Home » Check My Insurance » Tricare West/Prime Insurance Information for Drug Rehab
Kickstart your recovery with Gratitude Lodge. Our treatment programs for alcoholism, drug addiction, and mental health disorders are covered by most PPO insurance providers, including drug rehab Tricare West/Prime with insurance coverage and drug rehab Aetna with insurance.
Access the following evidence-based services:
Today’s guide will help you to determine whether you have the best health insurance for drug rehab. You can also discover how to access drug rehab centers that accept Tricare West/Prime insurance for addiction treatment.
Two of the most common questions for those exploring addiction recovery are:
Fortunately, most health insurance will offer at least partial coverage for alcohol use disorder and substance use disorder treatment. Addiction is widely recognized as a chronic and relapsing brain disorder. As such, addiction requires treatment in the same way as other physical and mental health conditions like heart disease, cancer, and PTSD (post-traumatic stress disorder).
Nevertheless, there are many factors that impact the amount of coverage and type of coverage an insurance plan will provide for addiction treatment. You will also need to find a drug rehab that takes insurance.
If you require rehab services not included in your insurance coverage, you could consider a personal loan or private pay to make treatment financially feasible.
Does Tricare West/Prime insurance cover drug rehab and alcohol rehab, then?
At Gratitude Lodge, we believe there should be no barrier to accessing drug and alcohol addiction treatment. To improve accessibility, we are happy to work with most major insurance plans to cover the cost of your treatment.
Tricare health insurance typically covers the cost of alcohol rehab. If you are diagnosed with alcohol use disorder – the clinical descriptor for alcoholism – you are eligible for Tricare coverage at many treatment facilities, including Gratitude Lodge. Rehab coverage with Tricare depends upon the specifics of the health plan.
Whether you need inpatient rehab or an intensive outpatient program for alcohol addiction, call Gratitude Lodge today to discuss your Tricare coverage. Call (888) 861-1658.
If you need treatment for substance use disorder (drug addiction), Tricare plans usually provide coverage for detox, inpatient rehab, and IOPs (intensive outpatient programs).
Tricare coverage for detox will be contingent on whether admittance to a medical detox center is deemed essential for your recovery.
Some Tricare plans allow to you to connect with treatment from out-of-network providers. The costs will always be higher than using an in-network treatment provider like Gratitude Lodge.
To learn more about inpatient or outpatient rehab at Gratitude Lodge, reach out to the friendly team right now at (888) 861-1658.
The ACA (Affordable Care Act) passed in 2010. This law has three primary goals:
By 2014, the ACA required all new insurance plans – both group and individual- to cover ten core health benefit categories. Both substance use disorder services and mental health disorder services are considered essential health benefits.
Beyond this, the Affordable Care Act also calls for insurers and health plans to offer coverage in line with coverage for general medical care and surgical care.
Resultantly, you may find that your health insurance policy covers the costs of outpatient rehab, inpatient rehab, and other substance use disorder treatment services. The level of coverage will differ from policy to policy and from plan to plan.
What this means is that it can be challenging to navigate the coverage and exclusions in place on your health insurance policy. Beyond this, you will also need to establish whether the rehabs on your shortlist will accept payment through health insurance. In most cases, this should not be an issue. Most reputable rehabs will employ an insurance specialist to help those considering recovery to better understand the specifics of their health insurance policies.
As well as speaking with rehab centers directly, you can also contact your insurance provider to determine the specifics of coverage.
The first thing you should do is to check your health insurance policy. Call the insurance carrier and inquire about the different types of addiction treatment the policy will cover. This will enable you to compare rehab centers and treatment programs more confidently.
In general, private health insurance plans offering the most robust coverage for addiction treatment will cost more. The following insurance companies will typically provide coverage for at least some of the costs of addiction treatment:
Veterans in need of rehab may find that Tricare/West covers at least part of the cost of addiction treatment, depending on the specifics of the plan.
You may find that group insurance plans provided by employers are costly and also subject to restrictions. You may find the insurance plan covers the costs of first-time addiction treatment, but excludes additional treatments in the event of relapse.
While health insurance plans are required to cover treatment for alcohol use disorder and substance use disorder, benefits vary from state to state and from provider to provider. Always review your insurance benefits before pursuing treatment.
Most health insurance plans will provide coverage for the following:
Beyond those core basics, some plans will also provide coverage for these treatments and therapies:
Even if you have health insurance, there is no guarantee it will provide enough coverage for the addiction treatment you need.
For example, research shows that while outpatient treatment is effective for most mild addictions, many moderate and severe addictions benefit from inpatient rehab. Not all health insurance plans provide coverage for residential rehab, though.
If services are not deemed medically necessary, most health insurance policies will not provide coverage for these, even if they might aid in your recovery.
The following services are not normally covered by health insurance:
While health insurance providers might be required to provide coverage for first-time addiction treatment, they are not obliged to cover relapses. If you relapse, consult your care manager, and ask if they will advocate on your behalf so you get the coverage you need for your sustained recovery.
Even if you don’t carry private health insurance, this does not need to be a barrier to receiving the therapy you need.
You could first investigate free rehab and state-funded rehab if you have absolutely no funding options at your disposal. Some states will offer financial assistance to those requiring low-cost addiction treatment programs, while other states offer partially-funded programs and services.
You could also consider exploring other avenues of funding, such as:
You first need to verify that your health insurance policy offers coverage for addiction treatment and at what level.
Next, consult your healthcare provider to determine your treatment needs. Expect an assessment to establish the scope and severity of substance abuse, as well as outlining the treatment required for a successful recovery.
Establish that the rehab you select accepts insurance for payment and verify that your insurer will pay the costs for this treatment.
You can then work with the rehab center to check that insurance coverage extends to the cost of the care you need. Most treatment centers employ specialists to guide you through this process.
From here, all that remains is to focus fully on your recovery, preparing yourself to embrace life substance-free.
You can check your insurance coverage eligibility right here.
Call (888) 861-1658 today for immediate assistance from detox to discharge and beyond.