TriWest Drug Rehab Coverage
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Understanding TriWest Coverage for Addiction & Dual Diagnosis at The ARTS
At The ARTS (Absolute Recovery Therapeutic Solutions), we understand how complex and deeply personal the journey through addiction and mental health recovery can be — especially for those covered by TriWest Healthcare Alliance. For veterans, service members, and their families, navigating behavioral health treatment under TriWest can feel daunting. That’s why we’re committed to offering clear, compassionate, and comprehensive guidance for using your benefits, especially when it comes to dual diagnosis (the co-occurrence of substance use disorder and mental health conditions).
Insurance and Treatment
What Is TriWest, and Who Is Eligible?
TriWest Healthcare Alliance acts as a third-party administrator for certain TRICARE and VA Community Care programs. Under this model, TriWest helps coordinate access to behavioral health providers within its network, including outpatient rehab, psychiatric care, and more.
If you’re a veteran, active or retired service member, or eligible dependent working with TriWest, you may have access to treatment services that address both substance use and mental health needs — whether through detox, partial hospitalization, intensive outpatient, or ongoing therapy.
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How Insurance Can Help
Why Integrated Dual‑Diagnosis Treatment Matters
Dual diagnosis — also called co‑occurring disorders — refers to when someone is dealing with both a substance use disorder (SUD) and a mental health condition such as depression, PTSD, anxiety, or bipolar disorder. Treating them in isolation can leave critical issues unaddressed. At The ARTS, we believe in a holistic, integrated treatment model:
- Improved outcomes. Studies (and clinical best practices) show that treating mental health and addiction together leads to better long-term recovery, fewer relapses, and a more stable recovery foundation.
- Trauma-informed care. Many veterans and service members carry trauma from their military experiences (such as PTSD or moral injury). These experiences can intensify substance use; when therapy addresses trauma alongside addiction, healing is more complete.
- Comprehensive support. Dual-diagnosis treatment often includes psychiatric evaluation, medication management, individual & group therapy, life-skills training, and family involvement — all working in concert.
Individualized Care For You.
We Can Help
What Behavioral Health Services Are Covered by TriWest
Under TriWest-administered behavioral health plans, a wide range of addiction and mental health services are eligible — provided the treatment is medically or psychologically necessary and delivered by an in-network provider.
Here are key services often covered:
Outpatient
TriWest typically covers individual, group, and family therapy, when needed. Pre-authorization is often not required for basic outpatient services — though there are exceptions.
Partial Hospitalization Programs (PHP)
For more intensive support, PHPs provide structured clinical care. TriWest requires prior authorization for PHP.
Intensive Outpatient Programs (IOP)
IOPs offer a higher level of care without full residential placement. Patients may attend in the evening or on weekends, so they can continue many daily responsibilities.
Medication-Assisted Treatment (MAT)
For certain addictions (such as opioids or alcohol), TriWest may cover FDA-approved medications (e.g., buprenorphine) integrated with therapy.
Psychiatric Assessment & Medication Management
For dual diagnosis clients, psychiatric evaluations and ongoing medication support are covered when clinically indicated and delivered by qualified providers.
Family, Trauma, and Specialized Therapies
Many evidence-based therapies — cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), EMDR, trauma processing — are included when part of a medically necessary treatment plan.
What Sets Us Apart
How The ARTS Works With TriWest to Support You
As a TriWest in-network outpatient provider, The ARTS is well-equipped to help you make the most of your TriWest behavioral health benefits. Our approach includes:
Benefit Verification & Pre-Authorization Support
Our admissions team assists with verifying your TriWest benefits, understanding your out-of-pocket obligations (if any), and coordinating any necessary pre-authorization paperwork for PHP, IOP, or higher levels of care.
Personalized Treatment Planning
During intake, we conduct a full assessment — covering clinical history, substance use, mental health, and life skills. Based on this, our multidisciplinary team designs a dual-diagnosis care plan centered on your unique needs.
Continuum of Care
We offer a step-down model: for instance, after stabilization in a more intensive setting, clients may transition to IOP or outpatient therapy with The ARTS. This ensures continuity and helps prevent relapse.
Trauma-Informed, Veteran-Sensitive Care
Our clinical staff are trained in working with trauma and understand the challenges unique to military life. This means treatment that is culturally competent and respectful of your service.
Outcome Tracking & Aftercare
We don’t just treat symptoms — we build long-term recovery strategies. Together, we map out aftercare, relapse prevention, peer support, and resources to help sustain recovery beyond the formal therapy program.
Here to Help
Benefits of Choosing The ARTS with TriWest
- Cost Efficiency: Since we’re in-network with TriWest, your coverage helps reduce out-of-pocket costs when medically necessary.
- Expert Clinical Team: Our clinicians are not only skilled in addiction treatment but also in co-occurring mental health care, and many have experience working with military and veteran populations.
- Holistic, Evidence-Based Approach: We blend evidence-based therapies with a holistic outlook — addressing trauma, relationships, life skills, and emotional well‐being.
- Flexible Care Options: Whether you need a high level of structure (PHP), flexibility (IOP), or ongoing outpatient therapy, we can adapt to your situation.
Seamless Care Coordination: We help with the administrative burden of TriWest — from benefit checks to preauthorizations — so you can focus on healing.
Individualized Care For You.
Getting Started
What to Expect When You Choose The ARTS with TriWest
- Referral & Intake
- If you’re a veteran or TRICARE beneficiary, your VA or primary care provider may initiate a referral through TriWest.
- Our intake team will gather clinical information, benefit details, and coordinate with TriWest to approve the next level of care.
- Clinical Assessment
- We conduct a biopsychosocial evaluation, including screening for substance use patterns, psychiatric symptoms, trauma, and life stressors.
- A psychiatric evaluation may be included to decide on medication needs.
- Treatment Initiation
- Depending on your needs and authorization, you may begin in PHP, IOP, or outpatient therapy.
- You’ll attend a blend of individual therapy, group therapy, psychoeducation, and specialized modalities (e.g., trauma work).
- Medication Management
- If prescribed, psychiatric medication is monitored and adjusted via regular appointments, in coordination with your therapy.
- Transition & Aftercare
- As you progress, you may step down to less intensive levels of care, or build a tailored aftercare plan.
- We’ll help coordinate referrals to ongoing community support or peer programs, ensuring your path forward is sustainable.
Let Us Help You Recover
Why TriWest Policyholders Choose The ARTS
- Veteran-centered care. For many TriWest clients, the overlap of military experience, trauma, and substance use is foundational — and The ARTS is deeply experienced in that space.
- Integrated support. We treat addiction and mental health not as separate issues, but as parts of a larger story.
- Continuity & trust. Our team is with you through every step — from intake to aftercare — helping you build a recovery that lasts.
- Insurance savvy. We have deep familiarity with TriWest policies, authorizations, and best practices, helping minimize delays and maximize covered services.
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Frequently Asked Questions
TriWest FAQs
Not always. Outpatient therapy and medication management often do not require pre-authorization. However, higher levels of care — like PHP or IOP — typically do.
Yes — in cases of medical necessity, TriWest may cover institutional detox or residential rehab, but prior authorization and documentation are required.
TriWest supports treatment for conditions like PTSD, depression, anxiety, bipolar disorder, and other co-occurring mental health issues — especially when part of a documented dual-diagnosis treatment plan.
It depends on your specific plan and benefit structure. Many veterans and TriWest beneficiaries incur minimal costs for medically necessary behavioral health services. We help verify your coverage before you begin.
Simply reach out to our admissions team. We’ll walk you through benefit verification, referral paperwork, and scheduling your clinical assessment.