How to Use Tricare Insurance to Pay for Addiction Treatment Center Miami

Addiction is one of the most painful things a person can face. It can make you feel like you’ve lost control of your life, like you’ve lost the people you care about, and like you’ve lost all hope for a positive future. But there are people who can help. Addiction treatment centers in Miami have multiple treatment methods that can help you get clean and sober, plus learn the coping skills you need to stay that way.

If you’re a member of the military or a member of a military family, you may be eligible to enroll in the Tricare healthcare system. Tricare gives civilian health coverage to military retirees, active duty military personnel, and their spouses and dependents.

Addiction Rates in the Military

Illicit drug use is lower among military personnel than it is among civilians, but military personnel are far more likely to abuse alcohol than civilians. Some of this can be attributed to the stress of being deployed during wartime. Other pieces of it can be attributed to the military’s culture. The military has a lack of confidentiality that sometimes discourages personnel from seeking substance abuse treatment when they need it.

Military personnel who have had multiple deployments and been exposed to combat are at a higher risk of developing a substance abuse problem. They’re also more likely to binge drink and to have larger numbers of behavioral medications prescribed. The military’s zero tolerance policy for illegal drugs explains the high rate of alcohol abuse and low rate of drug abuse; alcohol is legal and will not result in an expulsion from the military.

PTSD, depression, and other mental health issues are common in combat veterans and military personnel who have seen multiple deployments. These mental health issues can lead to substance abuse problems when the individual comes home from their deployment or retires from the military.

What Tricare Insurance Covers

If you need treatment for a substance abuse problem or alcohol addiction, you don’t need to worry. Tricare covers substance use disorders. The circumstances they’ll cover vary case to case.

Tricare will cover emergency inpatient hospital services if you meet certain conditions:

  • You have a psychiatric or medical emergency
  • You require immediate admission to the hospital

Treatment will be administered by the closest hospital to you.

Tricare offers coverage for additional emergency inpatient services related to substance use disorders. They will cover:

  • The detoxification process
  • Your stabilization
  • Any and all medical complications that may arise due to the substance abuse disorder

Tricare will also cover residential treatment centers, although some limits apply to the coverage. Technically, the coverage is for psychiatric treatment centers. However, a substance use disorder is considered a mental health condition; you can make a case that an addiction treatment center is a specialized psychiatric residential center.

You must meet the following qualifications to be approved for residential treatment:

  • You have a primary diagnosis that is not a substance use disorder
  • You have significant impairment which interferes with day-to-day life
  • You cannot function in your community with outpatient services only
  • You don’t have the physical need to be in a hospital full-time
  • You are transitioning from another program as a pre-approved part of a treatment plan

You’ll have to get prior authorization for the coverage.

How to Get Tricare to Pay for Your Treatment

You may have noticed that the coverage for hospitalizations only lasts as long as your detoxification and stabilization. Additionally, residential treatment is only approved for people with a psychiatric diagnosis besides their substance use disorder.

If you need treatment in a residential rehabilitation center, your first step will be getting a psychiatric diagnosis. You’ll have to find a psychiatrist who is covered by Tricare insurance. This doctor can help you pinpoint a mental health diagnosis and take the first steps toward inpatient residential treatment.

If you need residential treatment, you are almost guaranteed to have an underlying mental health condition that can be diagnosed. This mental health condition is part of what causes the substance use disorder, because you try to medicate it with your substance of choice. If you didn’t have an underlying mental health condition, you could complete the detoxification process and move on without any risk of relapse.

You’ll also need documentation proving that you cannot function in the community and need inpatient services instead of outpatient services. This means you’ll have to start with outpatient treatment and, if it doesn’t work, apply for residential treatment afterward.

Many Miami addiction treatment centers offer outpatient services in addition to their inpatient services. Outpatient services might include behavioral therapy, creative therapy, group therapy, and family therapy.

A Full List of Addiction Treatment Methods Covered by Tricare

Tricare will cover the following circumstances, provided you meet the qualifications:

  • Emergency and non-emergency inpatient services (including detoxification and stabilization)
  • Intensive outpatient treatment programs
  • Medication assisted treatment for opioid users
  • Therapeutic mental health services
  • Opioid treatment based in an office
  • Comprehensive opioid treatment programs
  • Partial hospitalizations
  • Residential treatment for substance use disorders

Tricare won’t cover aversion therapy or any treatment that has not been approved by the FDA.

You’ll need to pinpoint the type(s) of treatment you need and begin gathering your documentation of the necessity. Official diagnoses and letters from doctors, personal affirmations of symptoms, and a history of your substance use disorder will all be helpful. If you’re overwhelmed by the paperwork, you may be able to get in contact with a social worker who can help with the process.

You deserve to get the treatment you need. Even if you need to wait a while for approval, some treatment in the meantime is better than no treatment. To ask questions about Tricare insurance coverage or take the next step in your recovery, call (866) 840-6411 to speak to one of our trained counselors.