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Does VA Insurance Cover Addiction Treatment?

The short answer to the question of whether a military veteran’s insurance—if it’s provided by the federal government—will cover treatment for a substance use disorder is “yes”.

But while some veterans may be reluctant to seek help, others may struggle with access to the treatment they are entitled to. The nearest VA hospital may be far away. Other veterans may struggle with chronic transience—without a home address, they may not know which hospital they can work with.

And, health insurance can be complicated. We try to simplify it a bit.

The VA website has a treatment finder to help any veteran get started, and the Substance Abuse and Mental Health Services Administration (SAMHSA) website’s treatment locator can specify VA-eligible locations.

But that’s just the beginning. Read on to learn what different insurances offer veterans when it comes to substance abuse treatment.

Veteran Insurance for Substance Abuse and Mental Health Treatment

Some U.S. military service veterans struggle with substance abuse, co-occurring mental health problems, and behavioral disorders. An estimated 20% of active duty service members meet the criteria for heavy alcohol abuse, and 11% of service members who served in the conflicts in Iraq and Afghanistan have been diagnosed with a substance use disorder.

The federal government provides access to healthcare for all military veterans, provided the veteran has not been dishonorably discharged.1

This medical care includes a full range of mental and behavioral health services, such as:

  • Medical services.
  • Inpatient treatment.
  • Counseling to overcome addiction.

The United States Veterans Affairs Administration

sign for U.S. Department of Veterans AffairsThis is a public medical care program provided to former military service members by the federal government. Applying for healthcare through the VA system is as easy as going to the website and starting the application process.

Although the VA is not a health insurance program, not having insurance won’t stop you from from getting treatment at a VA hospital.2 If a veteran has insurance, VA hospitals will bill the veteran’s private insurance for services.

If the veteran doesn’t have insurance, staff at the VA hospital may be able to help the veteran apply for Medicaid, if they are eligible, or determine if they meet specific low-income requirements.

Enrolling in treatment through VA healthcare ensures comprehensive treatment for any and all veterans. There are two priority groups:3

  1. Priority Groups 1-3. These groups include veterans who have received a disability rating through the VA, former prisoners of war (POWs), and Purple Heart or Metal of Honor recipients.
  2. Priority Groups 4-8. These groups include other veterans, such as those who have diagnosed chemical exposure, certain income levels, specific combat statuses, and other diagnosed medical conditions.

Community Care Options for Substance Use Treatment

The VA is the foundation of healthcare treatment for veterans, but there are other health insurance programs veterans can work with. To expand treatment access for veterans, or if there isn’t space in a VA hospital, the VA will contract with non-VA healthcare facilities4 like Recovery First.

Recovery First’s Salute to Recovery program is geared toward veterans, with veteran staff members and group therapy sessions that only have veterans present.

TriCare

This private insurance program is a regionally managed healthcare program for active duty service members as well as veterans of the U.S. Armed Forces, their families, and survivors. This insurance program helps cover substance abuse treatment through VA hospitals. As of July 2017, benefits through TriCare have been expanded to include:5

  • Emergency and non-emergency inpatient hospitalization.
  • Psychiatric residential treatment for children.
  • Partial hospitalization.
  • Outpatient and office-based mental health and substance abuse treatment.
  • Inpatient and residential substance abuse treatment.

Ensuring private insurance covers these behavioral and mental conditions will help more veterans feel confident in the quality of their care, as well as the financial support they receive to stay in treatment. This also provides greater flexibility for veterans who may not live near a VA hospital and need to access treatment through a closer rehabilitation program.

Medicaid

For many vulnerable populations around the U.S., Medicaid offers free or low-cost health insurance and supplements Medicare (which you can learn about below), private insurance, and other types of health coverage, including veterans’ benefits.

Over 1.75 million veterans, or one in 10, uses Medicaid coverage to some extent. Two in five veterans surveyed in 2015 reported having Medicaid as their sole source of health insurance coverage; 41% reported Medicaid coupled with military or veterans’ benefits; 11% reported Medicaid and private insurance; and 9% reported both Medicaid and Medicare coverage.6

Not all addiction treatment centers accept Medicaid as a form of payment. However, many treatment centers like Recovery First will perform a free insurance benefits check to confirm which benefits, if any, you can receive from Medicaid for addiction treatment.

Medicare

Older veterans likely qualify for both veterans’ benefits and Medicare.7 However, Medicare Part B and veterans’ benefits do not work together, so it’s important to know how and when to apply to either program.

Older veterans who go to a non-VA doctor and who have enrolled in Medicare will be automatically covered by Medicare Part A or B. However, these options are not billable to VA hospitals or VA program care.

Medicare does not provide the same level of comprehensive treatment as VA hospitals do, but there are some programs that may be easier to access closer to home compared to traveling to a VA hospital for substance abuse services.

Overcoming Addiction or Co-Occurring Disorders

doctor and veteran shaking hands in front of an american flagWorking-age veterans who find employment in the public or private sector after leaving active duty likely have access to insurance coverage through their employer, while aging veterans may consider applying for Medicare to help them.

However, a significant number of veterans struggle with homelessness, suffer from severe mental illnesses, or have unstable financial lives due to substance abuse. These conditions make it difficult to maintain employment and consistent health insurance coverage.

The VA will offer free or very low-cost treatment for these veterans while billing private insurance or charging copays for veterans who have consistent employment and other insurance options.

For many veterans, working with addiction specialists who understand the specific struggles unique to former soldiers, pilots, sailors, and more helps them feel comfortable with the quality of treatment they receive. Their individual needs can be better assessed by those who understand post-traumatic stress disorder, military life, and military families.

That’s why at Recovery First, we have veteran staff work on our Salute to Recovery program, geared specifically toward military veterans. We also provide group therapy environments for veterans only, so that you can be with people who have had similar life experiences.

For veterans who cannot receive immediate treatment at a nearby VA hospital, doctors and addiction specialists all over the country are expanding their practices to treat veterans as a unique group with specific treatment needs. More private doctors are contracted through the VA to work with this federal program and provide mental, behavioral, and physical health treatment.

References:

  1. Bureau of Substance Abuse Services. (2018). Practice guidance: engaging veterans in treatment May 2018.
  2. S. Department of Veteran Affairs. (2019). VA health care and other insurance.
  3. gov. Basic medical benefits package for veterans.
  4. gov. VA care in the community.
  5. Military Times. (2017). Tricare expands mental health, substance abuse, opioid treatment options.
  6. Kaiser Family Foundation. (2017). Medicaid’s role in covering veterans.
  7. (2012). Medicare and veterans’ health coverage.
About The Contributor
Laura Close
Senior Web Content Editor, American Addiction Centers
Laura Close is a Senior Web Content Editor at American Addiction Centers and an addiction content expert at Recovery First Treatment Center. She has a bachelor’s degree in English and has nearly a decade in professional editing experience... Read More