For those in the throes of active addiction, finding the best treatment center can feel like an uphill battle. Fortunately, at the Retreat of Broward, we work with most major health insurance providers — including TRICARE — to make our detox in Pompano Beach as accessible as possible to those in need.
TRICARE provides civilian healthcare benefits to U.S. military personnel, retirees, and their dependents. All TRICARE-eligible beneficiaries have access to mental health and substance use disorder benefits. At the Retreat of Broward, we work directly with TRICARE insurance, which covers most/ of our professional detoxification services. Read on to learn more about options for TRICARE detox in Pompano Beach, Florida.
What is TRICARE Insurance?
TRICARE is the U.S. military’s healthcare program. While it includes healthcare providers and facilities—delivered in military medical treatment facilities—it essentially functions as government-managed, single-payer health insurance.
TRICARE enrollees and beneficiaries have a choice of plan options depending on military status and place of residence. This does not apply to active-duty service members who pay zero out-of-pocket costs for coverage. Managed by the Pentagon’s Defense Health Agency, TRICARE’s various coverage plans provide healthcare for millions of current and former service members and their dependents. Learn more about Tricare inpatient mental health coverage below.
Types of TRICARE Insurance
There are several different types of TRICARE insurance. At the Retreat of Broward, we work with all types of TRICARE insurance, remaining committed to keeping our detox in Pompano Beach as accessible as possible to those in need.
TRICARE Prime
TRICARE Prime resembles a typical civilian HMO (health maintenance organization), where users are assigned a primary care manager who parcels out referrals to specialty caregivers. The out-of-pocket costs of medical services depend on the enrollee’s military service status. For instance, active-duty military and their dependents enrolled in TRICARE Prime pay no medical fees so long as they follow referral rules. Military retiree families pay some out-of-pocket costs.
TRICARE Select
TRICARE Select resembles more of a civilian PPO (preferred provider organization). Enrollees in TRICARE Select can select their primary care manager and self-refer to specialist caregivers. However, some medical appointments have out-of-pocket costs. Again, how much enrollees pay depends on military service status.
TRICARE Reserve Select
TRICARE Reserve Select is a plan for traditional National Guard members and those in the National Reserve. Enrollees must pay a monthly premium; otherwise, it resembles TRICARE Select.
TRICARE Young Adult
TRICARE Young Adult is an option for unmarried adult children who have aged out of regular TRICARE coverage. The plan provides both medical and pharmacy benefits. TRICARE Young Adult comes with two main options: Prime and Select. These plan options closely resembled TRICARE Prime and TRICARE Select (listed above). Out-of-pocket costs associated with these plans are based on the sponsor’s military status and where the care is given.
Do I Need a Referral for Addiction & Mental Health Services?
When looking for a substance use disorder treatment program that TRICARE covers, or when looking for a TRICARE mental health provider, obtaining a referral from a primary care physician is beneficial. Some TRICARE enrollees may need a referral for certain office-based outpatient services. In most situations, pre-authorization is not required for outpatient addiction treatment or mental health treatment.
However, active-duty service members should always seek non-emergency mental health care at military facilities when available. It is recommended that TRICARE beneficiaries contact their regional contractor to find out if their therapist or counselor requires a physician referral before obtaining their services.
Does TRICARE Cover Detox in Pompano Beach?
Most TRICARE plans provide comprehensive treatment for substance use disorders, including emergency and inpatient hospital services. In other words, yes — detox is covered as part of TRICARE’s inpatient (emergency and nonemergency) services. That said, TRICARE only reimburses the cost of care if the enrollee visits a TRICARE-authorized provider—either an authorized hospital or a dedicated substance use disorder rehab facility.
For those seeking treatment for substance use disorder, TRICARE covers the following:
- Residential addiction treatment
- Inpatient services (emergency and non-emergency; this includes detox)
- Intensive outpatient programs (IOP)
- Partial hospitalization programs (PHP)
- Opioid treatment programs (OTP)
Medication-Assisted Treatment
Medication-assisted treatment (MAT) is a therapeutic approach to addiction treatment. It combines prescription medication and mental health therapies to treat a substance use disorder. TRICARE-authorized physicians, physician assistants, and nurse practitioners may provide MAT services. To do so, they must have a special certification from the Drug Enforcement Agency to prescribe buprenorphine medications like Suboxone.
Does TRICARE Cover Mental Health Treatment?
TRICARE covers mental health and substance use disorder treatment, including both inpatient and outpatient treatments. The program covers office-based psychotherapy when deemed medically or psychologically necessary. This is for any combination of individual, family, or group sessions for a diagnosed and covered condition from a TRICARE-authorized provider.
Though it requires pre-authorization, TRICARE mental health also covers psychoanalysis, the long-term mental health therapy that explores subconscious thoughts to gain insights into certain behaviors and symptoms. The program also covers psychological testing and assessment as well as most telemedicine services. Please note, that these have the same requirements for referral and pre-authorizations as mental health services.
Will I Have a Deductible for My TRICARE Coverage?
Active-duty service members are required to enroll in TRICARE Prime. Additionally, they are the only beneficiaries who never have to pay deductibles or out-of-pocket (OOP) costs for services and prescriptions covered under their plans. Other TRICARE Prime and Select plan users usually must pay deductibles and other costs.
Depending on one’s beneficiary status and the specific Prime or Select plan someone chooses, they may have to pay one or more of the following:
- Annual deductibles
- Copayments
- Cost-shares
- Enrollment fees or premiums
TRICARE maintains a compare-cost tool for recipients.
Find TRICARE Detox in Pompano Beach, Florida
For those seeking addiction treatment and mental health services under their TRICARE plan, The Retreat of Broward is here to help. No one should have to continue living with a substance use disorder or mental health disorder because of cost. Our partnership with TRICARE ensures that out-of-pocket costs for necessary care remain at a minimum. Learn more about Tricare inpatient mental health coverage today.
For more information about our services, contact us today.
