TRICARE Rehab Coverage for Behavioral Health

Mental Health, Trauma, and Addiction Treatment Using TRICARE at Catalina

Are you seeking treatment for mental health, post-traumatic stress disorder, or substance abuse with TRICARE insurance? Getting the mental health help you need right now starts with getting a clear picture of what your insurance provider will cover. If you have arrived looking for support using TRICARE, whether for yourself or a loved one, you have come to the right place.

But what does TRICARE rehab coverage include to allow you and your immediate family to get help for your substance use and mental health? Keep reading to get answers and options with Catalina!

Catalina Behavioral Health is a desirable destination for anyone seeking assistance with trauma and PTSD, as well as substance use. Our facility also offers state-of-the-art treatments for everything from eating disorders and complex trauma to BPD and other mental health issues.

When you are ready to face down therapy and receive help, our warm and welcoming team can help you pinpoint what your TRICARE insurance will cover, so read on and feel free to reach out by phone at any time!

Does TRICARE Offer Addiction Treatment Coverage and Mental Health Care?

Addiction treatment services and mental health are both mandated to be covered by TRICARE, as well as any other insurance provider you may have as a secondary source of insurance. Both inpatient and outpatient treatment are often covered services, but it will help to know what to expect from each and which will be of the most benefit.

Inpatient Services or Mental Health and Substance Abuse

Inpatient or residential rehab services are covered by TRICARE through the auspices of the Defense Health Agency and include any situation where you may need around-the-clock care. This can stem from a psychiatric concern or could be a great way to detox during substance abuse treatment. You can get medication-assisted treatment to make these early days of sobriety more comfortable.

Keep in mind that you will need to meet the inpatient criteria before TRICARE will cover an inpatient stay for any purpose.

If you need help with an immediate concern for your well-being, you can head to a hospital or treatment facility to get the help you need as soon as possible. Some services that may warrant an inpatient hospital or mental health treatment facility stay can include a psychiatric emergency such as suicidal thoughts and actions and detox from substances.

Outpatient Treatment for Lower Levels of Care

Outpatient treatment is also a robust way to get the help you need without spending the night outside your home. Some people fare better when they have the familiar routines and experiences of being in touch with their family members and loved ones during treatment.

If this describes you, TRICARE does often cover outpatient rehab and mental health services.

This can cover several levels of care including individual, family, or group therapy sessions in an office setting. It also includes psychological testing for more insight into your struggles.

Partial Hospitalization Programs and IOP: Supportive Options

Sometimes, you may find that you need a higher level of care which is where intensive outpatient programs or partial hospitalization programs come into play. Intensive outpatient programs or IOPs offer the option of several hours a day in treatment, with 2-3 meetings each week. You can come and go between sessions, but you will have multiple hours of different types of therapy each week.

Partial hospitalization programs are a more full schedule, usually allowing you to spend all day in the facility, five days a week. At night, you can go home to sleep in your bed and spend time with loved ones.

What Types of Therapy Are Covered by TRICARE Insurance?

In terms of covering multiple levels of treatment, TRICARE and its associated program for the Western US, TriWest cover several different types of rehab services across these different programs. Many people are familiar with individual counseling, and this might be the first thing you seek out. However, you should not feel limited only to see a one-on-one trained counselor.

TRICARE is also great for offering more robust therapies. For example, you could work on interpersonal dynamics with your family members in family therapy. You might also benefit from learning skills along with your peers in group therapy for dialectical behavioral therapies. It might even cover marriage counseling if you need it to move past trauma, mental health, or substance use.

If there is a type of therapy out there that you would like to try, it is worth seeing what TRICARE will cover.

Remember that the Substance Abuse and Mental Health Services Administration (SAMHSA) found that 44 to 72 percent of service members had difficulty transitioning to civilian life. Seek help when you need it to make this transition as easy as possible.

Who Does TRICARE Insurance Cover?

Knowing who can receive help with your TRICARE insurance is equally important when seeking care for yourself or a loved one. Coverage under this umbrella extends beyond yourself and also applies to your spouse. Whether they need inpatient rehab for mental health or addiction treatment coverage using health benefits, TRICARE offers the help they need at accredited facilities.

It also extends to children and young adults who may need help under your policy. Keep in mind that Catalina only serves adults, but it is useful to know that children also benefit from covered services under your insurance provider.

The benefit of TRICARE insurance is that it covers all family members. If your loved ones are struggling with trauma or mental health, it can be a great time to seek help. Reach out to a facility like Catalina that can help you find the resources you need for everyone in the family and provide prompt and confidential verification of benefits.

How to Seek Help with TRICARE Coverage

Whether you are on TRICARE Retired Reserve or a different form of TRICARE insurance, you need to know how to go about seeking help. There is a standard operating procedure to get your mental health services covered or enter into medication-assisted treatment.

What are the Differing Policies of Various TRICARE Plans?

Here are the various scenarios you may need to follow for your TRICARE coverage to kick in:

• Active-Duty Service Members: Your first step is to seek nonemergency care at a military hospital or clinic. If you see a civilian health professional, you will need pre-authorization and a referral to access services.
• TRICARE Prime: Under this insurance, you do not need a referral to access outpatient treatment in a standard office setting. You may need prior authorization for inpatient treatment options.
• TRICARE Select: All TRICARE providers are authorized for you, but out-of-pocket costs will be much lower for in-network providers. Do your homework before you select a provider.
• TRICARE For Life: This plan encourages you to use your Medicaid benefits first before your TRICARE insurance provider will kick in. If Medicaid benefits have been exhausted, prior authorization is necessary to solicit treatment via a TRICARE drug rehab.

The type of TRICARE insurance you have dictates what type of treatment you can receive, how much it will cost you, and what the prior authorization process will look like. Both residential treatment for mental health and substance abuse can be covered by TRICARE health insurance, but you will need to follow their guidelines to minimize out-of-pocket spending.

Under some of these plans, you can also seek out-of-network providers at a slightly higher cost than those in-network. For example, TRICARE Reserve Select, TRICARE Young Adult, and TRICARE Prime Remote all offer this benefit. Consult with the facility to see what might be covered under these plans.

Mental Emergencies and TRICARE Coverage

If you have a mental health emergency or need help to deal with withdrawal symptoms, you do not have to go through the process of finding prior authorization. Instead, you can head immediately to your local emergency room or treatment facility to be seen immediately and given mental health treatments on an urgent basis.

This is the case if you are a danger to yourself or others or need monitoring. Alternatively, you can dial 911 to receive help from emergency medical services.

Remember that you do need to notify your insurance company within 72 hours of hospital admission so that they can help you plan for the next steps. You may also need to let them know you sought emergency services within 24 hours (or on the next business day).

Always seek help if you need it, and do not let insurance providers hold you back from getting the help necessary to function.

Are All Costs Covered by TRICARE?

It is important to note that not all costs may be covered in their entirety under TRICARE insurance, especially if you select an out-of-network provider. Cost should not be the thing that holds you back from receiving treatment though. Do your homework to find a facility in your desired location that can work with you on the price and verify your benefits, such as Catalina.

When insurance does not cover your entire treatment, you may consider asking for a payment plan. This allows you to focus on your treatment in the here and now. Later, you can consider the repayment plan when you are feeling better and can return to your life.

At Catalina Behavioral Health, we are more than willing to talk about payment options with you so that you can get the help you need to heal.

Allow Catalina Behavioral Health to Check Coverage

Will TRICARE cover inpatient rehab for you, a spouse, or an adult child? At Catalina Behavioral Health, we can reach out to your insurance and verify what your benefits will cover. Don’t go through the process of seeking help entirely on your own. Our friendly admissions team is waiting to help you decide on the perfect facility for treatment.

In just a few minutes, we can verify your insurance coverage and help you see what you qualify for. Reach out to us today to see how we can come alongside you to improve your mental health.

Get Help from a Robust Treatment Facility like Catalina

Catalina Behavioral Health is a great place to land if you need help with mental health, trauma, or substance use disorder. Our drug and alcohol rehab, as well as our mental health services, are great options to help you through a difficult time.

We are proud to be a Joint Commission-accredited program that does its best to meet the needs of each one of our clients as individuals. There are no one-size-fits-all treatment options at our facility. Instead, everything is customized based on your unique needs and experiences.

We can do our best to help you find a place to land that you can afford with any TRICARE insurance company. Let us help you enroll in mental health, eating disorders, or alcohol and drug rehab centers today, reach out for a confidential call now!