| Behavioral Health Disorder |
- Benefits are limited to 30 days per fiscal year or per admission for acute inpatient care for ages 19 and older.
- Benefits are limited to 45 days per fiscal year or per admission for acute inpatient care for ages under 19.
- Benefits are limited to 150 days per fiscal year or per admission for care in TRICARE-approved residential treatment centers.
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| Substance Use Disorders: Acute Inpatient Care |
- Covered for complications of alcohol and drug abuse or dependency and detoxification only when the patient’s condition is such that the personnel and facilities of a hospital are required.
- Days count toward the 30- or 45-day mental health inpatient limits.
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| Substance Use Disorders: Rehabilitation |
- Benefits are limited to 21 days per benefit period (combined partial and/or inpatient).
- Benefit period starts the first day of covered treatment and ends 365 days later.
- Up to seven days of detoxification are allowed in addition to the 21 rehabilitative days.
- Days count toward the 30- or 45-day mental health inpatient limits.
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| All Behavioral Health Care Inpatient Services |
- All nonemergency admissions require prior authorization.
- TRICARE Standard and TRICARE Extra beneficiaries living in designated catchment areas must obtain a nonavailability statement (NAS) before receiving nonemergency acute inpatient services.
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