Admissions / Insurance
Mountain View Health verifies TRICARE benefits for free, for service members, retirees, and families. You get a written breakdown for partial hospitalization, intensive outpatient, and outpatient care.
TRICARE at a Glance
Possibly. Whether TRICARE pays for outpatient treatment at Mountain View Health depends on your plan type, your beneficiary category, and authorization. We verify TRICARE benefits for free, with no obligation, and send a written breakdown for partial hospitalization, intensive outpatient, and outpatient care.
Verification reports what your plan covers today. It is not a guarantee that a claim will be paid, and your insurer makes the final call.
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About TRICARE
TRICARE is the health care program of the United States Department of Defense, run by the Defense Health Agency. Regional contractors handle networks, authorizations, and claims. Your plan type and beneficiary category decide what you owe, so the plan named on your card matters more than the program name.
1 to 2 hours
Usual wait for a written benefits breakdown
TRICARE Plan Types
TRICARE Prime
A managed care option that active duty service members use. Care is coordinated through a primary care manager, and specialty care usually needs a referral.
TRICARE Select
A self-managed preferred provider option. You can see any TRICARE-authorized provider without a referral, and some services still need prior authorization.
TRICARE For Life
Coverage that works alongside Medicare for TRICARE beneficiaries who are eligible for Medicare.
TRICARE Reserve Select
A premium-based plan for qualified Selected Reserve members and their families.
TRICARE Young Adult
Coverage for adult dependent children up to age 26 who have aged out of regular TRICARE eligibility.
How TRICARE Covers Substance Use Treatment
TRICARE covers substance use disorder treatment, and the Defense Health Agency publishes the rules that apply to it. What TRICARE pays depends on your plan type, your beneficiary category, and whether the care is authorized.
Plans decide what they cover by medical necessity. For substance use treatment, many use the ASAM criteria, which weigh severity, treatment history, medical needs, and the level of care that fits. Mountain View Health assesses you clinically, and your plan makes the coverage decision.
Our Levels of Care
Whether TRICARE pays for a level of care depends on your plan and on medical necessity. Admissions checks your benefits for each level below before you decide anything.
Speak With Admissions25 to 30 hours a week over 5 to 6 days, with daily individual and group therapy. You go home in the evening.
9 to 12 hours a week over 3 to 5 days, with morning, afternoon, and evening tracks. It includes individual therapy and group therapy.
The same 9 to 12 hours a week over secure video, open to adults anywhere in Washington, with daytime and evening tracks.
1 to 3 hours a week over 1 to 3 days, for stable recovery or as a step down from a higher level.
Understanding Out-of-Pocket Costs
A clinic in network for your plan usually costs you less. Verification shows whether Mountain View Health is in network for yours.
Covered care under TRICARE Prime typically has no out-of-pocket cost for active duty service members.
For other beneficiaries, cost-shares depend on plan type, sponsor status, and group classification.
TRICARE's annual limit on what a family pays in cost-shares for covered care.
Annual deductibles apply to most TRICARE Select and Reserve Select plans. Prime enrollees generally have none.
Some plans require prior authorization for partial hospitalization and intensive outpatient care. Admissions tells you what your plan requires when it verifies your benefits. Your plan may also review care while it is underway to decide whether the level of care still fits.
Referrals differ by plan. TRICARE Prime usually requires one from your primary care manager, and TRICARE Select usually does not.
Federal law, including HIPAA and 42 CFR Part 2 for substance use treatment records, limits who can see your treatment records. Benefits verification starts from a secure form.
No-Cost Benefits Verification
Because benefits differ by plan type, beneficiary category, and group classification, a verification is the most accurate way to see your TRICARE coverage. You submit a secure form, and admissions runs your plan.
Network Status Comes First
Only a contract creates in-network status, and it changes what you owe. Verification tells you where your TRICARE plan stands before you commit to anything.
Verification confirms:
There is no cost or obligation for a benefits verification, and it is not a guarantee of coverage.
Common Questions
Active duty service members typically pay nothing for covered care under TRICARE Prime. Other beneficiaries pay cost-shares that depend on plan type and beneficiary category, up to an annual catastrophic cap. Verification shows what applies to you.
Mountain View Health verifies TRICARE benefits for free, with no obligation. Network status changes what you owe, and only a contract creates it, so the check confirms where your plan stands before you decide anything.
TRICARE Prime usually requires a referral from your primary care manager for substance use treatment, and TRICARE Select usually does not. Some services need prior authorization under either plan. Admissions checks this when it verifies your plan.
Retirees enrolled in TRICARE, including TRICARE For Life, can ask admissions to verify their plan. Veterans who receive care only through the Department of Veterans Affairs use a separate benefit, and Mountain View Health does not run a VA program.
TRICARE has a formal appeals process with more than one level of review. Your denial letter explains the steps and the deadlines. Ask admissions what documentation your plan will need.
Medication coverage depends on your plan and on how a medication is given, and some medications need prior authorization. If medication-assisted treatment is part of your plan, a prescriber decides whether it fits.
That depends on the service member's command, duties, and Department of Defense policy, and Mountain View Health cannot advise on it. Ask your military treatment facility, your command, or a legal assistance office before you decide.
Sources: HealthCare.gov glossary; Centers for Medicare & Medicaid Services, federal parity law. Benefits vary by plan, and verification is not a guarantee of coverage. See what drives rehab cost in Washington.
Benefits Verification
Benefits verification is free, carries no obligation, and starts from a secure form. Admissions explains what your plan covers so you know your next step.
How The Process Works
Secure Submission
Provide your basic policy info through our secure form. Submitting it is confidential and carries no obligation.
Admissions Review
Admissions checks what your plan covers for partial hospitalization, intensive outpatient, and outpatient care.
Clear Guidance
If your plan can be run, a written breakdown usually arrives within 1 to 2 hours. It is not a guarantee of coverage.