TRICARE Coverage for The Grove: 2026 Costs & Rules

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## Quick answer "The Grove" (specifically The Grove at Grovetown) is a specialized residential treatment facility in Georgia that provides intensive mental health and substance use disorder services. For TRICARE beneficiaries, this facility is typically accessed as an authorized Residential Treatment Center (RTC) for children and adolescents or a Substance Use Disorder Rehabilitation Facility (SUDRF) for adults, requiring prior authorization from Humana Military (East Region).

In detail

The Grove at Grovetown is a well-known provider within the TRICARE East Region network. Because it offers high-level behavioral health care, it falls under the "Residential Treatment" category of the TRICARE benefit.

### Mental Health Services and TRICARE Coverage TRICARE covers inpatient and residential mental health care when it is "medically or psychologically necessary." The Grove provides several levels of care that intersect with TRICARE's 2026 benefit structure:

* **Residential Treatment Centers (RTC):** For beneficiaries under age 21 who require 24-hour care in a therapeutic environment. This is a common referral pathway for military families in the Augusta, GA/Fort Eisenhower area. * **Substance Use Disorder (SUD) Treatment:** TRICARE covers detoxification, stabilization, and residential rehabilitation. * **Partial Hospitalization Programs (PHP):** Intensive day treatment (usually 6+ hours per day) for those who do not require 24-hour supervision but need more than standard outpatient therapy.

### The Authorization Process (2026) Since Jan 1, 2025, TRICARE East is managed by **Humana Military**. To seek care at The Grove: 1. **Referral:** Your primary care manager (PCM) must submit a referral for mental health or SUD services. 2. **Pre-authorization:** Humana Military must approve the clinical necessity of the residential stay before admission. Standard outpatient "office visits" do not require a referral for Active Duty Family Members (ADFMs) on Select, but residential care *always* requires authorization. 3. **Network Status:** As of 2026, The Grove is typically a network provider. Using a network facility ensures lower out-of-pocket costs compared to non-network providers.

## Who this applies to * **Active Duty Families:** Children or spouses in the CSRA (Central Savannah River Area) needing intensive behavioral health intervention. * **Active Duty Service Members:** May be referred to The Grove for SUD treatment, though they typically require a direct command referral and military medical officer oversight. * **Retirees and their Dependents:** Covered for residential treatment, though they face higher cost-shares than active duty families. * **TRICARE For Life (TFL) Beneficiaries:** If Medicare does not cover residential SUD/Mental Health, TRICARE often acts as the primary payer for these specific residential services, provided they are TRICARE-authorized.

Common scenarios

### Scenario 1: Adolescent RTC Care An E-6 stationed at Fort Eisenhower has a 15-year-old child requiring long-term psychiatric stabilization. The PCM refers the child to **The Grove**. Because the family is on **TRICARE Prime**, Humana Military authorizes a 30-day stay. The family pays **$0** for the residential stay because they are active duty and the facility is in-network.

### Scenario 2: Adult Substance Use Treatment A retired Navy veteran on **TRICARE Select (Group A)** seeks treatment for alcohol dependency at The Grove's rehabilitation wing. The facility is in-network. For a 14-day stay, the retiree may be responsible for a copayment of approximately **$310 per day** (2026 rates), up to the annual Catastrophic Cap of $3,000–$4,000 depending on the specific enrollment group.

## Related terms * **Residential Treatment Center (RTC):** A facility providing 24-hour therapeutic services to minors under age 21. * **Pre-authorization:** A required review by the regional contractor (Humana Military) to determine if a service is medically necessary. * **Humana Military:** The current TRICARE regional contractor for the East Region (including Georgia). * **Medically Necessary:** Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms. * **Catastrophic Cap:** The maximum out-of-pocket amount a family pays for TRICARE-covered services each year.

## Sources * **TRICARE.mil - Mental Health Coverage:** https://www.tricare.mil/CoveredServices/IsItCovered/MentalHealthCare * **Humana Military - Residential Treatment:** https://www.humanamilitary.com/provider/education-and-resources/health-care-programs/behavioral-health * **Defense Health Agency (DHA) - SUD Care:** https://health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Substance-Use-Disorder-Treatment