Before undergoing treatment, it’s natural to have concerns about insurance coverage. Going through insurance can seem like a tricky task to navigate. However, we assure you that Tricare insurance can help you receive the help that you deserve.
Our addiction counselors will also be able to help you understand your Tricare insurance benefits. We’ll speak to your provider and give you the rundown on what your insurance covers.
It’s helpful to understand some insurance vocabulary as you start the treatment process. Although we’ll take care of the insurance evaluation for you, it can still be useful to understand these terms. See below for the following Tricare insurance terms:
An insurance plan premium is a payment you make to your provider that keeps your plan active.
This is the most that you’ll have to pay for covered services within a plan year. After these costs are taken care of through deductibles, copayments, and coinsurance, your insurance provider will cover the remaining costs.
This is when your policy begins. In other words, this is when it will be deemed as effective. You’ll get access to your benefits, which vary depending on your plan.
A deductible is an amount that must be paid for covered medical services before your provider begins paying.
A copayment, or copay, is a cost you may pay before you receive a medical service. For instance, let’s say you need to pay $2,000 for inpatient treatment at a treatment center. Your health insurance plan may pay half of that price, and then require a $500 copayment to cover the rest.
Tricare insurance covers mental health treatment. When treating addiction, it’s crucial to take into account the underlying roots of addiction. It is much more than a physical disease. Addiction affects an individual’s emotional and mental state as well.
Fortunately, with Tricare insurance, you’ll be able to reap the benefits of mental health treatment at our recovery center. We offer many evidence-based forms of therapy, such as cognitive behavioral therapy and group therapy.
Therapy will help you develop a toolkit of skills that will help you cope with stress and cravings. Each recovering individual will receive a unique combination of services that best suits their recovery needs.
Co-occurring disorders are when an individual has an addiction, as well as a mental illness. These are treated at our recovery center. If you require treatment for a mental health disorder and addiction, then you’ll require dual diagnosis treatment.
Dual diagnosis treatment targets co-occurring disorders through different methods. We treat disorders such as:
When we go through Tricare insurance, we’ll be able to let you know exactly what your plan offers. Our goal is to provide you the highest quality of treatment at the most effective cost. Our dedicated addiction treatment staff will constant your Tricare insurance provider and go through your plan.
We go through a simple two-step process. The steps are as follows:
We’ll start with a complimentary and thorough evaluation of your insurance benefits. This takes a lot of stress off of your hands! We’ll reach out to your provider and determine what kind of benefits are covered under your specific plan.
After the in-depth evaluation, we’ll let you know:
Tricare Prime is a managed care option available in “Prime Service Areas,” such as the East Coast. This plan ensures medical readiness of active duty by adding to the capability and capacity of military hospitals and clinics. Prime Service Areas were also built around the Base Realignment and Closure sites.
*When retired service members and their families become eligible for Medicare based on age, they aren’t able to participate in Tricare Prime.
You have an assigned primary care manager (PCM) who will help guide you through coverage. Your primary care manager will help:
All other members pay annual enrollment fees and network copayments.
East Region: Under the new regional contracts, the East Region is a merger of the North and South Regions and includes Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin. Tel: (800) 444-5445
West Region: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington, and Wyoming. Tel: (844) 866-9378
Tricare Select is a fee-for-service plan available in the U.S. You must show eligibility for Tricare in the Defense Enrollment Eligibility Reporting System (DEERS). You need to register in DEERS in order to get Tricare insurance under the Select Plan.
There are two types of Tricare-authorized providers: Network and Non-Network. Referrals are not required, but you may need prior authorization from your regional contractor for certain services.
Costs will be dependent upon the sponsor’s military status. You will have to take care of:
If you’re on active duty (including activated Guard/Reserve members), you are not eligible for Tricare Select.
Tricare Select may be a great fit for you if:
Tricare insurance covers medically and psychologically necessary mental health and addiction care. This includes both inpatient and outpatient rehabilitation treatment.
Tricare insurance can also help you cover treatments such as:
Tricare covers residential treatment if several conditions are met, including that:
If these requirements are met, Tricare will cover both emergency and non-emergency residential treatment.
Tricare insurance takes care of detoxification, stabilization, and any medical complication costs when it comes to emergency treatment.
Non-emergency treatment is when an individual decides to look for addiction treatment on his or her own. This will require prior authorization from Tricare before coverage will be provided. Tricare insurance generally covers detox and stabilization, as well as treatment for any additional co-occurring disorders.
They will also cover outpatient treatment if an individual’s plan meets certain qualifications. An individual that is currently struggling with addiction, but not in need of hospitalization or around-the-clock care is the ideal candidate.
Tricare insurance coverage takes care of all the different types of outpatient programs. Standard outpatient treatment is the least intensive form of care. Other programs, such as intensive outpatient care, consist of scheduled treatment sessions several days per week.
A partial hospitalization program offers the most intensive outpatient program and requires daily treatment that lasts about four to eight hours.
Don’t delay getting treatment any longer because you worry about paying for it. Find out how affordable treatment can be with Tricare insurance.
At Harmony Ridge, we believe in providing the highest quality of treatment at affordable costs. We’ll help you show you the potential you’ve always had. Addiction doesn’t have to control your life anymore. With the right treatment and support, your life can drastically change for the better.
We’re here to help you not just through insurance coverage and benefits, but everything else you may need as well. If you have any questions, comments, or concerns, please don’t hesitate to reach out to us. We’re ready to take your call!