condition. All purchased treatment for SUDs requires prior authorization from the regional TRICARE contractor (TMA, 2008).
Chemical detoxification is covered for up to 7 days, although more days can be covered if medically or psychologically necessary. These 7 days count toward the 30- or 45-day limit for acute inpatient psychiatric care per fiscal year. If an inpatient general hospital setting is not needed, however, up to 7 days of chemical detoxification is covered in addition to any further rehabilitative care. Rehabilitation for SUDs may occur in an inpatient or partial hospitalization setting. Coverage encompasses 21 days (or one inpatient stay per benefit period) in a TRICARE-authorized facility. These 21 days also count toward the 30- or 45-day limit for acute inpatient psychiatric care (TMA, 2008).
Outpatient group therapy for SUDs must be provided by an approved Substance Use Disorder Rehabilitation Facility (SUDRF) (for more information on these facilities, refer to Chapter 7). The benefit includes 60 group therapy sessions in a benefit period. These sessions are in addition to the 15 sessions of outpatient family therapy covered by TRICARE. Family therapy is covered upon the completion of rehabilitative care (TMA, 2010). Note that individual outpatient therapy is not covered for SUDs unless it is provided through a SUDRF. As a TRICARE benefit, access to SUD services through contracted TRICARE providers requires preapproval through the contractor. Each of the contractors has a phone number that begins the preapproval process. SUD services can also be accessed through a provider-based toll-free number that is not limited to TRICARE beneficiaries; TRICARE specialists return all calls to this number and assist with referrals. Chapter 7 of this report describes the availability of and access to SUD care through the TRICARE benefit.
Other Avenues for SUD Care
In addition to the direct care and purchase care systems described above, members of the military and their families have several other avenues for SUD care. Like nearly all employers in the United States, the military has access to employee assistance programs; the specific contract provisions vary somewhat among the branches. An additional avenue is Military OneSource, which includes a website and nonclinical counseling that offer referral information on a wide range of topics, including substance abuse. Service members and their families may also receive care through Warrior Transition Units, the Soldier 360 Program, the Veterans Health Administration, and community programs such as Give an Hour. Some of these programs are reviewed in Chapter 6 and Appendix D of this report.