TRICARE provides drug and alcohol rehab coverage for active duty service members, military retirees, dependents, and reserve members. Villa Wellness Center accepts TRICARE members through self-pay arrangements and reimbursement claim filing. We verify your TRICARE benefits in 15 minutes and explain the full cost picture before treatment begins.
TRICARE
TRICARE Coverage for Substance Abuse Treatment
TRICARE covers substance use disorder treatment for eligible beneficiaries under its Mental Health and Substance Use Disorder benefit. The benefit applies to active duty service members, military retirees, family members and dependents, and certain reserve and National Guard members.
TRICARE is administered regionally. TRICARE East, which includes New Jersey, is administered by Humana Government Healthcare Services. TRICARE West is administered by TriWest Healthcare Alliance, which took over the contract from Health Net Federal Services in January 2025.
Villa Wellness Center accepts TRICARE members for treatment. Villa does not directly bill TRICARE; instead, TRICARE members access care at Villa through self-pay arrangements and reimbursement claim filing, depending on their plan type. We explain these paths and help with the documentation TRICARE requires for claim submissions.
WHY CHOOSE US
What TRICARE Covers for Addiction and Mental Health
TRICARE covers the standard continuum of addiction and mental health treatment for eligible beneficiaries. Coverage detail varies by TRICARE plan type and authorization status, but the standard benefit includes:
– Partial hospitalization programs (PHP)
– Intensive outpatient programs (IOP)
– Standard outpatient counseling and therapy
– Dual diagnosis treatment for co-occurring mental health conditions
– Mental health diagnoses including depression, anxiety, PTSD, and bipolar disorder
TRICARE applies the Mental Health Parity Act and ACA parity standards to its behavioral health coverage. TRICARE Prime plans require Primary Care Manager (PCM) referrals for specialty care. TRICARE Select plans offer broader provider flexibility, with members able to file reimbursement claims directly to TRICARE for treatment at facilities like Villa Wellness Center.
Levels of Care TRICARE May Cover at Villa Wellness Center
Villa Wellness Center offers the levels of care that TRICARE typically covers for substance use disorder. For TRICARE Select and Reserve Select members, these may be eligible for out-of-network reimbursement. For TRICARE Prime members, accessing Villa Wellness Center typically requires self-pay arrangement.
Intensive outpatient programs (IOP)
meets several times per week, working well for those stepping down from higher levels or balancing treatment with work and family.
Partial hospitalization (PHP)
with full-day clinical programming five or more days per week
Dual diagnosis treatment
treatment for co-occurring mental health and substance use disorders
How TRICARE's Coverage Process Works
TRICARE’s coverage process differs by plan type. Each plan has its own provider access rules, referral requirements, and claim filing procedures.
TRICARE Prime members access care through their assigned Primary Care Manager (PCM) and require a referral for specialty care, including most SUD treatment. Accessing Villa Wellness Center typically requires either a self-pay arrangement or, in limited cases, a Single Case Agreement negotiated between TRICARE and the facility.
TRICARE Select, Reserve Select, and Retired Reserve members have broader flexibility in choosing providers. These plans allow members to submit reimbursement claims directly to TRICARE for treatment at facilities like Villa Wellness Center. Cost-shares, deductibles, and reimbursement amounts vary by plan.
For higher levels of care including partial hospitalization and intensive outpatient, TRICARE typically requires prior authorization. Authorization is managed by the regional contractor. In New Jersey, that is Humana Government Healthcare Services for the East Region.
How TRICARE Members Can Access Villa Wellness Center
TRICARE’s coverage process differs by plan type. Each plan has its own provider access rules, referral requirements, and claim filing procedures.
TRICARE Prime members access care through their assigned Primary Care Manager (PCM) and require a referral for specialty care, including most SUD treatment. Accessing Villa Wellness Center typically requires either a self-pay arrangement or, in limited cases, a Single Case Agreement negotiated between TRICARE and the facility.
TRICARE Select, Reserve Select, and Retired Reserve members have broader flexibility in choosing providers. These plans allow members to submit reimbursement claims directly to TRICARE for treatment at facilities like Villa Wellness Center. Cost-shares, deductibles, and reimbursement amounts vary by plan.
For higher levels of care including partial hospitalization and intensive outpatient, TRICARE typically requires prior authorization. Authorization is managed by the regional contractor. In New Jersey, that is Humana Government Healthcare Services for the East Region.
TRICARE Plan Variations We Work With
TRICARE includes several plan types serving different beneficiary categories. We work with TRICARE members across all plan types through the self-pay and reimbursement filing paths described above.
TRICARE Prime. The plan for active duty service members, retirees, and their families. PCM referrals are required for specialty care. Accessing Villa Wellness Center typically requires self-pay or a Single Case Agreement.
TRICARE Select. The flexible-provider plan for active duty family members, retirees, and their families. Offers reimbursement filing for treatment at Villa Wellness Center, with cost-shares and reimbursement amounts varying by plan.
TRICARE Reserve Select and TRICARE Retired Reserve. Plans for Selected Reserve and retired Reserve members. Operate similarly to TRICARE Select, with reimbursement filing available for treatment at Villa Wellness Center.
TRICARE For Life. Wraparound coverage for Medicare-eligible TRICARE beneficiaries (typically retirees age 65+). Medicare is primary; TFL is secondary. Per SAMHSA Treatment Locator records, Villa Wellness Center does not accept Medicare, so TFL members would discuss self-pay options.
TRICARE Young Adult. Premium-based plan for unmarried adult children of TRICARE-eligible sponsors, ages 21-26. Operates with Prime or Select structure depending on enrollment.
Options When TRICARE Does Not Cover Treatment at Villa Wellness Center
If your TRICARE plan does not reimburse out-of-network treatment at Villa Wellness Center, or if reimbursement amounts are lower than expected, you still have options.
Villa Wellness Center offers payment plans and self-pay arrangements. We work with TRICARE members to structure payment in a way that fits your situation. Call (844) 609-3035 to discuss your specific financial picture.
Frequently asked questions
Dr. Courtney Scott
Medical Director
Dr. Courtney Scott
Medical Director
Medical Reviewer
Dr. Courtney Scott, MD. Board-eligible in Addiction Medicine, Medical Director at Villa Wellness Center. For full bio visit our team page.
Will Villa Wellness Center bill TRICARE for my treatment?
No. Villa Wellness Center is not a TRICARE-authorized network provider. TRICARE members access care at Villa Wellness Center through self-pay arrangements or out-of-network reimbursement claims, depending on plan type. We help you understand the cost picture before treatment begins.
Will I need a referral from my PCM?
TRICARE Prime members typically need a Primary Care Manager (PCM) referral for SUD treatment. TRICARE Select, Reserve Select, and other non-Prime plans do not require a PCM referral but may have authorization requirements for higher levels of care. We help clarify what your specific plan requires.
Can I keep my substance use treatment private from my command?
Self-pay treatment at a non-TRICARE facility like Villa Wellness Center generally does not generate records in your TRICARE medical file. This is a common reason active duty service members choose self-pay options for SUD treatment. We do not share treatment records with TRICARE, your command, or anyone outside Villa Wellness Center without your written authorization.
Does TRICARE cover dual diagnosis treatment?
Yes. TRICARE covers integrated treatment for substance use disorder and co-occurring mental health conditions, including PTSD, depression, and anxiety. For OON treatment at Villa Wellness Center, dual diagnosis services may be reimbursable for TRICARE Select and Reserve Select members.
I am stationed elsewhere. Can I get treatment at Villa Wellness Center in New Jersey?
Yes. TRICARE benefits apply nationwide, and self-pay arrangements do not depend on duty location. Service members traveling to NJ for treatment, or family members of service members stationed elsewhere, can access Villa Wellness Center through the same self-pay or OON paths described on this page.
Does VA Community Care work for Villa Wellness Center treatment?
VA Community Care is a separate program from TRICARE, administered by the Department of Veterans Affairs for veterans (not active duty or TRICARE beneficiaries). Villa Wellness Center is not currently a VA Community Care network provider. Veterans interested in VA-funded treatment should contact their local VA medical center to discuss authorized community providers.
Verify Your TRICARE Coverage Today
Submit the form on verify-insurance page or call (844) 609-3035. We are available 24/7 to verify your TRICARE benefits, answer questions about coverage, and help you understand your next step at Villa Wellness Center.