Free interactive tool

TRICARE Coverage Checker

Answer four questions about your plan and the level of care you are considering. Get a plain-English summary of what TRICARE typically covers, whether prior authorization is required, and the official reference to verify.

No name or personal details required at any step

Who Plan Level of care Network

Who is seeking treatment?

This affects the cost-share rules that apply.

Active-duty service member

Currently serving on active duty at JBSA or elsewhere

Active-duty family member (dependent)

Spouse or child of an active-duty service member

National Guard or Reserve member

Not currently on active duty orders

Military retiree or retiree family member

Retired from active duty or dependent of a retiree

Adult dependent (age 21 to 26)

Adult child covered under TRICARE Young Adult

Which TRICARE plan do you hold?

Check your TRICARE ID card or log in at tricare.mil if you are not sure.

TRICARE Prime

HMO-style plan with a primary care manager. Lowest cost-share. Requires referrals for specialty care.

TRICARE Select

PPO-style plan. No referrals needed. Higher cost-share than Prime but more flexibility in choosing providers.

TRICARE Reserve Select (TRS)

For National Guard and Reserve members not on active duty. Similar to Select with some differences.

TRICARE Young Adult (TYA)

For adult dependents age 21 to 26. Available in Prime and Select versions.

TRICARE for Life (TFL)

For Medicare-eligible retirees and dependents. Works alongside Medicare as a secondary payer.

Not sure

I will check my TRICARE ID card or tricare.mil

What level of care are you looking at?

Not sure? The levels of care guide explains each one in plain English.

Medical detox

Medically supervised withdrawal. Usually the first step before residential or PHP.

Residential (inpatient) treatment

24-hour structured care living at the treatment facility. Typically 28 to 90 days.

Partial Hospitalization Program (PHP)

Day program, 4 to 6 hours per day, 5 days a week. You live at home or in sober living.

Intensive Outpatient Program (IOP)

Structured sessions 3 hours per day, 3 to 5 days per week. More independence than PHP.

Standard outpatient

Weekly or bi-weekly individual or group therapy appointments.

Do you know if the facility you are considering is in the TriWest network?

TriWest is the TRICARE regional contractor for San Antonio. Network status affects your cost-share significantly.

Yes, it is in the TriWest network

The facility confirmed it is in-network with TriWest for TRICARE in the San Antonio region

No, it is out of network

The facility is not in the TriWest TRICARE network, or is a non-network authorized provider

Not sure yet

I have not confirmed the facility's network status with TriWest

TRICARE covers this level of care

Based on the plan and care level you selected

Coverage status

Covered

Subject to medical necessity review

Prior authorization

Required

Submit before admission

Estimated cost-share

See note

Verify with TriWest

Network status entered

In-network

Affects cost-share

Official references to verify

TRICARE substance use disorder coverage at tricare.mil Prior authorization requirements at tricare.mil Cost and fees by plan at tricare.mil

This summary is based on published TRICARE benefit rules and is provided for general information only. It is not a benefits verification, a pre-authorization, or a guarantee of coverage. Your actual coverage depends on your specific plan's current deductible status, your catastrophic cap, and the medical necessity documentation your treatment team submits. Always confirm your coverage by calling TriWest directly or logging in to your TRICARE account before making any treatment decision.

Estimate your out-of-pocket cost → View treatment centers →

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How this tool works

Based on published TRICARE benefit schedules sourced from tricare.mil

No personal information collected at any step

Results include the official TRICARE reference to verify

Not a benefits verification. Always confirm with TriWest before deciding.

Before you call a center

Have your TRICARE plan type ready. It is printed on your ID card.
Ask the center whether they are in the TriWest network specifically for San Antonio.
Ask them to initiate a benefits verification with TriWest before you commit to anything.
Prior authorization is the center's job to submit, not yours, but confirm they have done it before you arrive.