Understanding TriCare Drug Treatment Coverage

Learn about using your TriCare insurance policy to cover substance abuse treatment


Alcohol and Drug Treatment Coverage with TriCare

When you’re struggling with alcohol or drug addiction, the last thing you want to worry about is whether your insurance will cover the treatment you need.

TriCare, the health care program for active duty service members, their families, National Guard and Reserve members, retirees, survivors, and certain former spouses, offers coverage for substance abuse treatment to help you get back on track.

In this guide, we’ll examine TriCare’s drug treatment coverage, including in-network and out-of-network options, the claims approval process, plan types, deductibles, and navigating financial hardships so you can focus on your recovery.

By understanding your coverage, you’ll be better prepared to focus on recovery and lead a healthier, drug-free life.

we accept most health insurances- substance abuse treatment

Now Accepting AHCCCS, TriCare, and Triwest Insurances

Addictions we treat at Cornerstone

TriCare drug treatment coverage

When seeking drug treatment with TriCare, it’s best to choose an in-network provider to save on out-of-pocket costs and for easier claims processing, thanks to TriCare’s negotiated rates.1

Some plans, such as TriCare Reserve Select, TriCare Young Adult, and TriCare Prime Remote, allow out-of-network care at higher costs. Other plans require in-network providers to ensure the lowest possible expenses.2

While in-network options provide the best value, they may have fewer facilities and potential waiting lists.

Information about TriCare Plan Types

TRICARE Prime is a mandatory plan for active-duty members of the military. It covers active duty and retired military members and their families, as well as activated members of the National Guard and their families.

TRICARE Prime offers coverage for most forms of substance misuse treatment, including inpatient and outpatient treatment and detox.3

Like an HMO, you must choose a primary care physician to coordinate your care and provide specialist referrals. You’ll have lower out-of-pocket costs but less flexibility in choosing providers.

TRICARE Select is another option for active duty and retired military members and their families.4

While members have additional choices in the providers they see, there are higher costs.

This coverage is very similar to TRICARE Prime, but certain services must be approved before they’re authorized.

Like a PPO, TRICARE Select gives you more freedom to see out-of-network providers, but you’ll pay more for those services.

You won’t need referrals to see specialists.

TRICARE Standard Overseas is a plan offered to active-duty and retired military members and families that allows a choice of providers but has higher costs.

As with the TRICARE Standard, authorization is required for many services.

Like an EPO, you’ll need to stay within the plan’s network, but you won’t need to choose a primary care physician or get referrals.

TRICARE Reserve Select coverage is for reserve members who are not on active duty. It resembles a typical insurance plan with a deductible, monthly payments, and a provider network.

Members can choose to go to a non-network provider for treatment but will pay a higher deductible and copay.

This is comparable to a POS plan, which blends elements of HMOs and PPOs. You’ll have a primary care physician but can see out-of-network providers at a higher cost.

TRICARE Retired Reserve offers coverage for eligible retired reserve service members under 60 and some surviving spouses of eligible retired reserve members.

As with Reserve Select, members of this plan have monthly premiums, deductibles, and copays but can use non-network providers at a higher cost.

This plan is similar to an HDHP, which has lower premiums but higher deductibles. They’re often paired with a health savings account (HSA) to help you save for medical expenses.

TRICARE for Life is a program for people who receive Medicare Part A and B. It is a form of health insurance that covers many expenses that Medicare does not.

TRICARE Young Adult offers coverage for those needing healthcare after their “regular” TRICARE coverage ends after age 21 (23 if in college).

You must also be under 26, unmarried, and the child of an eligible TRICARE member. These plans work alongside Medicaid and Medicare to provide comprehensive coverage.

Understanding Policy Terminology

The deductible is the amount you pay out of pocket for covered healthcare services before your insurance plan starts to pay.

For example, if your plan has a $1,000 deductible, you must pay the first $1,000 of covered services yourself.

After you have paid your deductible, your insurance will begin to pay its share of the costs.

Deductibles can vary depending on your specific TriCare plan and whether you choose an in-network or out-of-network provider.4

TriCare Approval Process for Treatment

The first step in the approval process is verification. The treatment center will verify your TriCare coverage and determine what your specific plan covers. They will contact TriCare to confirm your eligibility and get details on your benefits, including any deductibles, co-payments, or co-insurance amounts. The treatment center will then let you know if you’ll need to pay anything out of pocket for your treatment. It’s important to provide accurate information to the treatment center so they can verify your coverage correctly.

Get Help Paying Your Deductible

File a Hardship With TriCare

If paying your deductible would cause significant financial strain, you may be able to file a hardship request with TriCare. A hardship is a situation that causes significant financial difficulty, such as a loss of income, unexpected medical expenses, or a natural disaster. To file a hardship, you must contact TriCare directly and provide documentation of your financial situation. If your hardship request is approved, TriCare may waive or reduce your deductible, making it easier to afford the necessary treatment.

Assistance Programs & Payment Plans 

Many treatment centers offer financial assistance programs or payment plans to help make treatment more affordable. These programs can help you cover your deductible or spread the cost of treatment over time. Some centers may have sliding-scale fees based on income, while others offer grants or scholarships. When exploring treatment centers, be bold and ask about these options. Feel free to explain your financial situation and ask for help. The admissions staff at the treatment center can work with you to find a solution that fits your budget.

Community Resources & Charitable Organizations

Community resources and charitable organizations, such as local faith-based groups, community foundations, and national non-profits focused on addiction recovery, may be able to help cover your deductible for drug treatment. These organizations understand the importance of timely care. Your treatment center or local health department may have information on these resources, but remember that they may have limited funds and eligibility requirements. Don’t let financial concerns stop you from seeking the drug treatment you need.

FAQs About Using TriCare Benefits
to Pay for Alcohol and Drug Treatment

Will TriCare cover my entire stay in drug rehab?

TriCare is committed to providing comprehensive healthcare assistance, including coverage for medically necessary substance use treatment.

If a healthcare professional determines that your rehabilitation stay is essential for your health and recovery, TriCare typically covers the associated treatment expenses, depending on the specifics of your policy.

However, to fully understand your benefits, you should review your TriCare policy or speak with a Cornerstone admissions representative for detailed coverage information.

We can verify your insurance coverage, check your benefits, and ensure you receive the necessary treatment.

What types of treatment does TriCare cover?

TriCare offers a broad spectrum of coverage to assist individuals confronting substance use disorders, emphasizing both immediate medical intervention and holistic, long-term recovery.5

Below is an overview of services TriCare supports:

  • Inpatient Services (Including Emergency): TriCare provides coverage for both emergency interventions and planned inpatient care, ensuring timely access to necessary treatments without delay.
  • Intensive Outpatient Programs (IOPs): TriCare supports intensive outpatient programs for individuals requiring regular oversight without constant inpatient care. These programs typically feature group therapy, individual counseling, and structured recovery activities.4
  • Detoxification: Recognizing the difficulty of managing withdrawal symptoms, TriCare covers detoxification services, which are crucial for the safe mitigation of withdrawal under professional supervision.
  • Mental Health Services: Acknowledging the frequent overlap between addiction and mental health issues, TriCare extends coverage to a variety of mental health services, including cognitive-behavioral therapy (CBT), psychotherapy, and counseling, to tackle underlying mental health challenges.
  • Opioid Treatment Programs: For severe opioid dependency, TriCare includes comprehensive treatment programs that combine medication-assisted treatment, counseling, and ongoing recovery planning.
  • Partial Hospitalization Programs (PHPs): PHPs balance intensive inpatient care and outpatient services covered by TriCare, facilitating substantial care without overnight stays.
  • Residential Treatment for Substance Use Disorders: TriCare also covers residential treatment programs for individuals needing immersive, 24/7 care. These programs offer medical oversight, therapy, and peer support in a residential setting.


TriCare’s wide-ranging coverage ensures that military members and their families have access to varied treatment pathways, catering to diverse needs for achieving sustainable recovery from substance abuse.

Are there any restrictions on types of addiction treatment TriCare will pay for?

Like other insurance providers, TriCare sets certain restrictions or limitations on the addiction treatments it covers, considering factors like medical necessity, evidence-based effectiveness, cost efficiency, and the details of your specific insurance plan.

Common restrictions may include:

  • Type of Treatment: Coverage may be restricted to certain types of treatment, such as inpatient, outpatient, or Medication-Assisted Therapy (MAT). In contrast, more luxurious or experimental treatments might not be covered.
  • Provider Network: TriCare has a network of approved addiction treatment providers. Getting care outside this network could lead to higher out-of-pocket costs or lack of coverage.
  • Pre-Authorization Requirement: Many TriCare plans require pre-authorization for addiction treatment services, meaning approval is needed in advance to ensure coverage.
  • Duration and Frequency of Treatment: Limits may be placed on how long and how often treatments can be received, for example, a maximum number of days for inpatient care or a limited number of therapy sessions.
  • Substance-Specific Coverage: The coverage might differ based on the substance being treated, with certain substances or behaviors possibly facing exclusions or limitations.
  • Evidence-Based Treatments: TriCare generally covers treatments proven effective through scientific research.
  • Appropriate Level of Care: Coverage is provided only for the level of care deemed necessary for the patient’s specific condition, which could restrict access to more intensive treatment options unless there is a medical justification.


There are many factors to consider when determining your coverage.

Contact our admissions team for personalized guidance based on your unique situation.

Does TriCare cover therapy?

Yes, TriCare provides coverage for a wide range of psychotherapy services for its members.

This includes individual therapy sessions, counseling appointments, marriage and family counseling, and various forms of group therapy designed to address different mental health conditions.

In addition to these standard therapy options, TriCare may also cover psychological testing and assessments that help diagnose patients with specific mental health disorders.

Some plans may even cover experiential therapies, such as art therapy and music therapy, though this can vary depending on the specific plan and provider.

You must check with your TriCare representative to understand the particular therapy benefits included in your plan.

How soon can I get into rehab with TriCare coverage?

We have made the admission process as simple and convenient as possible.

Once we verify your TriCare insurance, we can proceed with treatment planning and admission without delays.

So you can start your journey toward recovery as soon as possible!


lionel estrada LISAC headshot clinical director scottsdale

Lionel Estrada, LISAC


Lionel, our Clinical Director is a Licensed Independent Substance Abuse Counselor (LISAC) with over 4 years at Cornerstone, specializes in addiction and mental health. Trained in EMDR therapy, he employs a trauma-informed, empathetic approach to address the underlying causes of these issues.

Still have questions about treatment?

Our admissions specialists are here to explain the process, answer any questions you may have, and ensure you’re getting the help you need to live a healthy life free from addiction.

Get Started

Call and speak with one of our caring team members about help for you or a loved one.