TRIWEST SUBSTANCE ABUSE TREATMENT

TriWest provides extensive coverage options for individuals struggling with substance abuse, with a focus on immediate medical assistance and a sustainable path to recovery.³

Below is an overview of the services provided by TriWest:

• Emergency and Planned Inpatient Services: Covers both emergency and non-emergency hospital stays to ensure timely access to necessary care.
• Intensive Outpatient Programs (IOPs): For those requiring consistent monitoring without 24/7 hospitalization, including group therapy, individual counseling, and structured recovery activities.
• Detox Services: Supports managing withdrawal symptoms safely under medical supervision, facilitating a smoother recovery process.
• Mental Health Services: Addresses co-occurring mental health conditions with treatments like cognitive-behavioral therapy (CBT) and psychotherapy, recognizing the intricate link between addiction and mental health.
• Partial Hospitalization Programs (PHPs): Offers a middle ground between inpatient care and outpatient services, providing intensive treatment without an overnight stay.
• Residential Treatment Programs: For individuals needing continuous care in a residential environment, encompassing medical oversight, therapy, and peer support.

TriWest’s comprehensive coverage facilitates a holistic approach to substance abuse treatment, empowering military members and their families to embark on a personalized recovery journey.

TriWest typically provides coverage for addiction treatment stays, though the extent of coverage can vary significantly based on your policy, the required type of treatment, and other factors.⁴

It’s important to understand the fundamental aspects of your insurance coverage, which include:

• Treatment Types: TriWest supports inpatient and outpatient treatments, encompassing detoxification, residential care, and necessary medical interventions for inpatient services. Outpatient services include therapy sessions, group counseling, and partial hospitalization programs.
• Pre-Authorization Requirement: Many treatments necessitate pre-authorization from TriWest, requiring approval before commencement to ensure coverage.
• Choosing Providers: Opting for in-network providers generally guarantees fuller coverage with TriWest, as it operates with a network of preferred providers. Services from out-of-network providers may still be covered but at a reduced rate, subject to the details of your plan.
• Understanding Deductibles and Co-pays: It is essential to familiarize yourself with your deductibles and co-pays, as they will affect your out-of-pocket treatment costs.
• Coverage Duration: Policy specifications will dictate the length of coverage for inpatient stays or the allotment of outpatient sessions.
• Type of Addiction: The nature of the substance or behavior being treated can influence coverage, with certain plans imposing specific limitations or exclusions for various types of addiction.
• Ongoing Treatment Review: The necessity for continued treatment is regularly evaluated to ascertain its medical necessity, which influences the coverage duration.

Understanding these factors can help you better understand your insurance coverage for addiction treatment from TriWest.

Reviewing your policy in detail or consulting with a healthcare professional is recommended to navigate and comprehend your specific coverage nuances.

At Cornerstone, we can help you determine your benefits by verifying your insurance coverage and clarifying any uncertainties about what is and isn’t covered.

Finding out exactly what your TriWest insurance policy covers can be a straightforward process if you follow these steps:

1. Review Your Insurance Card: Begin by locating your TriWest insurance card. This will have important information such as your policy number and contact details for customer service.
2. Log In to Your TriWest Account: Visit the TriWest website and log into your account. You’ll need to register using your policy details if you haven’t set up an account yet.
3. Review Policy Documents: Once logged in, access your policy documents. These documents provide detailed information about your coverage, including benefits, exclusions, and limitations.
4. Check the Summary of Benefits: Look for a summary of benefits, which outlines the key aspects of your coverage in an easy-to-understand format. This summary will include information on types of covered services, deductibles, co-pays, and out-of-pocket maximums.
5. Search for Specific Services: Use the website’s search feature or navigate the menus to find information on specific services, such as substance abuse treatment, to see what your policy covers.
6. Contact Customer Service:If you have questions or need clarification, call your insurance card’s TriWest customer service number. Be ready with your policy number and specific questions about your coverage.
7. Consult with Healthcare Providers: Speak with healthcare providers who are in the TriWest network. They can provide insights into what treatments are typically covered and assist with pre-authorization.
8. Pre-Authorization: For certain services, you might need pre-authorization. If necessary, find out how to initiate this process for your treatment.⁵
9. Understand Appeals and Grievances: Familiarize yourself with the process for filing an appeal or grievance if a claim is denied or you disagree with a coverage decision.
10. Stay Informed About Changes: Keep an eye on any updates or changes to your policy. TriWest may send updates through mail, email, or your online account.

If you’re concerned about needing multiple stays in rehab, it’s good to know that TriWest insurance generally allows for this as long as each treatment is considered medically necessary. While nobody plans on multiple treatment episodes, addiction is often a chronic condition that may require ongoing care. Keeping a few things in mind when using your TriWest insurance for more than one rehab stay is important.

First, you’ll need to check the specifics of your policy to see if there are any limitations on the number of treatments you can undergo or any time restrictions between treatments. While TriWest generally supports ongoing care, insurance policies can differ in their particulars.

For the most accurate and personalized information, we recommend consulting with TriWest directly or allowing our admissions team to verify your insurance coverage. By doing so, you’ll clearly understand what your plan covers, how many treatment episodes are included, and whether you should be aware of any out-of-pocket costs.

So, yes, you can absolutely utilize your TriWest insurance multiple times for rehab if it’s medically necessary. This flexibility helps ensure you have the coverage you need to fully engage in your recovery journey, no matter how long it takes. Always remember to verify the specifics of your policy to make informed decisions.

TriWest insurance offers broad coverage for many types of substance abuse treatments, supporting various approaches to recovery. This typically includes established and evidence-based treatments like inpatient care, outpatient programs, detox services, and behavioral therapies.

However, it’s essential to understand that while TriWest has a comprehensive approach to treating addiction, there may be some limitations. For example, experimental or less conventional treatments—such as specific holistic therapies or newer, non-FDA-approved medications—may not be covered by your policy.⁶

So, what should you do to navigate these limitations? The most effective strategy is to get the specifics before treatment begins. You can do this by consulting directly with TriWest to confirm what treatments are covered under your policy.  Alternatively, our admissions team at Cornerstone can assist you in verifying your insurance coverage, helping to ensure that you’re making choices that align with your medical needs and insurance benefits.

By being proactive and checking your coverage details, you can enter treatment with a clearer mind, free from the stress of unexpected financial commitments. Knowing what your insurance covers will let you focus on what’s most important: your path to recovery.

We understand that time is critical in addiction treatment. Therefore, we have simplified our admissions process to quickly get you into the right program.

After verifying your active TriWest insurance and the treatments it covers, we will promptly initiate your recovery journey. Our team will work closely with TriWest to handle all the necessary paperwork and approvals, cutting through the red tape for you. We aim to minimize waiting periods so you can start your treatment as soon as possible, often in days or hours, depending on your situation.

With TriWest’s coverage and our expedited admissions process, you won’t have to put your life on hold while waiting for treatment. Instead, you can begin your path to recovery sooner than you might have thought possible. Taking swift action can be crucial, especially when immediate intervention is necessary.