Veterans often wonder if VA Health Care will cover addiction treatment. In many cases, the answer is yes. Learn more about using VA health insurance for addiction rehab.
VA Health Care and Addiction Treatment
VA health care plans cover a range of services that treat illnesses, prevent health problems and improve overall functioning. Among covered services are those that treat substance use disorders and co-occurring mental health problems like PTSD and depression.
Each veteran’s health care package is unique, but you can expect addiction treatment to be covered in many cases. In fact, eligible members can access services at vet centers, which provide assessment and referral for substance abuse problems. These centers also offer individual, group and family counseling.
What Type of Addiction Treatment Does VA Health Insurance Cover?
The VA covers a range of services for substance use disorders and co-occurring mental health conditions, including:
[elementor-template id="4848"]- Inpatient care: The VA refers to this as short-term programming in severe or life-threatening situations. For instance, a medical detox program falls under inpatient care. Medical detox programs provide medication and support as a person undergoes withdrawal.
- Residential programs: These structured programs allow veterans to live on-site at a facility while receiving treatment. Depending on their needs, they might stay for 30, 60 and 90 days.
- Primary care: The VA provides coverage for veterans who visit a primary provider, such as a family physician, for treatment related to substance use.
- Outpatient services: These include a range of services provided within the community, such as individual and group counseling. Outpatient care is also available via telehealth. Some outpatient services are partial hospitalization, meaning a veteran receives 20 or more hours of service per week. Others are classified as intensive outpatient, providing at least nine hours per week.
- Supported work services: Some veterans may benefit from supported employment programs that help them find work within the community. The VA will cover participation in these programs.
- Co-occurring disorders treatment: The VA covers treatment for substance use disorders and mental health conditions. When a veteran has both conditions, they are said to have co-occurring disorders.
How To Use VA Health Insurance for Addiction Treatment
There are two primary pathways to using VA Health Insurance for addiction treatment: seeking services through a VA facility or using the VA Community Care Network (CCN) to access services at another provider in the community.
Seeking Care at a VA Facility
If you plan to seek addiction treatment at a VA facility, the first step is to apply for VA Health Insurance if you’re not already enrolled. You’re eligible if you’ve served at least 24 months, or the full term of your active duty, and were discharged for any reason that wasn’t dishonorable.
If you were discharged because of a disability caused or worsened by your time in the service, or if you were discharged for a hardship or “early out,” you could be eligible without the minimum requirement.
Once you determine eligibility, you can apply for VA benefits online. This process takes just 30 minutes, and the VA will walk you through it.
Finally, once enrolled, you can locate a VA treatment provider using the VA’s online search tool.
Using the Community Care Network
If the provider you’d like to seek treatment from isn’t part of the VA, you can use the Community Care Network (CCN) to access treatment. If you complete the pre-authorization process, the VA will cover the cost of your treatment. You can use the CCN if the VA doesn’t offer the quality care you need within a certain distance from your home or if it’s in your best interests to receive care through the CCN facility.
The process of seeking services using CCN is as follows:
- Consult creation and review: The first step toward requesting VA Community Care is talking with your doctor about beginning the “consult creation and review” process. Your VA doctor will ask to refer you to another medical and/or behavioral care provider. The request, called the “consult,” will be reviewed by the Community Care department.
- Scheduling: The Community Care department will contact you after they approve the consult. Then, they will reach out to your preferred Community Care provider to verify they are in-network and schedule an appointment.
- Authorization: Before you attend your appointment, you must receive VA approval. Once your appointment is scheduled and your care is authorized, you’ll get a letter with information about where you’re approved to seek care, what care you can receive and how long you’re approved to receive care. The VA will give you an authorization number for your records.
- Community Care visit: Attending your appointment is the final step. After your first appointment, you can schedule additional appointments directly with the provider if you’re approved for ongoing care. Once you attend your allotted number of visits, you’ll need to receive reauthorization from the VA to cover additional care from the community provider.
Tips To Navigate VA Health Insurance for Private Drug & Alcohol Rehab
Seeking services through a private drug and alcohol rehab program doesn’t have to be complicated. Consider these tips for navigating the process:
- Use information on the VA webpage for assistance locating a provider within the CCN. The VA will link you to Medicare and TRICARE to help you find a provider.
- You can contact an addiction treatment provider directly and inquire whether they are part of the CCN.
- Stay in communication with the VA staff member making your referral; they ultimately make all eligibility decisions.
- Contact the Community Care department on weekdays from 8:30 a.m. to 3:30 p.m. at 320-255-6401 with questions.
- Access resources on the VA’s webpage to obtain additional information.
- Keep the authorization letter the VA sends you once your care is authorized. This will include an authorization number and other pertinent information.
Coordinating VA Insurance With Other Plans
The VA allows you to use other insurance plans, such as Medicare, Medicaid and private insurance with your VA benefits. The VA will ask you to provide information about any other coverage you may have.
If you’re receiving care for a condition not connected to your time in the service, the VA will bill your other health insurance provider first. The payment received from your other insurance provider can offset some or all of the cost of your copay through the VA.
In addition to notifying the VA that you have additional insurance, it’s important to inform the addiction treatment provider that you have multiple insurances.
Length of Stay and VA Insurance for Treatment
The VA provides veteran-centered treatment, with services tailored to each veteran’s unique needs. The VA will consider the severity of your addiction and contributing factors like homelessness to determine the appropriate level and length of care.
If you seek services through the CCN, the VA will authorize a specific length of care. You will need a reauthorization if you need additional care beyond this approved timeframe. Your addiction treatment provider can submit a new referral request to the VA to authorize additional care.
Your Rights and VA Health-Covered Rehab
The VA offers coverage for substance use disorder treatment. However, it’s important to understand that your right to confidentiality may sometimes be limited. When people seek treatment for addiction, information about the care they receive is protected and private, but your status as a service member could limit some aspects of confidentiality.
For example, under the Military Command Exception, HIPAA regulations may not always apply to service members. Information about your treatment could be disclosed to Command officers to determine fitness for duty. Your information is generally protected unless you display a serious risk of harm to yourself, someone else or the armed forces’ mission.
Navigating Your VA Health Insurance With Our Veteran Advocates
If you’re unsure how to navigate your VA Health Insurance, help is available. First, consider talking with your primary care provider through the VA. One of the best things you can do is advocate for yourself. You can achieve this by telling your VA provider you’d like to seek care at a CCN facility.
Many facilities, including The Recovery Village, will assist you with navigating the process. Our veteran advocates will help you determine the steps you need to follow to obtain authorization for care. We will also cooperate with the VA’s Community Care Department to get a signed and approved referral form so you can access our services.
What To Expect From VA Health-Covered Rehab
When you seek rehab through a VA-approved community provider, you’ll participate in different services to help you overcome the effects of substance misuse. While the specific schedule will vary based on the level of care (inpatient vs. outpatient), you can expect to participate in individual and group counseling, support group meetings and alternative therapies like art or recreational activities.
In an inpatient facility, you’ll follow a structured daily schedule. You’ll receive all meals on-site, beginning each day with a healthy breakfast. Your days will be filled with individual and group therapy and other therapeutic activities, and they’ll end with some free time in the evening. Your treatment team will ultimately decide the best schedule to meet your needs.
Assessing VA Community Care Partner Rehab Facilities
Many options are available when seeking addiction treatment. Before choosing a VA Community Care Partner facility, assessing whether it’s a good fit is important.
First, it’s wise to choose an accredited facility. Accreditation means the facility has passed rigorous quality standards, so you can be sure you’re receiving evidence-based treatment.
It’s also helpful to consider whether staff are trained in trauma-informed approaches, such as EMDR. These approaches are often beneficial for veterans.
Finally, you may benefit from choosing a facility that provides veteran-specific treatment. For instance, some programs may offer veterans-only support groups so you can connect with your peers. Others may make rooming arrangements based on veteran status, so you’ll room with another veteran.
At The Recovery Village, we offer veteran-specific programming, and our Veteran Advocates will walk you through every step of the process so you can access the care you need. Contact The Recovery Village today to get started.