Tricare Prime: Substance Use and Tobacco Services

Hi Everyone!
We are back with another Prime topic today!

Today we are talking about the services provided under Prime for substance use (drug or alcohol) and tobacco use.

First lets talk about Substance Use Disorder Services.  Substance use disorders include alcohol and/or drug use, abuse or dependence.  Just like with most of the other services, you must see an authorized provider for Tricare to cover the cost of care.  These include authorized hospitals, organized treatment programs in authorized freestanding or hospital-based rehabilitation facility.  These treatments can include things like detox, rehab in an inpatient or partial hospitalization program and outpatient services.  Tricare will cover three substance use disorder treatment benefit periods in your lifetime and only one per benefit period.  A benefit period begins the day the covered treatment starts and ends 365 days after that date.  As usual, I recommend you contact your PCM before seeking treatment unless it is an emergency.  Prior authorization from your regional contractor is required in many cases.  Emergency and inpatient hospital services re covered when hospital personnel and facilities are required.  Again you will need to contact your regional contractor within 24 hours of admittance.

Tricare's Tobacco-Cessation Program
Tricare provides services to help prime members and active duty service members quit tobacco products.  There are some Tricare covered tobacco cessation products, a Quitline and the website
The products covered include prescription and some over the count products to help you quit.  These are often covered at no cost (check with your PCM) through Tricare pharmacies and on base pharmacies.  They are not covered when purchased at retail pharmacies.
Counseling for quitting is covered for all beneficiaries age 18 and older who are not Medicare eligible and live in the US.  This also include the Tricare Quitlines which are listed below.
North Region: 1-866-549-8766
South Region: 1-877-414-9949
West Region: 1-888-713-4597