TRICARE for Life Rehab Coverage

Understanding TRICARE for Life Rehab Coverage Options and Benefits

Using TRICARE for Life Health Insurance for Addiction Treatment

TRICARE for Life is generally considered an additional financial benefit for veterans who receive covered services through a Medicare plan. It helps reduce additional out-of-pocket expenses associated with healthcare providers.

However, many TRICARE for Life recipients don’t realize that this form of TRICARE Insurance can be a helpful financial tool for veterans seeking rehab services like inpatient treatment or intensive outpatient programs.

This article covers how to leverage TRICARE for Life rehab coverage for military veterans who decide to take essential steps toward recovery, and also outlines some of our accredited support options offered at South Shores Detox.

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TRICARE for Life: Providing the Boost Our Veterans Need

If you’re a current or former member of the United States Armed Forces, the chances are high that you know the benefits available through TRICARE insurance. When you’re still enrolled in active duty and receive full-time compensation, out-of-pocket insurance costs for health care services typically aren’t as stress-inducing as when you’re retired.

Living on a retirement pension that doesn’t generate the monthly revenue you were accustomed to before retirement is a significant concern for many elderly military veterans.

Combined with the fact that medical bills typically grow as we age and require more frequent visits to primary care physicians and, at times, a range of specialists for various conditions that come with age. This doesn’t include non-standard forms of certain services—most specifically, substance abuse treatment.

Considering the percentage of veterans who contend with PTSD and drug or alcohol addiction, this can become a challenging situation for retired service members seeking recovery during their golden years.

What Is TRICARE for Life and How Does It Differ from Standard TRICARE Insurance?

TRICARE Coverage for Rehab Services

TRICARE for Life is a program available for standard TRICARE recipients that benefits veterans as a Medicare wraparound coverage for enrollees looking to avoid the mounting out-of-pocket expenses many seniors face.

It is designed to work for veterans who also carry Medicare Part A and Part B at a time when Medicare covers the majority of their medical expenses. Standard TRICARE, used by active duty personnel as employer-sponsored insurance, provides excellent dental, medical, behavioral, and mental health services coverage.

Is It Too Late to Reach Out for Recovery Services?

However, after reaching 65 or older, well into full retirement, Medicare pays for most of your health requirements. This means Medicare pays for skilled nursing services, primary care visits, and certain specialized healthcare provider services for most veterans.

Unfortunately, many senior-aged veterans miss much-needed substance abuse recovery opportunities, as out-of-pocket costs for services like inpatient rehabilitation leave them financially ineligible without additional support.

This is when TRICARE for Life becomes a priceless benefit available for veterans enrolled in TRICARE Insurance into retirement.

Who Qualifies for TRICARE for Life Benefits?

Before diving further into how TRICARE offers coverage for outpatient programs, residential treatment, inpatient rehab, and other counseling services through the TFL package, let’s clarify the eligibility requirements for recipients of TRICARE for Life:

  • TRICARE recipients who are 65 or older who receive Medicare Part A and Part B
  • TRICARE recipients who are under 65 enrolled in Medicare Part and Part B with specific medical disabilities

Many clients who contact South Shores Detox often inquire about the specific care levels covered by TRICARE for Life. Fortunately, TFL covers many of the same treatment plans that TRICARE covers, particularly in the TRICARE West region (also called TriWest).

What Rehab Services for TRICARE for Life Pay For?

TRICARE Coverage for Different Rehab Services

Veterans committed to taking the brave steps toward recovery, which can be especially difficult considering the length of time they’ve had to contend with addiction, are eligible to receive coverage for the following services at South Shores Detox:

  • Inpatient addiction treatment. If you suffer from a particularly severe form of substance use disorder or co-occurring disorders, inpatient services provide the comprehensive care you need to recover.
  • Outpatient therapy. At South Shores Detox, we provide standard outpatient services and intensive outpatient programs. The standard form includes 2 to 3 days of counseling sessions that take about 2 hours of your time. Intensive outpatient treatment extends this to 3 to 4 days and sometimes involves an additional hour per day.
  • Partial hospitalization. Clients who require intensive treatment that mirrors inpatient therapy but cannot commit to a 30-, 60-, or 90-day residency can attend a PHP program that includes an average of 8 hours of treatment per day, Monday through Friday.
  • Peer group and family therapy. Some of our clients do well with a more scaled-back form of treatment, similar to an AA or NA setting that involves peer group or family meetings.

You must know how the process works when presenting your insurance at any treatment center to maximize your benefits.

How Do I Use TRICARE for Life and Medicare?

Medicare Insurance

The following list outlines the order of operations when using TRICARE for Life in conjunction with Medicare insurance:

  1. Medicare covers the majority of the cost of treatment services, making Medicare the primary payer in this exchange. TFL acts as a secondary means of support for out-of-pocket expenses.
  2. After determining the total amount covered by Medicare, TFL pays the remaining balance not included in your Medicare plan.
  3. In most situations, TRICARE for Life covers the remaining cost of your treatment. If any amount is left, the chances are high that the amount is minimal and far more manageable than in situations where TFL is unavailable as a funding source.
Up To 100% of Rehab Costs Covered By TRICARE
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South Shores Offers an Ideal Source of Recovery for Veterans

South Shores Detox is Medicare-certified, satisfying the primary requirement for a rehab facility to accept TRICARE for Life as a secondary funding source for your personalized treatment plan.

If you or someone you love is a retired service member motivated to take the courageous steps toward recovery finally, South Shores Detox is standing by to help you navigate the process and welcome you to our state-of-the-art facility.

Contact a member of our admissions team today, and we’ll help you finalize the process, understand your coverage, and ensure you get the treatment you need for the recovery you’ve been waiting for.