When it comes to health insurance for active duty military members, veterans, and their families, TRICARE is one of the most comprehensive and trusted programs available today. But navigating its structure, eligibility, and benefits can feel overwhelming, especially during times of transition, uncertainty, or personal crisis. Whether you’re newly enrolled, recently retired, or supporting a family member who served, understanding how TRICARE works can make a world of difference in getting the care you truly deserve.
At Westwind Recovery®, we’re proud to announce that we’re now in-network with TRICARE, offering full access to addiction and mental health care for eligible beneficiaries. This guide will help you break down what TRICARE covers, who’s eligible, the plans available, and how to easily access benefits through our center with confidence and clarity.
What is TRICARE?
TRICARE is a health care program run by the U.S. Department of Defense that provides civilian health benefits to active duty service members, retirees, and their families. It combines military health care resources with a network of civilian providers to ensure comprehensive coverage across the globe for its members.
Whether stationed at home or abroad, TRICARE gives military families the ability to access care through military treatment facilities (MTFs) or private providers in the community. For families dealing with substance use or emotional distress, this dual access can mean the difference between delayed care and immediate intervention.
TRICARE also serves as a critical bridge between active duty care and the transition to civilian life, especially for those dealing with mental health concerns, chronic conditions, or trauma that may not fully emerge until after service ends.
Who Is Eligible for TRICARE?
TRICARE eligibility spans across a wide range of military-connected individuals and their families. You may qualify if you fall under any of the following categories:
- Active Duty Service Members (ADSMs): All branches of the U.S. military.
- Retired Service Members: Includes those who’ve completed 20+ years of service.
- National Guard and Reserve Members: Eligibility begins upon activation.
- Family Members: Spouses and children of active duty or retired service members.
- Survivors: Dependents of deceased military members.
- Medal of Honor Recipients and Their Families
- Former Spouses: In some cases, under the 20/20/20 rule.
- Dependent Parents and In-Laws: May qualify for TRICARE Plus.
If you’re unsure whether you or a loved one qualifies for coverage, you can check your status through the Defense Enrollment Eligibility Reporting System (DEERS), which determines access to TRICARE benefits and helps verify plan enrollment.
TRICARE Plan Options: Breaking Down Your Choices
TRICARE isn’t one-size-fits-all. Beneficiaries can choose from multiple healthcare plans based on status, location, family size, and specific care needs. Each plan is designed to serve different stages of military life, whether you’re actively serving, transitioning to civilian life, or caring for dependents. Here’s a breakdown of the most common plans offered:
Who it’s for: Active duty service members and their families.
Coverage: Assigned Primary Care Manager (PCM), with referrals required for specialist visits.
Cost: Low or no out-of-pocket costs for most services.
Ideal for: Those who prefer structured care, coordinated appointments, and convenient access to military treatment facilities (MTFs) or network providers nearby.
Who it’s for: Retirees, their families, and others who want more freedom of choice.
Coverage: No PCM required; See any TRICARE-authorized provider without needing referrals.
Cost: Annual deductibles and cost-shares apply based on group and beneficiary status.
Ideal for: Families who travel frequently, live far from MTFs, or simply prefer to manage their own healthcare decisions without PCM oversight.
Who it’s for: National Guard and Reserve members (not on active duty) and their families.
Coverage: Offers a broad range of medical services at a fraction of civilian insurance costs.
Note: Must be purchased through TRICARE; not automatic.
Why it works: A flexible and affordable solution for reservists balancing military and civilian life who still want reliable coverage.
Who it’s for: Retired Reserve members under age 60 and eligible family members.
Coverage: Offers full medical benefits including preventive care, prescriptions, and mental health services.
Tip: This plan fills the gap between military retirement and TRICARE For Life eligibility, offering continuity in coverage during the “gray area” years.
Who it’s for: Unmarried dependents aged 21–26 (or up to 23 for full-time students).
Coverage: Option to enroll in TRICARE Prime or Select, depending on location and preference.
Why it matters: Gives young adults ongoing access to critical care, especially during transitional years when mental health challenges or stressors like college, work, or independence are common.
Who it’s for: TRICARE beneficiaries who also qualify for Medicare Part A & B.
Coverage: TRICARE serves as secondary coverage to Medicare, paying most out-of-pocket costs.
Ideal for: Seniors and retired service members seeking peace of mind with nearly full medical coverage, including hospitalization, specialty care, and prescriptions with minimal expenses.
Don’t forget: Other valuable programs include TRICARE Plus (for care at MTFs without formal enrollment), TRICARE Dental (for dental coverage based on eligibility), and TRICARE Pharmacy, which offers prescription drug coverage with convenient home delivery or retail options.
Tip: Life events such as marriage, relocation, retirement, childbirth, or activation can all impact your TRICARE plan eligibility and coverage level. Always check the TRICARE Life Events page to make sure you’re properly enrolled and protected during major life transitions
What Does TRICARE Cover?
TRICARE covers a wide range of medical services, including:
- Primary care & specialist visits
- Hospitalizations and surgeries
- Prescription medications
- Emergency services
- Mental health care
- Substance use treatment
- Preventive services (immunizations, wellness visits)
TRICARE also offers telehealth services, expanding access for families in remote or underserved areas. This is especially useful for military spouses stationed overseas or in isolated stateside posts.
When it comes to behavioral health, TRICARE offers extensive coverage for:
- Inpatient detox and stabilization
- Residential substance use treatment
- Outpatient rehab and therapy
- PTSD and trauma-focused counseling
- Dual diagnosis care (mental health + substance use)
This level of support is especially vital considering the high rates of PTSD, anxiety, and depression among service members and veterans. TRICARE’s behavioral health benefits allow families to heal together, restoring peace and stability that military life may have disrupted.
At Westwind Recovery®, we align our treatment plans with TRICARE’s covered services, ensuring clinical excellence while minimizing the financial burden for our clients.
Using TRICARE at Westwind Recovery®
Westwind Recovery® is proud to be in-network with TRICARE, which means:
- No surprise billing
- Easy access to addiction and mental health services
- Streamlined verification and admissions process
- Support for both the individual and the family
Whether you need detox, trauma-informed therapy, or long-term recovery support, Westwind works hand-in-hand with TRICARE to remove roadblocks and create a smooth, empowering healing journey.
Real-Life Scenarios: Navigating TRICARE in the Civilian World
Tom retired after 22 years in the Navy and began experiencing symptoms of PTSD, anxiety, and alcohol dependency. Using his TRICARE Select benefits, he was able to self-refer to Westwind Recovery® for outpatient treatment, with nearly all services covered after meeting his deductible.
Sarah, whose husband is stationed overseas, began experiencing depression and reached out to Westwind Recovery®. Because she’s covered under TRICARE Prime, she first contacted her PCM, got a referral, and started virtual therapy within a week, with zero out-of-pocket expenses
James, a recently deactivated National Guardsman, enrolled in TRICARE Reserve Select and sought support for substance use following deployment. Westwind Recovery® was able to confirm his coverage and start treatment within 24 hours.
These stories show just how accessible and versatile TRICARE can be when paired with a responsive, compassionate provider like Westwind Recovery®.
How to Get Started with TRICARE and Westwind Recovery®
Getting started is easier than you think. Here’s a step-by-step guide:
- Verify Eligibility through DEERS: Make sure you’re enrolled and active in the DEERS system.
- Choose the Right Plan: Consider your status, location, and flexibility preferences.
- Confirm Coverage: Contact TRICARE or Westwind Recovery® directly to verify your plan.
- Contact Westwind Recovery®: Our admissions team will walk you through the rest, from benefits verification to admissions and treatment planning.
We know military families already carry a heavy emotional load. Navigating benefits shouldn’t be another burden. That’s why we’ve built our process around clarity, compassion, and rapid access to care.
Your Next Step Starts Here
Military life comes with unique challenges, but accessing high-quality addiction and mental health treatment shouldn’t be one of them. Whether you’re active duty, retired, or supporting someone who served, TRICARE provides the benefits to help you thrive, and Westwind Recovery® is here to walk beside you every step of the way.
Our team understands military culture. We honor your journey. And we provide care that’s compassionate, confidential, and covered.
Call us today or reach out online to speak with our TRICARE admissions specialists. Your healing begins now, and we’re here to guide you home.
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.
