Addiction and Alcoholism in the Military: Part 3

Navigating your Tricare Insurance Benefits in Maryland

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Shlomo Hoffman
Feb 03, 2021
  1. Are you your family members eligible for Tricare?
  2. The Basics: Tricare Regions
  3. Tricare Plans
  4. What kinds of treatments does Tricare cover?
  5. Does Tricare cover alcohol and drug detox?
  6. Does Tricare cover residential drug and alcohol treatment?
  7. Does Tricare cover outpatient programs?
  8. Can Veterans Affairs Beneficiaries access Tricare?
  9. Arranging your Tricare benefits at Avenues Recovery Center.

Who is eligible for Tricare?

One of the most overwhelming parts of getting drug and alcohol addiction treatment is navigating your insurance coverage. Although insurance companies are obligated to provide coverage for mental health and addiction care, as mandated by the Affordable Care Act (ACA), there are different kinds of plans and it can be confusing. Knowing just who is eligible for Tricare is an important first step.

Tricare Insurance is the federal insurance program available for active military as well as veterans. If you and your dependents are eligible for Tricare benefits you will be able to get substance abuse and addiction treatment .

Avenues Recovery Center of Maryland, with locations at Prince Frederick and on the Eastern Shore, has a staff of experts thoroughly knowledgeable in the varied Tricare plans and programs. If you are seeking treatment, or want to know who qualifies for Tricare, reach out to our team. They will handle all the details. We will reach out to your provider, gain exact understanding of your benefits, access your eligibility and help you with every step of the approval process.

The Basics of Tricare Insurance  

Tricare Regions

Tricare is available across the globe. Its management is split into three different regions.

Tricare West includes 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.

Tricare healthcare plans in this region are administered by Health Net. This means that Health Net serves as the contractor to the government to provide access and benefits to the end users, in this case active military personnel, veterans, and their dependents. They provide networks, processing and education.

Tricare East 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.

The contracting partner for the east region is Humana Military.

Anywhere outside the United States is called the overseas region and is managed by International SOS.

Tricare Plans

Tricare Prime

Who can enroll?

  • Active military personnel and family members
  • Retired military veterans and dependents (until eligibility for Medicare is reached)
  • Those who have received the Medal of Honor and families
  • Activated members of the National Guard, and in some cases Reserve and Retired personnel.
  • Former spouses who fill specific qualifications.

Any member of Prime on active duty as well as their families have zero out-of pocket costs. All others are subject to nominal enrollment fees and co-pays.

Tricare Select

Select is accessible in the U.S. and is a fee-for-service program. All above mentioned members are eligible outside of those on active duty. Out of pockets costs will include annual deductibles and some cost sharing. This varies according to each client’s military status.

This can be a great option for those who have supplemental insurance to Tricare, like Medicare or their place of work, or people who are happy with their current healthcare situation and don’t want to change to an in-network Tricare provider.

In order to confirm your eligibility and registration, you should connect with a preferred Tricare provider. Because Avenues Recovery is a Tricare preferred provider, we are authorized to provide Tricare benefits and we can get you properly set up. Our staff will navigate the Defense Enrollment Eligibility Reporting System (DEERS), get you registered, and connect with your Primary Care Physician (PCM) to arrange necessary referrals. All you have to do is give us a call. We will take care of the rest.

Variations of these two main plans include:

  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Select Overseas
  • TRICARE For Life
  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult

Again, by calling Avenues Recovery of Maryland, you will learn which plans work best for you.

What kind of treatments does Tricare cover?

Included in the long list Tricare covered treatment are the following:

  • Applied Behavior Analysis
  • Autism Spectrum Disorder
  • Cognitive Rehabilitation Therapy
  • Collateral Visits
  • Drug Testing
  • Eating Disorder Treatment
  • Electroconvulsive Therapy
  • Family Therapy
  • Gender Dysphoria
  • Intensive Outpatient Programs
  • Inpatient Hospital Services (emergency and non-emergency)
  • Management of Withdrawal Symptoms (Detoxification)
  • Medication Assisted Treatment
  • Office Based Opioid Treatment
  • Opioid Treatment Programs
  • Partial Hospitalization
  • Psychoanalysis
  • Psychological Testing
  • Psychotherapy
  • Psychotropic Drugs
  • Residential Treatment Facility Care
  • Substance Use Disorder Treatment
  • Therapeutic Services
  • Transcranial Magnetic Stimulation

Conditions such as PTSD, depression, and all forms of addictions are covered by your Tricare plans.  

Does Tricare cover drug and alcohol detox in Maryland?

People receiving addiction treatment services from approved provider such as Avenues Recovery in Maryland, in many cases, can have coverage for detox services. Medications and care managing withdrawal and their symptoms are part of Tricare benefits. Furthermore, once a member is enrolled in Tricare approved programs like Inpatient rehab and Partial-Hospitalization Programs, detox services may be included as well.

Does Tricare cover residential drug and alcohol treatment in Maryland?

The answer is yes!

As long as you have been diagnosed with substance use disorder (SUD), are dealing with withdrawal symptoms requiring medical attention, and are having difficulties coping with daily routines, residential treatment is absolutely necessary and covered by your Tricare plans. This falls under emergency treatment.

In the event of non-emergency addiction treatment, such as when a person feels the need for treatment on his own, he must be authorized by Tricare or its management partner. Avenues can help facilitate those authorizations upon contact from the client seeking addiction treatment.

Does Tricare cover outpatient programs in Maryland?

When qualifying, Tricare will give coverage to for many types of outpatient programs. Intensive Outpatient Programs (IOP) and PHP are often eligible. There are many individuals who while not needing round the clock medical care and supervision, greatly benefit from treatment groups and counseling session s offered by Tricare preferred providers. The flexibility of such treatment gives clients the chance to resume their daily routines, family responsibility and jobs while remaining under the care of addiction treatment facilities. In some cases, Medication-assisted treatment (MAT) is necessary and covered as well.

Can Veterans Affairs Beneficiaries access Tricare?

The Department of Veterans Affairs is a cabinet level agency tasked with providing benefits and and support for military veterans in their time after service. The VA provides health care through its medical facilities and clinics across the country. Since 1995 every Veterans Affairs’ health care facility has been part of the Tricare network. This means that they are able to service all Tricare members, including Active Duty personnel, retirees and their families on a space available basis. This is true for both primary and specialty care.

Arranging your Tricare benefits at Avenues Recovery Center of Prince Frederick and at the Eastern Shore of Maryland.

At Avenues Recovery the gratitude we feel towards those military personnel who have sacrificed greatly to protect us is endless. We will leave no stone unturned in doing all in our power to ensure that the chance at a normal productive life that you all so richly deserved is within your reach without any unnecessary financial hardship. So many mental health and addiction treatment option are available with your Tricare coverage and we will explain them all, facilitate the insurance coverage that is needed and hold your hand through the entire drug and alcohol rehab process.

You deserve a second chance! Let us help you find the path to recovery!  

Since joining the Avenues Recovery content team, Shlomo has become a thought leader in the addiction field. His popular addiction podcast "Rubber Bands" is a must listen for anyone involved in Substance abuse treatment. He is a Seinfeld junkie, a recovering Twitter fanatic, and a sports expert. He enjoys milk shakes and beautiful views from rooftops.

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