Addiction Treatment

Mental Health Treatment

TriWest Healthcare Alliance Rehab Coverage

Whether your TRICARE benefits are handled by TriWest Healthcare Alliance, you may still be covered for addiction treatment and mental health care services. Our staff will check your benefits without charge.

What TriWest Healthcare Alliance members should know

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Does TriWest Healthcare Alliance Cover Substance Abuse Rehab?

TriWest Healthcare Alliance works for the federal government and offers TRICARE plans for service members and their families that may include drug and alcohol rehab benefits.

TRICARE is required by the Mental Health Parity and Addiction Equity Act (MHPAEA) to provide behavioral health benefits equivalent to other medical and surgical benefits.

If you would like more information about mental health services specifically for veterans and active-duty military personnel, please see veterans mental health.

TRICARE Prime functions similar to a health maintenance organization (HMO), which means your primary care manager (PCM) must make a referral to any specialist in order for treatment to be covered, including behavioral health services.

TRICARE Select functions similar to a preferred provider organization (PPO), which gives patients more flexibility when choosing an in-network provider. While you can seek out-of-network providers without a referral under TRICARE Select, doing so will increase your out-of-pocket costs.

TriWest Healthcare Alliance administers TRICARE for West Coast residents and covers outpatient and inpatient substance abuse treatment as well as prescription drug therapy. Some of the behavioral health services you need may require prior authorization.

TriWest Healthcare Alliance is not a health insurance plan; it is a government contractor that administers your TRICARE benefits in the West Coast region. Your health insurance coverage is dictated by which plan you have under TRICARE.

You can seek out-of-network care, but your out-of-pocket costs will be higher.

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Substance Abuse Treatment That May Be Covered by TriWest Healthcare Alliance

Depending on your TRICARE insurance plan and how severe your illness is as assessed by a clinician, covered services may include these levels of care:

Medical Detox

TRICARE plans that are managed by TriWest Healthcare Alliance may be able to cover medical detoxification as the first stage of treatment if it has been deemed medically necessary.

Intensive Outpatient Programs (IOP)

Outpatient benefits under TRICARE may include behavioral health treatment, intensive outpatient programs, individual and group therapy, and outpatient psychiatric care if medically necessary.

Inpatient / Residential Rehab

24-hour treatment for substance abuse and dual diagnosis may be covered with prior authorization and a PCP referral for TRICARE Prime members.

Outpatient Treatment

Behavioral health services such as ongoing outpatient programming, counseling, and scheduled therapy are often included as part of TRICARE plans offered by TriWest.

Telehealth Intensive Outpatient Programs (IOP)

Banyan Alaska and Banyan Castle Rock also provide telehealth programming, and may offer this treatment to TriWest members.

Continuing Care

TRICARE plans offered by TriWest comply with federal guidance for behavioral health authorization, with authorization often staged in line with medical necessity, so that care teams can expect to receive documentation that allows for continued care.

Note: Authorization and coverage varies by plan. The quickest way to confirm what applies to you is verification.

Note: Length of stay and level of care are typically determined by medical necessity and clinical evaluation.

Does TriWest Healthcare Alliance Cover Mental Health Treatment?

Since TRICARE complies with federal parity law, mental health coverage is included as part of TRICARE plans offered by TriWest. TriWest oversees behavioral health directly, with no separate behavioral health carve-out which could potentially make coordination between mental health and medical care smoother.

Covered services could include:

Individual and group therapy
Psychiatric evaluation and medication management
Treatment for co-occurring substance use and mental health conditions
Telehealth behavioral health services for eligible members

Inpatient Mental Health Coverage

TRICARE plans offered by TriWest may offer inpatient mental health treatment, depending on medical necessity.

Banyan Castle Rock in Colorado provides residential treatment for co-occurring substance use and mental health conditions for eligible TRICARE members.

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How Much Will Rehab Cost With TriWest Healthcare Alliance?

Out-of-pocket expenses under TRICARE plans offered by TriWest can vary, depending on plan type, whether you're active duty or a family member of a sponsor, and whether care is in-network.

Variables That Affect Out-Of-Pocket Costs

Type of TRICARE plan (i.e. Prime or Select)
Sponsor status (i.e. active duty or retiree, family member)
In-network or non-network provider
Level of care (inpatient, residential, PHP, IOP, outpatient)
Whether you meet PCM referral and prior authorization requirements

What To Do Right Now

Give Banyan our admissions team a call for a free, confidential insurance verification.

We'll review what your TRICARE plan may cover, walk you through any prior authorization steps, and help you identify your right level of care.

Questions? Get help now

If You Call TriWest Healthcare Alliance Directly, Ask:

Is medical detox covered?
Are inpatient or residential programs covered under my plan?
Are PHP or intensive outpatient programs covered?
Do I need prior authorization?
Is this facility in-network?
What are my deductibles, copays, and coinsurance?
Are there limits on the number of treatment days or sessions?

Or, We Can Verify for You (Recommended)

We contact your insurance provider directly
We review coverage details and medical necessity requirements
We explain the benefits clearly and confidentially

How to Find Treatment That Accepts TriWest Healthcare Alliance

Both Alaska and Colorado are part of the TRICARE West Region, so both Banyan Alaska and Banyan Castle Rock are open to TriWest members.

Banyan provides a range of treatment options within your region of coverage, from outpatient to residential levels of care.

View all facilities to find a center near you.

Matching You With the Correct Level of Care

Following a verification, Banyan’s clinical staff reviews your assessment to match you with a treatment level that fits your specific needs and TRICARE plan benefits. This can range from outpatient care to inpatient.

Next Steps: Verify your TriWest Healthcare Alliance coverage or speak with an admissions specialist today.

Questions? Get help now

Frequently Asked Questions

1Does TriWest cover therapy?

TRICARE plans administered by TriWest generally include benefits for behavioral health, which typically include both individual and group therapy. Copay structures and visit limits vary based on the TRICARE plan type.

2Does TriWest cover telehealth addiction treatment?

TRICARE plans administered by TriWest may include benefits for telehealth behavioral health services. Both Banyan Alaska and Banyan Castle Rock also offer telehealth programming that may be available to TriWest members.

3Does TriWest cover psychiatric care?

TRICARE plans administered by TriWest generally cover psychiatric evaluation and medication management when medically necessary. You may need to obtain a prior authorization, or TRICARE Prime members may need a PCM referral.

4How do I find providers that accept TriWest?

To search for a provider you can use the TriWest provider directory or call TriWest directly. Alternatively, Banyan’s admissions team can provide verification and match you with an appropriate location that is in network with TriWest Healthcare Alliance.

5How long will TriWest pay for rehab?

TRICARE plans administered by TriWest follow federal authorization protocols. TRICARE Prime members require a PCM referral and an authorization per stage, while Select members have more coverage flexibility. Regardless of which TRICARE plan you are enrolled in, authorization for continued treatment is based on medical necessity.

Coverage varies by America’s Choice plan and state. Insurance verification is required to confirm eligibility and benefits.

6Which Banyan rehabs accept TriWest Healthcare Alliance?

Banyan accepts TriWest Healthcare Alliance at Banyan Alaska (Wasilla, AK), as well as Banyan Castle Rock (Castle Rock, CO), which are both located in the TRICARE West Region.

Coverage varies by TriWest Healthcare Alliance plan and state. Insurance verification is required to confirm eligibility and benefits.