Does TRICARE Cover Dual Diagnosis Treatment?

Get Help for Co-Occurring Disorders Using TRICARE at Ingrained

For those who have served and their families, finding compassionate but still effective care for substance abuse or mental health treatment can sometimes feel elusive. Striking the right balance between excellent mental health services and getting the most coverage possible from your TRICARE benefits can present a challenge.

You might even not be sure what’s covered, and are likely asking yourself: Does TRICARE cover dual diagnosis treatment programs?

Ingrained Recovery, an outstanding rehab ranch in Eastman, Georgia, provides each client with expert care for substance abuse and any additional mental health disorder.

The Peach State has thirteen active military bases with 61,000 military personnel on active duty. We consider it an honor to serve the brave men and women who serve our nation by working with TRICARE coverage.

We invite you to join us and learn about TRICARE Health Insurance and how it unlocks mental health services for military members and their families, as well as get briefed on our programs for recovery support at Ingrained.

Does TRICARE Cover Dual Diagnosis Treatment?

Both mental health services and substance abuse treatment are covered by TRICARE and all other insurance plans in the United States, thanks to the Affordable Care Act’s passage in 2010.

The ACA (Obamacare) ensures that every insurance plan listed on the HealthCare Marketplace treats every mental health disorder, including substance abuse, equally to medical and surgical benefits.

So yes. TRICARE does cover dual diagnosis treatment.

But, it can get tricky when seeking pre-approvals for the different levels of care. They may approve partial hospitalization programs or an outpatient treatment facility for some who need help with a drug or alcohol addiction and mental disorder. Then, they might approve inpatient rehab services for someone with more significant mental health challenges.

Determining Mental Health Treatment Under TRICARE Insurance

If you or a loved one needs care for a substance use disorder and one or more additional mental health conditions, call Ingrained Recovery for help. We will help you make sense of your TRICARE Insurance plan.

Our insurance coordinator will even reach out to TRICARE to explain the mental health issues and get your substance abuse treatment pre-approved by a TRICARE representative for you.

Call us with your TRICARE membership card in hand. We’ll ask you for your card information and a callback phone number. Then, we will ask you to give us an overview of the mental health and substance abuse issues.

This information helps us verify what benefits are available for your dual diagnosis treatment plan. We want to make sure you get the alcohol or drug rehab you need to feel better again.

Worried about confidentiality concerns? Please know that your call to our insurance staff is free and confidential.

What Is TRICARE Coverage?

TRICARE provides health benefits to active duty service members, retirees, and their families. They also cover some reservists and National Guard members. The programs fall under the oversight of the U.S. DOD’s Defense Health Agency, which helps ensure military personnel health and readiness.

TRICARE considers members’ healthcare program needs, location, and eligibility. Because of those considerations, TRICARE offers different insurance coverage and plan options to meet the changing needs of the large armed forces community. Here are some of the plans offered by this military health system:

• TRICARE Prime: This coverage provides an HMO-like option that coordinates coverage through a primary care manager. It’s a top choice for active duty service members and family members.
• TRICARE Select: This program is a flexible PPO offering open to active duty and retired service members and families.
• TRICARE Reserve Select and TRICARE Retired Reserve: These plans are similar to Select but for Reservists and retired reservists.
• TRICARE Prime Remote and TRICARE Prime Remote Overseas: TRICARE offers coverage specifically for active duty members and families who live in locations over fifty miles from a military treatment center.
• TRICARE Standard Overseas: This coverage provides healthcare program options to military members and families stationed overseas, allowing them to get exceptional care away from home.
• TRICARE Young Adult: TRICARE Covers young adults up to age 26 who have aged out of their parents’ TRICARE but are still eligible for coverage due to the Affordable Care Act.

There are several other TRICARE coverage options. If you have a different TRICARE besides the ones we listed above, we can help you get the addiction treatment you need.

Why TRICARE Covers Dual Diagnosis Treatment for Co-Occurring Disorders

The original question was: Does TRICARE cover dual diagnosis treatment? For anyone new to supporting a loved one who has addiction or mental health issues, this may be a familiar term they hear without having much context.

Dual diagnosis, or a co-occurring disorder, is when someone has both an addiction and mental health issues at the same time. This can mean someone engages in substance abuse to dull their social anxiety – an example made famous by the character “Raj” on the hit comedy series Big Bang Theory. Millions laughed at these antics each week on the show, but a real-life dual diagnosis is not a reason for laughter.

Fortunately, addiction treatment combined with treating the co-occurring mental illness is possible with well-constructed treatment plans and caring professionals.

TRICARE insurance provides comprehensive coverage that allows dual diagnosis treatment providers to design a customized medical program that suits each person’s needs.

Addressing mental health needs – substance use disorders and mental illness alike – ensures an effective dual diagnosis treatment program.

One Example: Military Members Need Dual Diagnosis Treatment for PTSD and Alcohol Abuse

A typical example we see in terms of military mental health care is the co-occurrence of Post-traumatic Stress Disorder (PTSD) driving the need for alcohol rehab treatment.

Uniformed service members have greater odds of experiencing a disturbing or horrific event. However, they sometimes don’t seek the help of a therapist. Many veterans believe they must be stoic about these things. To make matters even worse the stigmatization of mental illness can be commonplace among military personnel.

They live with flashbacks or nightmares that keep them awake at night. In desperate need of sleep, they start drinking to escape those disturbing thoughts. As their body grows dependent on alcohol misuse to quiet the brain, they slip into Alcohol Use Disorder. This example demonstrates how co-occurring disorders arise.

The military can be a relatively sheltered place. Some military personnel don’t realize their TRICARE health insurance will cover their dual diagnosis treatment. Others have never heard of a dual diagnosis or don’t realize they can get addiction and mental health care for their substance abuse.

How Common Is a Dual Diagnosis?

Having a dual diagnosis can feel pretty lonely. But the truth is that you are far from alone. The Substance Abuse and Mental Health Services Administration reported in 2022 that about 21.5 million American adults have a co-occurring disorder.

Their survey noted that the most common mental disorders involved in dual diagnosis are:

• Anxiety and mood disorders
• Schizophrenia
• Bipolar disorder
• Major depressive disorder
• Conduct disorders
• PTSD (trauma)
• Attention deficit hyperactivity disorder.

Those surveyed admitted to the following addictions:

• Alcohol
• Marijuana
• Tobacco
• Opioids
• Stimulants
• Prescription Drugs
• Hallucinogens

SAMHSA also reminds us that dual diagnosis conditions can also become physical ailments in the case of substance abuse: HIV, hepatitis, cirrhosis, and other diseases that may be caused or worsened by drug and alcohol use.

TRICARE Rehab Coverage: Evidence-Based Therapies and Mental Health Services

TRICARE coverage includes addiction treatment for active duty military members and veterans suffering from mental health challenges while also offering civilian health care for family members.

Some of the levels of care and treatment options that are available to United States Military members signed up for TRICARE include these:

• Residential treatment (inpatient treatment)
• Outpatient treatment centers
• Intensive outpatient programs (IOP)
• Partial hospitalization programs (PHP)
• Individual and group therapy
• Family counseling services
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Alternative therapies (art therapy, yoga, equine therapy)
• Medication-assisted treatment
• Medical detox at the start of addiction treatment

These are the most frequently used addiction treatment options and therapies usually approved by TRICARE insurance. Remember that our admissions staff is available to verify outpatient and inpatient treatment services.

Get Effective Treatment at Ingrained Using TRICARE Coverage

Having a dual diagnosis of drug or alcohol addiction and mental health issues simultaneously creates disruptions in careers, education, and family life. But with TRICARE Insurance, you can receive the help you need.

If you are ready to experience high-quality residential dual diagnosis treatment, we invite you to join us at Ingrained Recovery.

We will treat you or your loved one with the respect due to United States military personnel. Call us today to get help.