Rehabs That Accept TRICARE Insurance

TRICARE may cover several forms of substance use disorder treatment when services are medically necessary, proven and provided under the applicable program rules. Coverage, referrals, authorization and costs depend on the beneficiary’s plan, region, status and provider.

Does TRICARE Cover Drug and Alcohol Rehab?

TRICARE’s official substance use disorder treatment page states that it may cover inpatient services, intensive outpatient programs, withdrawal management, medication-assisted treatment, office-based opioid treatment, opioid treatment programs, mental health therapeutic services and partial hospitalization programs.

TRICARE also explains that the list is not all-inclusive, services must meet coverage requirements, and special rules or limits may apply. Aversion therapy and unproven treatments are listed as exclusions.

TRICARE Substance Use Treatment Services

Depending on clinical needs and benefit rules, a treatment plan may involve:

• Emergency or nonemergency inpatient services
• Management of withdrawal symptoms
• Residential or structured treatment when authorized under applicable rules
• Partial hospitalization
• Intensive outpatient programs
• Outpatient counseling and therapeutic services
• Medication-assisted treatment and opioid treatment services
• Care for co-occurring substance use and mental health conditions

TRICARE Prime, Select and Regional Rules

TRICARE Prime and TRICARE Select do not use identical referral and authorization processes. Active-duty service members can also have different requirements from retirees, dependents and other beneficiaries. The East Region, West Region and overseas programs use their own contractor contacts and provider tools.

Check the current enrollment information in DEERS, identify the plan and region, and use the official regional contact listed by TRICARE. Do not assume that approval under one plan or region applies to another.

Do TRICARE Rehab Providers Need to Be In-Network?

Network status can affect access, authorization and cost. TRICARE distinguishes between network, participating and nonparticipating providers. A provider’s ability to treat TRICARE beneficiaries does not necessarily mean every service at every location is covered.

Confirm the program’s current TRICARE status through the applicable regional contractor. Ask about the exact facility, level of care and treating professionals.

How to Verify TRICARE Rehab Coverage

1. Confirm that eligibility and enrollment information in DEERS is correct.
2. Identify the beneficiary’s TRICARE plan and region.
3. Contact the regional contractor using the official number on TRICARE’s website or the insurance card.
4. Ask whether a referral or preauthorization is required.
5. Confirm the proposed provider and facility through the official provider directory.
6. Ask about applicable copayments, cost-shares and nonparticipating-provider charges.
7. Request and retain authorization and call-reference information.

TRICARE Coverage for Dependents

Eligible spouses, children and other beneficiaries may have TRICARE coverage, but eligibility and plan rules must be confirmed in DEERS. The sponsor’s status does not establish that a particular program or service is approved for a dependent.

TRICARE West and TRICARE Prime Resources

Members looking for more specific guidance can review our TRICARE West rehab guide and TRICARE Prime rehab guide. Those pages supplement this national overview; current official TRICARE instructions control.

Privacy and Military Employment

Health information is subject to privacy rules, but military readiness, command-notification and duty requirements can involve circumstances that differ from ordinary civilian employment. Do not rely on a general website statement for a specific privacy or career question. A beneficiary can ask the treating provider, TRICARE and an appropriate military resource how the rules apply.

Official TRICARE Resources