TRICARE Coverage for Substance Use Disorders & Recovery
Overview
TRICARE covers substance use disorder (SUD) treatment as a behavioral health benefit. Coverage includes detoxification, inpatient rehabilitation, outpatient treatment, medication-assisted treatment (MAT), and ongoing recovery support. Active duty members may have additional programs available through their command.
Treatment Options Covered by TRICARE
- Medical detoxification
- Inpatient/residential rehabilitation
- Intensive Outpatient Programs (IOP)
- Partial Hospitalization Programs (PHP)
- Individual counseling
- Group therapy
- Medication-Assisted Treatment (Suboxone, Vivitrol, naltrexone)
- Family therapy and education
- Relapse prevention counseling
- Aftercare and recovery support
- Substance Abuse Rehabilitation Program (SARP) for active duty
How TRICARE Covers Substance Use Disorders & Recovery
TRICARE covers all levels of substance use disorder treatment with no annual visit limits for outpatient care. Medication-assisted treatment (MAT) medications are covered. Active duty service members have access to military-specific programs including SARP. The Mental Health Parity and Addiction Equity Act ensures TRICARE provides SUD coverage comparable to medical/surgical coverage.
Coverage by Plan
TRICARE Prime
SUD treatment covered with referral and authorization for higher levels of care. Outpatient counseling at $0 with referral. MAT medications at $0 from military pharmacy.
TRICARE Select
Standard behavioral health cost shares apply. Outpatient counseling at $28 copay (network, ADFMs). IOP and inpatient require authorization.
TRICARE For Life
Medicare + TFL covers SUD treatment. Outpatient counseling with standard cost shares. MAT medications covered.
Estimated Costs
| Scenario | Estimated Cost |
|---|---|
| Outpatient counseling (Prime ADFM) | $0 with referral |
| Outpatient counseling (Select ADFM) | $28 network copay |
| Inpatient rehab (Prime ADFM, 30 days) | $0 with authorization |
| MAT medication (military pharmacy) | $0 |
| MAT medication (retail pharmacy) | $14–$34 copay |
Authorization Requirements
Outpatient SUD counseling does not require authorization for initial visits. Inpatient detox, residential rehabilitation, IOP, and PHP all require prior authorization. Emergency detoxification does not require authorization.
Network & Provider Notes
TRICARE maintains a network of licensed substance abuse counselors, addiction medicine specialists, and accredited rehabilitation facilities. Military-specific programs are available at many installations.