types of drug and alcohol detox.¹ Having TRICARE inpatient coverage does not mean you will be immediately covered fully for drug and alcohol detox. Detox centers that take TRICARE may require you to pay partial fees based on your specific insurance plan or get the authorization and recommendation of a doctor. For example, many insurance plans require that you meet certain criteria for admission to an inpatient detox program. TRICARE may determine that you can successfully be detoxed on an outpatient basis.

Does TRICARE Cover Inpatient Rehab?

TRICARE covers inpatient rehab for drug and alcohol abuse if you meet the criteria for inpatient treatment.² Substance abuse treatment providers have certain guidelines that must be followed to determine if you need inpatient care. The first step in knowing whether TRICARE will approve inpatient rehab for you is to speak with a representative. If you are in immediate medical danger, they will provide treatment to stabilize your condition as long as it is medically necessary. While some people seeking treatment for addiction do not need 24/7 medically supervised treatment, others do.

TRICARE Outpatient Rehab Coverage (Standard, IOP, PHP)

TRICARE offers coverage for outpatient rehab, which is a type of treatment that allows patients to live at home or in a sober-living environment during rehab.³ Outpatient rehab is typically appropriate for people who need substance misuse treatment but don’t require 24/7 oversight.

At times, a person may go to outpatient rehab after having completed an inpatient treatment program as a way of stepping down or transitioning from a more intensive treatment program. Other times, a person’s first treatment episode might be in outpatient treatment.

However, under the general umbrella of outpatient treatment, two additional outpatient options are available: partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs).

• PHPs: Also known as day treatment, PHPs are intensive and highly structured types of outpatient treatment.¹⁴ PHPs, which are sometimes referred to as the halfway point between inpatient and outpatient rehab, offer evidence-based therapies and care similar to inpatient rehab. But the care is of a slightly lower intensity than inpatient, and patients live at home or in sober living environments.¹⁵
• IOPs: Similar to PHPs and traditional outpatient care, patients in an IOP live at home or in a sober environment while participating in this type of treatment. Again, therapies may be similar to inpatient treatment, but they’re less intensive and the number of sessions per week are usually less than those of PHPs.¹⁵

While the coverage limitations, required authorizations, and out-of-pocket expenses vary according to plans, facilities, and more, TRICARE covers standard outpatient rehab, PHP treatment, and IOP treatment. ^2,3,13

With treatment facilities scattered across the United States, American Addiction Centers offers a host of treatment options, including detox, outpatient (including IOP and PHP), inpatient care, aftercare, and sober living. Plus, AAC offers Veteran-specific care such as the Salute to Recovery program. Reach out to an admissions navigator at to learn more about treatment options and Veteran-centered care.

Do Treatment Centers Need to Be In-Network?

For some TRICARE plans, such as TRICARE Reserve Select, TRICARE Young Adult, and TRICARE Prime Remote, you can opt to receive care from an out-of-network provider, but the costs are higher than using an in-network provider. Other plans require you go to an in-network provider. It is important to note that an in-network provider with TRICARE can offer you the least expensive coverage as the rates negotiated between a provider and the TRICARE insurance plan are usually the best possible value for TRICARE members. Also with some providers, you will be required to pay the entire cost of treatment upfront and wait several weeks for TRICARE to reimburse you. This cost could range from hundreds of dollars for outpatient treatment to thousands of dollars for inpatient treatment.

How Can I Pay the Costs Not Covered by TRICARE Insurance?

Fortunately, if you use providers within the TRICARE network, you are only responsible for the costs that remain after TRICARE pays the provider the negotiated rate. If you chose a non-network provider, you will have a higher out-of-pocket cost. You can usually work out a payment plan with the provider to cover the remaining costs. However, the easiest way to determine your coverage, benefits, and costs will be to speak with a TRICARE representative and to discuss which options offer the best value for your situation.¹²

Does TRICARE Cover Suboxone?

More often than not, TRICARE covers the cost of Suboxone, a form of Medication-Assisted Treatment (MAT) and common medicinal method for the treatment of opioid addiction. Many forms of MAT, including Suboxone, are proven to lessen the severity of drug withdrawal symptoms and provide a fair amount of craving relief for patients. In turn, this allows patients to focus on other forms of addiction treatment, such as behavioral therapies.

To attain coverage for Suboxone, TRICARE members must first attain a pre-authorization for their treatment. Without insurance, the generic form of Suboxone may cost up to $200 for a 1-month supply.

Find Drug Rehab That Accepts TRICARE