How TRICARE East Covers Outpatient Drug and Alcohol Rehab in New Jersey

Drug and alcohol rehab at Rubicon Recovery Center may be partially covered by TRICARE East, but the level of coverage will depend on your exact plan and benefits.

If you’re an active-duty service member or a relative of one who is looking for evidence-based drug and alcohol rehab, you may be wondering if your insurance will cover it. Service members with TRICARE East can seek treatment at Rubicon Recovery Center, where we provide outpatient rehab programs for people with substance use disorders (SUDs) from New Jersey, Pennsylvania, and New York. Learn more about TRICARE East rehab coverage in New Jersey.

Key Takeaways

• TRICARE East may cover a portion of outpatient rehab treatment costs in New Jersey, but the extent of coverage depends on the exact policy and benefits.
• To confirm your TRICARE East coverage at Rubicon Recovery Center, you can get convenient insurance verification through our Admissions Department.
• The out-of-pocket costs you can expect with TRICARE East will depend which plan you have, whether you are active duty or retired, and your sponsor’s status.

What Does TRICARE East Typically Cover for Addiction Treatment?

TRICARE East is a government healthcare program that provides civilian health coverage for active-duty service members, retirees, and their families living in the eastern United States. It is not an insurance company, but it manages customer service, claims, and provider networks through Humana Military. TRICARE East may cover some or all of the following treatments:

Medical Detoxification

Medical detox is often the first step in recovery, especially for individuals who use opioids, heroin, and benzodiazepines, which have harsh withdrawals. Medically supervised detox helps people safely rid their bodies of substances while managing withdrawals with help from a healthcare team. TRICARE East typically covers medical detox when it’s medically necessary. While Rubicon Recovery Center does not provide detox services onsite, our Admissions Department coordinates placement with trusted detox partners before outpatient treatment begins.

Partial Hospitalization Program (PHP)

A Partial Hospitalization Program (PHP) is an intensive outpatient rehab program that provides patients with structured support for six hours a day, five to six days a week. When a patient demonstrates medical necessity for a high level of care, TRICARE East may cover some or all of the cost of PHP.

Intensive Outpatient Program (IOP)

An Intensive Outpatient Program (IOP) is a mid-level outpatient substance abuse treatment program. Patients generally attend IOPs for three hours a day, three to five days a week. TRICARE East often covers IOPs for addiction, but the extent of the coverage will depend on the specific plan and benefits.

Outpatient Program (OP)

An Outpatient Program is the lowest level of addiction treatment before weekly therapy. These programs generally run for an hour a day, two to three days per week. Although the level of coverage will depend on your plan, TRICARE East often covers a portion of outpatient treatment.

Mental Health and Dual Diagnosis Care

A dual diagnosis is when a person has a substance use disorder and a mental health disorder simultaneously. TRICARE East often covers some of the cost of dual diagnosis care, as the Affordable Care Act (ACA) and federal mental health parity laws mandate that insurance providers cover mental health and substance use conditions on par with physical health conditions.

How Can I Verify My TRICARE East Coverage at Rubicon Recovery Center?

If you want to determine whether treatment is covered at Rubicon Recovery Center, we provide convenient insurance verification through our Admissions Department. We will use your member ID to determine your coverage through TRICARE East, as well as your possible out-of-pocket costs, and will explain your benefits to you clearly. Simply email us at admissions@rubiconrc.com, fill out our web form, or call (908)-274-0015 to get your insurance verified.

What Do Out-of-Pocket Costs Look Like with TRICARE East?

When you have TRICARE East, your out-of-pocket costs will depend on several factors, including:

• Your sponsor’s status
• Whether you have Group A (before 2018) or Group B
• Your choice of Prime or Select health plans

Generally, active-duty service members pay $0 in out-of-pocket costs when they use their assigned providers or get referrals. Retired service members will pay enrollment fees, deductibles, and fixed copayments, which will depend on the factors listed above.

Get Started with Drug and Alcohol Rehab Near You in New Jersey

Military service members and their families deserve high-quality healthcare, including substance use treatment. For comprehensive addiction treatment near you in New Jersey, turn to Rubicon Recovery Center. We treat people from New Jersey, Pennsylvania, and New York. We accept most major insurance providers, including TRICARE East, and we offer an insurance verification process to confirm your insurance coverage in a few minutes. We will also help handle your insurance claims, helping make the process as simple and stress-free as possible. To learn more about TRICARE East addiction treatment coverage, contact us online today or call (908)-274-0015  to get started.

Frequently Asked Questions About TRICARE East Rehab Coverage in NJ

Does Rubicon Recovery Center accept TRICARE East?

Yes, Rubicon Recovery Center accepts TRICARE East and other major insurance providers.

Does TRICARE East cover outpatient rehab in New Jersey?

TRICARE East typically covers some or all of the cost of outpatient rehab in NJ. However, the scope of coverage will depend on the specific policy and benefits.

Does TRICARE East cover IOP and PHP at Rubicon Recovery Center?

IOP and PHP at Rubicon Recovery Center are often covered at least partially by TRICARE East, but coverage varies depending on the plan.

How do I verify my TRICARE East benefits?

To verify your TRICARE East benefits, you can request insurance verification through Rubicon Recovery Center by filling out our web form or calling (908)-274-0015.

What out-of-pocket cost should I expect with TRICARE East?

The out-of-pocket costs you can expect with TRICARE East will depend on many factors, including which plan you have, whether you are active duty or retired, and your sponsor’s status.

Does TRICARE East cover dual diagnosis treatment?

Yes, TRICARE East typically covers dual diagnosis treatment, but the extent of coverage will be determined by your plan and benefits.

What other insurance providers does Rubicon Recovery Center accept besides TRICARE East?

At Rubicon Recovery Center, we also accept Aetna, Anthem, Cigna, Meritain Health, Horizon BCBS, UnitedHealthcare, and other insurance providers, along with TRICARE East.