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TriWest Insurance for Alcohol Treatment

If you or someone you love is a veteran dealing with an alcohol use issue, you can get more information about how TriWest can help. This page will show you how TriWest works with the VA Community Care Network (CCN) to provide coverage for alcohol addiction treatment. It will also show you how to check your benefits.

What Is TriWest?

TriWest Healthcare Alliance serves veteran and military communities.1 Since 1966, the TriWest Alliance has been fulfilling its mission to assist these communities through the aid of the Department of Defense TRICARE program.1 TriWest offers provider health networks and assistance through the Department of Veteran Affairs (VA) Community Care Network (CCN) regions 4 and 5.1 The states covered in regions 4 and 5 include the following:2

  • Hawaii
  • Idaho
  • Montana
  • New Mexico
  • Nevada
  • Northern Mariana Islands

Who Qualifies for TriWest?

TriWest functions as a third-party administrator for regions 4 and 5 of the VA CCN.1 Consequently, they may serve to administer healthcare benefits to veterans. If you are a veteran, you are eligible for VA benefits, including alcohol addiction treatment. Eligibility is determined by the VA.

You will be notified by the VA about your status. However, it’s helpful to know what a veteran must do and what criteria they need to meet before moving forward. You don’t have to meet all of these criteria to be eligible for community care, only one:3

  • You need a service that the VA doesn’t offer.
  • You live in a U.S.-state that doesn’t have a full-service VA facility.
  • You live a certain distance away from a VA facility, making it difficult to get services.
  • The VA can’t schedule an appointment for you that is both within reasonable driving time and not too far in the future.
  • The service is in your best medical interest.
  • The VA service line doesn’t meet certain quality standards.

Does TriWest Cover Rehab for Alcohol?

Although TriWest isn’t exactly an insurance plan, it does serve as a third-party manager of healthcare services. This means you can use TriWest to access alcohol addiction rehab services.

Veterans may use their benefits in other ways aside from TriWest-managed healthcare. These include the following:4

  • TRICARE: this insurance is for active-duty service members, the national guard or reserve, and their families. When a military treatment facility can’t offer services, TRICARE steps in to offer health benefits.
  • Medicare: U.S. civilians who are 65 and older or qualify for disability qualify for this program. Many Veterans may have both Medicare and VA benefits.
  • Medicaid: This health care program funded by the federal government is for low-income families, people with disabilities, pregnant women, and others. The eligibility requirements vary depending on the state you live in. Veterans may have Medicaid in addition to their VA benefits.

What Types of Treatment Does TriWest Cover?

Veterans with an alcohol use disorder may use TriWest healthcare to gain access to different treatment options. TriWest may cover treatment programs, such as:5

  • Detox: This is also known as withdrawal management. During detox, individuals can safely rid their body of alcohol’s harmful toxins under the supervision of medical staff.
  • Hospital inpatient: Patients will have medical and therapeutic support 24/7 as they recover from addiction.
  • Residential: This program provides veterans with a live-in experience with counseling and support. It may last a few months or a year.
  • Outpatient treatment: This involves treatment and counseling in an outpatient facility. Participants attend sessions within in the facility but can return home at the end of each day.
  • Co-occurring disorder treatment: Co-occurring disorder treatment involves treating both mental health and substance misuse disorders together.

How to Check Your TriWest Insurance Coverage

You can begin the journey to recovery by taking the first step to verify your insurance. There are several ways you can go about this, which may include:

  • Web login: Visit the Veteran Self-Service Portal to see your eligibility and enrollment information and view your claims and approval status.
  • Call insurance: If you’d rather talk to someone or don’t have internet access, you can call TriWest at the number on the back of your card and speak to the agent about your options.
  • Check directly with a rehab treatment provider: If you have rehab in mind, call them directly, and they can verify your insurance benefits immediately while you wait. You can check your insurance and start the admission process in one call.

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