Guidance on Using TRICARE for Couples Therapy and Treatment
The person you share a relationship with is one of the people you spend the most time with. They can affect stress levels, overall mood, mental health, and even your likelihood to struggle with or overcome addiction.
So, what do you do if you’re concerned that your partner is negatively impacting things like stress, mental health, or substance use disorder? One option is couples therapy. This can leave you wondering – Does Tricare cover couples therapy for military families? What about couples rehab?
Yes, there are circumstances where TRICARE covers couples therapy and rehab – but you have to meet certain guidelines. Below, we’ll talk more about these guidelines, how to use TRICARE insurance to pay for couples rehab or marriage counseling, and what couples rehab looks like at South Shores Recovery.
Will TRICARE Cover Couples Therapy?
TRICARE covers couples therapy and marriage counseling if at least one partner carrying insurance has a diagnosed mental health condition. This includes substance use disorder, which is classified as a treatable mental illness according to the DSM-IV.
A mental health condition can be diagnosed by a family therapist, social workers at community centers, doctors, or other licensed professionals. In the case of active duty service members, you’ll need to have your primary care provider give you a referral for civilian mental health services.
The exception to the rule is authorized services that work with the healthcare program Military OneSource.
Does TRICARE Cover Marriage Counseling?
Depending on your specific TRICARE plan, marriage counseling may be covered if it is deemed necessary for the treatment of a mental health disorder.
However, TRICARE does not cover marriage counseling services for instances of infidelity, sexual issues, poor communication, unhappiness, or general relationship issues.
Who is Covered by TRICARE?
TRICARE insurance covers active duty service members, members of the National Guard and Reserve, retired service members, and Medal of Honor recipients.
Family members of these groups and individuals in the Defense Enrollment Eligibility Reporting System are also covered according to the official TRICARE website.
Dependents and secondary dependents may be covered during the circumstances, including children, parents, stepchildren, step-parents, and parents-in-law. Adult children who age out of coverage may be able to purchase TRICARE Young Adult. In the case of relationships, a person must be married to a military service member to receive benefits.
Does TRICARE Cover Couples Rehab?
If you and your spouse are both struggling with addiction, there’s a good chance that TRICARE covers marriage counseling, couples rehab, or other services needed to overcome substance use disorder. Often, for people with a certified marriage, TRICARE benefits cover both spouses separately. The person who did not serve in the military is considered a beneficiary.
Addiction is considered a diagnosed mental health disorder and one of the effective treatments for that is rehab. When you and your partner are both struggling, having support during the detox and recovery process can have a significant impact on treatment outcomes.
It also ensures that you both learn the skills to overcome addiction, making it less likely that one partner will relapse and drag the other one down with them.
That being said, there are instances where TRICARE limits residential treatment to beneficiaries under the age of 21 unless deemed medically necessary. You’ll also need to choose someone in-network unless being referred from the Defense Health Agency or your primary care manager. If you choose a non-network provider, you often have to cover treatment costs yourself.
Couples rehab at South Shores is in-network with TRICARE, and provides doubly accredited services sanctioned by DHCS and the Joint Commission.
How Do I Know if TRICARE Will Pay for Couples Rehab?
While TRICARE coverage will pay for couples rehab, family therapy, and similar services, some requirements must be met. Even with this in mind, understanding what exactly is covered by TRICARE can be confusing. There’s more than one type of plan (such as TRICARE and TRICARE Prime) and it’s not always easy to understand the language used.
The easiest way to know if you and your partner can attend rehab using TRICARE or TRICARE Prime insurance coverage is to reach out to South Shores directly. The decision to get sober is already a big step and we believe there’s no reason to make it complicated.
South Shores is a TRICARE-authorized provider and we can easily verify insurance coverage and discuss your treatment options over the phone!
Seeking Marriage Counseling or Rehab with TRICARE Insurance
TRICARE marriage counseling and/or rehab can be useful tools in treating many conditions that retired and active-duty military members may struggle with, ranging from anxiety and mood disorders to post-traumatic stress disorder and substance abuse issues.
Let’s take a look at what steps you’ll need to take to ensure you are covered.
Getting Diagnosed by a Mental Health Professional
For TRICARE to cover marriage counseling or couples rehab for military personnel, you’ll need prior authorization and a diagnosis from a mental health professional.
Unfortunately, for many current and retired military service members, struggling with mental health issues like PTSD or substance use disorder is not uncommon after returning home from military life.
If you have TRICARE coverage, South Shores can help you with this diagnosis. From here, we may recommend inpatient substance abuse treatment, couples counseling sessions, mental health treatment, and/or medication management if needed.
Understanding Your Coverage
There can be a lot of confusion surrounding what exactly is covered by TRICARE. This health insurance plan offers comprehensive coverage for medical services, mental health conditions, and more.
Often, for TRICARE to be used to pay for coverage, licensed clinical social workers, family therapists, or marriage counselors require the partner who is not covered to sign a participation agreement. This allows services to be paid for by TRICARE, TRICARE Prime, and other plans. Online counseling services may also be covered.
Rest assured that South Shores is in TRICARE’s network of specialists. This makes it easy for us to verify insurance, answer any questions you may have, and help you start down the road to recovery today.
What is Couples Rehab Like?
Even at rehab with your partner, your individual road to recovery might look a little different than theirs. While there are instances where you’ll come together for recreational therapies, group counseling, or couples counseling, there is also a big focus on learning the skills and how to overcome substance use disorder yourself.
At South Shores, we work hard to prioritize individual recovery while encouraging partners to work together to overcome problems. Each partner will develop a plan for care that focuses solely on their needs.
New patients are sometimes surprised to learn that you won’t be lodging with your partner at most rehab programs. This can vary depending on the facility, but you’ll often go through individual therapy and medical detox on your own. This gives you an opportunity to focus on your individual recovery.
During couples counseling, partners come together. These sessions have a focus on improving communication skills, exploring family dynamics, learning healthy conflict resolution, and providing support for each other during recovery.
Is It a Good Idea to Go to Couples Rehab?
Often, programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) discourage members from entering relationships during that first year. Navigating sobriety is difficult and the strain of new relationships and potential relationship problems can increase the risk of relapse.
This policy is much different when you are already married and struggling with addiction. Having a supportive partner through this process can strengthen your bond – but only if both partners see the benefits of sobriety. The benefits vary depending on the dynamic of your relationship.
Couples rehab is also not recommended for cases of abuse or severe toxic behaviors. However, it can still help you learn to communicate effectively, improve efforts in resolving conflicts, and increase your general sense of mental well-being.
When both partners are in the right mindset, there are numerous benefits of seeking treatment together. You’ll both learn skills for overcoming addiction and leading a healthy lifestyle. It also increases the accountability in sticking to your treatment plan. Lastly, the two of you can support each other during times when staying sober gets hard.
What if My Partner Doesn’t Want to Get Sober?
Unfortunately, you cannot force someone to get sober. If that were the reality, many families and friends would have forced their loved ones under the care of licensed substance abuse and mental health professionals.
The only person that you can be responsible for in that situation is yourself.
Options for Paying for Couples Rehab
Even when you’re faced with relationship challenges, TRICARE doesn’t always offer the coverage needed for both partners to attend rehab. In these cases, South Shores works hard to make treatment accessible to everyone.
We can help you contact TRICARE to understand coverage details and what requirements you need to meet to have rehab paid for.
We can also discuss alternate payment options, such as funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), private loans, and payment plans for people who qualify. Call us for more information or additional resources.
Overcome Addiction Together With Our Help at the Shores
Take your partner’s hand and take on the recovery process together. Overcoming addiction is always easier when you have support, whether that comes from your spouse, friends, or the staff at South Shores Recovery.
South Shores is in-network for TRICARE and TriWest members, making it easier to use your insurance to cover marriage counseling, couples rehab, and other services that will help you and your partner heal together.
Reach out to one of our knowledgeable staff members for more information on recovery and how you can walk that road with your significant other at South Shores.
877-919-8833
Recent Comments