Does TRICARE Insurance Cover Alcohol Rehab?
According to the National Institute on Alcohol Abuse and Alcoholism, excessive alcohol consumption is responsible for 95,000 deaths annually in the United States. That’s approximately 260 deaths each day. The cost of excessive alcohol consumption to our society was estimated at $249.0 billion in 2010.1
Many people don’t get help because they underestimate their issue or are discouraged by the cost of treatment. Furthermore, since alcohol is legal, mostly destigmatized, and widely distributed, a lot of people aren’t aware of the issue until alcoholism has already taken a serious toll on their lives.2
Most people who suffer from alcohol disorders never seek treatment, despite its proven effectiveness. Known barriers to treatment include the common barriers to health care such as low severity of the disorder, the reluctance of male users to accept the issue, and low income.2
However, the Affordable Care Act requires insurance companies to cover the cost of alcohol rehab for their policyholders and treat it in the same manner as any other medical service. This is a great step forward in helping those who struggle with addiction to get the treatment they need.3
While this also likely includes TRICARE healthcare plans, the coverage, services, and duration may vary. Fortunately, you can easily learn more about what TRICARE coverage nationwide entails in terms of alcohol addiction treatment by calling their helpline or reaching out to a recognized treatment provider such as American Addiction Centers.
What Is TRICARE Insurance?
Tricare insurance is a military health insurance program that provides health care coverage to eligible service members, military veterans, and their families. Tricare offers a variety of health plan options, including plans for families, retirees, and active duty service members. Tricare also offers special programs for National Guard and Reserve members, children of military members, and survivors of military members.4
The Scope of TRICARE Coverage: What Alcohol Treatment Services Does It Include?
Insurance companies vary in the types of alcohol abuse treatment they cover. Most policies should cover inpatient rehab, outpatient care, and medication needed for recovery.3
TRICARE alcohol rehab may cover a variety of services, including the following:3,5
- Screenings are important because they can help identify individuals who have an alcohol use disorder and need treatment.
- Interventions help motivate people to seek treatment and should be done in the presence of family and a licensed interventionist.
- Detox is necessary for some individuals who have an alcohol use disorder to expel the toxins from the body. The detoxification process can help people deal with alcohol withdrawal symptoms.
- Inpatient treatment is often necessary for those with a severe alcohol use disorder. It includes staying in a structured environment and participating in various individual and group therapies, counseling sessions, and other activities aimed at recovery.
- Outpatient treatment is a less restrictive form of rehab that allows individuals to live at home while attending therapy sessions during the day. This type of treatment can be helpful for those who do not need inpatient treatment or who cannot take time off work or school to attend rehab.
- Behavioral therapies are important because they can help people learn how to cope with their alcohol use disorder. They can help people learn how to deal with cravings, avoid relapse, and manage their emotions.
- Treatment for co-occurring disorders is also important because it can help people manage their mental health conditions. People with an alcohol use disorder are at risk of developing or suffering from a number of different mental health conditions such as anxiety, depression, and OCD. Treating both AUD and the co-occurring disorder is important for achieving remission from both conditions.
What Does TRICARE Addiction Treatment not Cover?
While insurance companies are required to treat alcohol rehab as any other medical emergency, this only refers to the medical services provided during treatment. However, any non-medical or non-evidence-based services are likely not covered by TRICARE healthcare plans. This may include:6
- Holistic care services and alternative therapies (such as yoga, reiki, and meditation).
- Recreation programs (such as swimming, hiking, and access to the gym or spa).
- Private treatment services (Concierge services, food delivery or fine dining, same-day treatment admission, private rooms, access to a phone or TV).
Some ancillary forms of therapy such as art, dance, music, or occupational therapy may be included in the coverage if they are a part of a treatment plan at an inpatient, intensive outpatient, residential, or partial hospitalization program.6
What Is the Cost of Alcohol Rehab in a TRICARE Substance Abuse Treatment Facility?
There are several variables affecting the price of alcohol rehab and therefore it may be difficult to give an estimate. In addition, the resources on the topic are scarce and difficult to find, discouraging some from seeking help.3
In general, the cost of treatment may depend on several factors including:3
- Type of program (inpatient, outpatient, or partial hospitalization).
- Treatment length.
- Location of the treatment facility.
- Services provided.
- Your insurance plan.
Usually, you will discuss these aspects of treatment with an admissions navigator prior or during the intake process at a facility. Once the type and length of treatment are determined, you will have a better idea of the cost. You can also call the TRICARE helpline for more information on your insurance coverage.3
How Much Does Inpatient Alcohol Treatment Cost?
The cost of inpatient alcohol treatment can vary depending on the program you choose. Some programs may be more expensive than others, but the cost of inpatient alcohol treatment is worth it since it can help you achieve sobriety. Inpatient treatment programs usually offer a variety of services, including detoxification, therapy, and individual or couples’ counseling sessions.5
The cost of inpatient alcohol rehab may be expensive, but the level of care and professionalism they provide is worth it. Patients receive accommodation and all the services they need in order to recover.5
How Much Does Outpatient Alcohol Treatment Cost?
Outpatient alcohol rehab costs can vary depending on the program and its location. However, due to the fact that patients aren’t expected to stay at a facility, but rather visit it for scheduled therapy and counseling sessions, the costs of outpatient rehab are usually significantly lower compared to local inpatient treatment programs.5
Private insurance companies typically cover at least some costs of a recommended outpatient alcohol rehab program, and many patients find that they only need to pay a small copayment.3
How Much Do Partial Hospitalization Programs for Alcohol Addiction Cost?
Partial hospitalization programs offer a middle ground between inpatient and outpatient treatment. While you aren’t expected to stay at the facility, you’ll spend most of your day attending various treatment programs and then return home or to your temporary residence.5
Since PHPs don’t provide living arrangements and 24-hour care, they are usually more affordable compared to inpatient programs. However, you can expect them to cost more than outpatient treatment.5
What Are the Costs of Medication-Assisted Treatment for Alcohol Abuse?
Medication-assisted treatment can be an effective way to overcome addiction and achieve lasting sobriety. The cost of MAT is usually determined by the type of treatment prescribed, length of treatment, and additional services offered (drug administration, counseling, or testing).7
The most commonly prescribed treatments for AUD include Disulfiram, Naltrexone, and Acamprosate.7
Medication-assisted treatment has been proven effective in helping veterans and other struggling individuals serious AUD overcome their addiction and stay sober. In addition, medication-assisted treatment can help reduce the risk of relapse, which is a common challenge for those who are struggling with addiction.7
What Is the Real Cost of Alcohol Addiction?
Lack of funding or insurance is among the most common reasons people are reluctant to seek treatment. While treatment costs may seem high, the cost of addiction is arguably higher.2
The United States lost $223 billion in 2006 due to excessive drinking in lost productivity, healthcare, criminal justice, and law enforcement costs. Furthermore, 23,1 million Americans over 12 years of age needed SUD treatment in 2010, but only 2.6 million received treatment at a treatment program the year before.8
Substance abuse treatment has many benefits, including reducing the costs associated with addiction. On average, the $1,583 cost of addiction treatment per patient is offset by $11,487 in benefit costs, representing a benefit-cost ratio of more than 7:1.9
Furthermore, alcohol can cause further damage and lead to medical conditions that are likely to worsen with time, resulting in increased medical bills. Therefore, it’s often more expensive to keep drinking than to seek treatment for AUD in the long run.5
How Long Does TRICARE-Covered Alcohol Rehab Last?
The length of treatment at an in-network TRICARE substance abuse treatment facility may vary based on your policy, but usually involves most if not all of your stay.3
Rehabilitation is a difficult process that takes time and effort. In most cases, it’s best to have a longer treatment length to achieve the best results.10
Longer treatment duration allows the patient to learn about their addiction and how to cope with it. Second, it gives them more time to develop the necessary skills to stay sober following rehab. Third, it allows them more time to build a support network of sober friends and family members. Finally, it allows them more time to adjust to life without alcohol.10
If you have questions about your TRICARE healthcare plan, you can also call the number on the back of your insurance card. Your insurance company can help you understand your coverage and answer any questions you have. All calls are completely confidential, so don’t hesitate to answer truthfully and ask for any information you need.
Is Inpatient Treatment for Alcohol Abuse More Effective Than Outpatient?
Inpatient and outpatient treatment for alcohol abuse and addiction can differ in a few ways. Inpatient treatment requires that a person stays at a facility while undergoing treatment. Outpatient treatment allows a person to go home each night and return for treatment during the day.10
There are pros and cons to both inpatient and outpatient treatment for alcohol abuse. Inpatient treatment generally lasts longer than outpatient treatment, and it requires that a person stays at a facility for the entire duration of treatment. This can be beneficial because it allows the person to focus exclusively on their recovery without any distractions. However, inpatient treatment is usually associated with higher treatment prices.10
Outpatient treatment allows a person to go home each night and return for treatment several times a week during the day. This can be beneficial because it is more affordable than inpatient treatment, and it allows people to continue working or attending school. However, some people may find it difficult to stick with outpatient treatment if they are not motivated to recover.10
How Does Using TRICARE Healthcare Plans for Alcohol Rehab Work?
It’s important to know what your TRICARE insurance covers when looking for substance abuse treatment. Most insurers have a deductible for alcohol abuse treatment, which means you will need to cover a certain amount of expenses before using your benefits.3
Once you know what your rehab insurance covers, ask the insurance agent for a list of in-network providers or facilities in your area. This will help avoid unexpected costs of treatment, as your insurance is generally more likely to finance services received from these providers.3
You may also be asked to provide a co-pay, which is a small upfront cost you’ll need to pay each time you visit a provider or facility. Make sure you know how much the co-pay is and how many appointments or what length of treatment is covered per year.3
How to Find Alcohol Treatment Programs That Accept TRICARE Substance Abuse Coverage?
If you are looking for drug treatment programs that are covered by TRICARE healthcare plans, your best option is to contact the helpline number printed on the back of your insurance card and ask them about a local in-network TRICARE substance abuse treatment facility.
In addition, you can get in touch with a local alcohol and drug rehabilitation hotline to find out about substance abuse treatment options that accept TRICARE and schedule an alcohol abuse assessment.
The American Addiction Centers (AAC) hotline and website can provide you with information on nearby treatment centers and what payment options might be available to you. Speaking to a licensed admissions navigator can help you verify your insurance coverage and find the best treatment center for your needs.