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Benefits for Veterans and their Dependents

VA Spouse Medical Benefits: Coverage for Rehab and Therapy Treatment

Active-duty and retired military officers often battle substance abuse. A staggering number of veterans struggles with substance use disorders because they resort to alcohol and drugs as a way of coping with trauma. Others may become addicted to prescription opioids for pain management and then switch to illicit opioids which are cheaper and easier to obtain.1

Engaging in continued excessive drinking constitutes alcohol abuse.2 Although alcohol is the primary substance of abuse for many veterans, it’s not uncommon for veterans to engage in both alcohol and drug abuse at the same time, making their substance use disorder more complex and more difficult to treat.2 

The Department of Veterans Affairs (VA) Alcohol and Drug Dependence Rehabilitation Program provides various therapies to eligible veterans, and possibly VA spouses, in need of alcohol and drug dependance treatment, including medical, social, vocational, and rehabilitation therapies. Various forms of treatment are incorporated in these programs, including but not limited to detoxification, rehabilitation, and psychiatric care.3

What Is VA and Benefits for Spouses?

Compensation through VA disability benefits may include financial support and other benefits like healthcare. To be eligible for Veterans Alcohol and Drug Dependence Rehabilitation Program, a veteran must be enrolled in the VA health care system (or qualify based on one of the exceptions in the law).4

Spouses of veterans may also be eligible for VA benefits if they meet certain requirements. If a veteran is just filing their original claim for disability compensation, they can also file a claim for additional compensation for a dependent at the same time.4

If a veteran receives a combined disability rating of at least 30%, they will automatically be considered for eligibility for additional compensation for a dependent. If a dependant is added at a later time, the veteran can also file a claim for additional disability compensation for that dependent then.4

Does VA Cover Rehab Treatment (Addiction Treatment) for Spouses?

Veterans who are eligible may add a dependent spouse, child, or parent to their VA disability benefits for additional compensation. So, in some cases and to an extent, VA may cover addiction treatment for spouses.

Addiction is a medical condition for which veterans may be entitled to receive disability benefits from VA, but only if they can prove that the condition was directly connected to their service in the military.6 

What Benefits Do Veterans Spouses Receive?

The VA has a diverse offering of benefits for veterans. These benefits can come in the form of physical and mental healthcare available to veterans and their dependents, but also in the form of monthly disability payments.4

For venterans’ spouses to become eligible for VA benefits, they need to meet certain requirements. Substance abuse treatment may be available through the TRICARE program.7 If a spouse does not qualify for that, they may be eligible for health insurance through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).8 

This program is reserved for the spouses of veterans with disabilities or the surviving spouses of deceased service members who died in the line of duty. CHAMPVA covers a portion of the cost of healthcare services and supplies. This includes mental health care and, by extension, substance abuse treatment.8

Veterans Spouse Benefits Eligibility for Substance Abuse Treatment

A person can be eligible for substance abuse treatment if their veteran spouse has been approved for disability benefits on account of an illness or injury sustained or made worse by active military service. Veterans need to have a combined disability rating of at least 30% to be able to receive additional disability compensation for their spouse and other dependants.6

Spouses of Disabled Veterans

Benefits available to spouses of disabled veterans may include various VA benefits, for instance:9

  • Disability compensation.
  • Health care.
  • Insurance coverage.
  • Survivors’ benefits.
  • Education and training.
  • Employee services.

Surviving Spouses

Benefits for the surviving veterans spouses available to qualified individuals may include:9

  • Health care through the CHAMPVA program.
  • The Department of Defense’s TRICARE program.
  • Veterans service-connected disability-related programs.

Divorced Spouses

Former spouses of veterans are entitled to the Continued Health Care Benefit Program (CHCBP), which is the Tricare version of Continuation of Health Coverage (COBRA). This is available for a period of three years.10

The divorced spouse of a veteran may remain on CHCBP for life if they meet two requirements: to remain unmarried and to be awarded a share of the military retirement.10

Do Rehab Centers Need to Be In-Network to Accept VA Insurance?

If a person qualifies for VA health care, they are entitled to coverage for any services they need to recover and stay healthy. The list of health care benefits is long and diverse.4

Like with any other type of insurance, treatment at a rehab center is most affordable when the centers is in the insurance provider’s network.11

American Addiction Centers is in-network with VA. Two of AAC facilities are in-network with VA and also serve the unique needs of veterans: Desert Hope in Las Vegas, Nevada and Recovery First in Hollywood, Florida.

Types of Addiction Treatment That VA Health Benefits May Cover

Different treatment programs may be covered by VA health benefits, including:12

  • Detox: medically supervised, medication-assisted withdrawal.
  • Short-term inpatient treatment or long-term inpatient treatment in a residential facility.
  • Partial Hospitalization (PHP): a structured program held for several hours for several days a week.
  • Intensive Outpatient Program (IOP): high-intensity outpatient treatment that matches the effectiveness of inpatient programs.
  • Outpatient treatment: a low-intensity program that comprises regular treatment sessions in an outpatient setting.
  • Therapy: individual or group behavioral therapy.

Does VA Health Benefits Cover Mental Health Treatment?

Mental health disorders often co-occur with substance use disorders, and this is referred to as a dual diagnosis or a co-occurring disorder. Insurance may also cover dual diagnosis treatment.12

When mental health treatment is conducted simultaneously with substance use disorder treatment, recovering individuals have a better chance of a successful lasting outcome where both conditions are kept under control.12

Commonly occurring mental health disorders include depression, anxiety, and posttraumatic stress syndrome or PTSD, which is something veterans often deal with.13

How Much of the Rehab Cost Does VA Health Benefits Cover?

Veterans seeking treatment for substance abuse rely on insurance to help pay for treatment costs. Free VA health care is only available for illnesses and injuries determined to be service-connected or directly related to a service member’s military service.4

For many veterans on a limited income, private pay options to cover treatment aren’t an option. If a person is approved for VA health benefits, VA covers treatment costs partially or in full.11 

Inpatient treatment for a substance use disorder typically costs more than outpatient drug and alcohol treatment, but it is also more likely to be effective.12

This is especially true at the initial stage of treatment which includes detoxification, a process which helps recovering individuals go through withdrawal with ease.12 Detoxification is safe when it is medically supervised and medication-assisted, unlike unsupervised detoxification which can be life-threatening.14

All insurance plans cover Essential Health Benefits or 10 essential health services, among which is help with mental health issues, drug or alcohol abuse, counseling and therapy.11

What Should I Do if VA Does Not Cover Substance Abuse Treatment?

Chronic substance abuse leads to a substance use disorder, which is a chronic, relapsing disorder characterized by compulsive drug seeking and use, despite detrimental consequences and far-reaching implications. Going to rehab implemented in accordance with effective treatment principles helps recovering individuals overcome drug addiction and keep it under control.12 

Treatment costs can be steep so many veterans rely on VA benefits to pay for treatment. VA insurance coverage options such as TRICARE, the U.S. military healthcare program, may also cover some forms of substance abuse treatment.7

But if VA does not cover substance abuse treatment, what other options are there? 

For many veterans, financing treatment can be challenging because they have a limited income with dependents to support or because they are unable to find steady employment. VA may not cover substance abuse treatment for a dependent, but there are always other viable alternatives to consider at private or publicly-funded facilities. Some facilities may also offer sliding scale fees or repayment plans.11

Treatment costs vary depending on resources and amenities available at the facility. Private rehab facilities may be more flexible and offer a higher diversity of services than their publicly-funded counterparts. It’s a wide spectrum. There are luxury rehab facilities which offer a higher level of comfort to recovering individuals, and there are also facilities which only offer basic rehabilitation services and short-term care.11

Treatment duration and setting is another important factor which impacts cost. High-intensity inpatient treatment will, therefore, be considerably more expensive than lower-intensity treatment in an outpatient setting, but it also correlates positively with beneficial treatment outcomes.11

How to Apply for Veterans’ Spouse Benefits?

There are two ways spouses of veterans who are also their dependents can apply for benefits:6 

  • If the veteran is applying for benefits for the first time, they can also file a claim for additional compensation for their dependents.
  • If the veteran is already receiving benefits and has a combined disability rating of at least 30%, any dependents will be automatically considered for additional compensation.

Finding VA Benefits Insurance Rehab Coverage

VA offers a range of benefits to veterans, including physical and mental healthcare and monthly disability payments. Benefits may be available to veterans and their dependents. Additionally, recovering individuals in treatment have confidentiality and privacy protections, so it’s best to start by calling an official representative.6 

It’s important to check coverage levels and in-network treatment options before deciding on a rehab facility/program. You can do so by calling a specific provider, such as American Addiction centers. Their admissions navigator team can be reached through a specialized hotline and help treatment-seeking individuals explore their payment options, as well as verify their insurance covers detox and rehab services

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