FALLS CHURCH, Va. –
Did you know that TRICARE covers treatment of substance use disorders? Substance use disorders can lead to problems in all aspects of a person’s life, according to the Centers for Disease Control and Prevention. TRICARE offers comprehensive services to treat the different ways substance use disorders present in patients.
“Substance use disorder treatment works best when we meet each patient where they are,” said Thomas Turnbaugh, LCSW-C, mental health specialist, at the Defense Health Agency. “TRICARE covers a full range of care, so you can find the right level of support for your recovery.”
These covered services give you or your family members the resources to seek help when you need it most. Most of all, they can help you get back to daily life. This article reviews what TRICARE covers, from hospital stays to outpatient care.
What TRICARE covers
TRICARE covers many kinds of care, including hospital stays, outpatient programs, detoxification, and medication-based treatment. Your care plan depends on your needs. Your provider will work with you to choose the best plan.
Emergency hospital care
You may need emergency hospital care if you have a medical or mental health crisis. If you have a mental health crisis, call 911 and seek treatment at the nearest hospital. You don’t need pre-authorization for emergency care. TRICARE covers care at the closest hospital. If you need more care after the crisis ends, you must get approval.
Planned hospital care
You may need planned hospital care if you don’t have a crisis. This type of care needs pre-authorization first. TRICARE covers hospital stays to treat mental health and substance use disorders.
Intensive outpatient programs
An intensive outpatient program offers care without a hospital stay. You may qualify for an IOP if you have a substance use disorder. You may also qualify if you need more care than regular outpatient visits offer. Check with your regional contractor to see if you need pre-authorization.
Detoxification
Detoxification treats withdrawal symptoms. TRICARE covers detoxification in several settings. These include hospital stays, IOPs, and opioid treatment programs. Your doctor will watch your symptoms and treat you as needed.
Medication assisted treatment
Medication assisted treatment combines medication with therapy. You don’t need pre-authorization for stateside MAT, but MAT overseas depends on local rules.
Opioid treatment programs
An opioid treatment program may help if you have an opioid use disorder. You may qualify if you need close medical support during detoxification. You may also qualify if you need medical support, but not a full hospital stay.
Therapy and other services
TRICARE also covers therapy for substance use disorders. This includes talk therapy, testing, and medication management. Your doctor will suggest care based on your diagnosis.
What TRICARE doesn’t cover
TRICARE doesn’t cover aversion therapy. It also doesn’t cover unproven treatments. Visit Mental Health Exclusions or call your regional contractor to learn more.
Talk to your doctor
Talk to your doctor if you or a loved one needs help with a substance use disorder. You can also call your regional contractor to learn about care options in your area.
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