VA Benefits for Substance Abuse & Rehab Programs

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Published June 24, 2021 

 

Veterans Affairs (VA) offers a range of benefits to veterans. These benefits can include health care, disability compensation, pensions, grants for education and vocational training, vocational rehabilitation and job placement, financial loans for homeownership, life insurance, and burial.1 The VA operates the largest healthcare network in the United States, and is available to many veterans around the county.  The VA benefits for substance abuse allows veterans to receive treatment at VA facilities.2, 3 This makes the VA a crucial resource for veterans seeking treatment for substance abuse. Even if the VA’s internal facilities cannot meet a veteran’s needs, the community care program can allow veterans to use their VA benefits for substance abuse treatment at select partnered facilities.

Table of Contents

What Are VA Benefits?

The VA offers a variety of benefits, ranging from healthcare to social support. VA benefits provide opportunities for treatment, growth, and support as veterans readjust to civilian life. Offering access to VA rehab and medical care can make it easy for veterans to address medical and mental health disorders. VA benefits help many veterans:2, 4

  • Veterans can receive health care at 171 VA Medical Centers and over 1,100 Veterans Health Administration outpatient clinics across the country.
  • Nearly 10 million veterans (49%) utilized at least one service or benefit through the VA in 2017.
  • 76% of veterans received health care and/or disability benefits in 2017.
  • 25% of veterans only received health are benefits in 2017.
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1 Insurance Disclaimer: American Addiction Centers will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” American Addiction Centers will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

VA Benefits Eligibility

In order for veterans to receive VA benefits, they must meet certain eligibility requirements. VA benefit requirements include:5, 6

  • Having served in the armed forces and didn’t receive a dishonorable discharge.
  • Serving either 2 years continuously or the entire period of active duty for which you were called.
  • If you were discharged due to your service causing or worsening a disability.

If you’re wondering about whether or not you qualify for VA benefits, the first place to check would be the VA website.

Can I Lose VA Benefits for Drug Use?

There are some situations that can disqualify someone from obtaining VA benefits. Veterans who received dishonorable discharge may be ineligible for VA benefits, or require you to have the VA conduct a special determination before granting benefits.7 If you’ve been court-martialed, refused to perform military duties, deserted, gone absent without leave (AWOL) for 6 months or more continuously, spied, been convicted of a felony, or committed certain sexual offenses, you can lose VA benefits. Continued substance use while enlisted can lead to a dishonorable discharge, disqualifying you for VA benefits.

Do VA Benefits Cover Drug & Alcohol Rehab?

If you’re a veteran struggling with substance abuse, you may be wondering if the VA will pay for some or all of the cost of alcohol or drug rehab. VA benefits do cover treatment services for substance use disorders.8 However, this coverage can depend on a variety of factors, including the level of care that you need, any insurance coverage you may have in addition to VA benefits, the length of time you need treatment for, and whether you attend a VA drug rehab or receive treatment through a community care provider.3

What Services Does the VA Cover?

The VA may cover a range of services to treat substance abuse and addiction. This can vary greatly, depending on your unique needs and where you choose to attend treatment. Rehab programs covered by VA benefits may include:8

  • Detoxification.
  • Inpatient rehab.
  • Residential treatment.
  • Intensive outpatient rehab.
  • Outpatient rehab.
  • Medication-assisted treatment (MAT).

Other potential services can include marriage and family therapy, peer support groups, relapse prevention and continuing care, specialized programming designed to address specific populations such as veterans who are female, homeless, diagnosed with co-occurring mental health conditions, or recently returned from military service in combat zones.

Does the VA Cover Prescription Medications?

VA benefits cover FDA-approved prescription medications to treat a variety of conditions.9 Whether the VA will cover prescription medications for the treatment of substance use disorders depends on the type of treatment services you receive and what type of substance use disorder you have, since medications have only been approved to treat certain types of addictions.10 Medications that are used in VA substance abuse programs include:8, 10, 11

  • Buprenorphine: Used to treat opioid use disorder.
  • Methadone: Used to treat opioid use disorder.
  • Naltrexone: Used to treat opioid use disorder and alcohol use disorder.
  • Acamprosate (Campral): Used to treat alcohol use disorder.
  • Disulfiram (Antabuse): Used to treat alcohol use disorder.

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Do I Have to Go to the VA for Substance Abuse Treatment?

Many veterans choose to attend VA alcohol rehab or drug treatment facilities, but those aren’t the only options available. While VA facilities can provide quality treatment for veterans at a low cost, these facilities can have long wait times, or lack specialized treatment tracks. Community Care Partners is a program operated by the VA to help mitigate the weaknesses of VA facilities. Facilities that are part of the community care program work with the VA to offer specialized treatment services. As a result, veterans can receive treatment through approved community care providers as long as they meet certain eligibility requirements and obtain approval from the VA.12 This allows veterans to have easier access to substance abuse facilities that accept VA benefits.

Is Substance Abuse a VA Disability?

In order to qualify for VA disability benefits, it needs to be shown that the veteran is affected by service-connected disabilities. While the VA approves service-connected conditions related to physical or mental health, substance abuse alone is not considered a VA disability.13 However, since veterans who are diagnosed with mental health disorders such as post-traumatic stress disorder (PTSD) are significantly more likely to struggle with substance use disorders, it is possible to obtain VA disability benefits if you have symptoms of both, especially if your substance use occurs as a response to symptoms of service-connected PTSD or another diagnosis.13

Can I Have VA Benefits & Other Forms of Insurance?

It is possible to have VA benefits as well as other types of health insurance. Having another form of health insurance provides additional avenues for treatment. This can allow a veteran access to a wider pool of providers that may not accept VA benefits, stay in treatment longer, utilize alternate forms of treatment, attend treatment outside of the area, or get into treatment sooner. Some common insurances that veterans may have in addition to VA benefits include:5, 14

  • Private insurance: This can be provided through employment, and can include coverage for a spouse or family members that may not be covered by VA benefits.
  • Medicaid: This is a federal program that offers health insurance to people who fall below set income levels, although the eligibility requirements may differ between states.
  • Medicare: This is a federal program available to Americans aged 65 or over as well as people with disabilities, allowing them to access health care.
  • TRICARE: This is military healthcare offered to active duty and retired service members, as well as their family members, and is provided through a network of providers within the community.
  • TriWest: This is a plan offering coverage for care received through VA community care providers.

How Does It Work?

If you have multiple types of insurance, such as VA benefits and private or public insurance, you can use them to cover treatment. You will need to provide information for both plans to the service provider. VA benefits are used when you receive care at a VA medical center or approved facility, while treatment received outside of the VA network will be covered by your other provider.15 Additional health insurance can be used to cover the cost of treatment for conditions that are not service-connected, and can also cover the partial or full amount of the VA copayment if you receive care at a VA facility. Finally, charges for health care at the VA may be applied towards your private health insurance deductible. 

Addiction Treatment Designed for Veterans

Substance abuse programs for veterans need to differ from treatment for the average American. This is because veterans face a number of unique challenges when receiving substance abuse treatment. It could be PTSD, survivor’s guilt, or simply the stress of dealing with the specific demands of military service. These issues need to be addressed in order for you to overcome your dependency. Veterans-specific programming that have staff trained in veterans’ issues, and which work to build a sense of community amongst participants, are often one of the best avenues for veterans seeking substance abuse treatment.

The VA is the first place to look for care. However, other programs are available as well. If the VA programs are full, or if you want additional options, the VA can help you find a private treatment provider like the ones we have around the country. You can work with facilities that are part of the VA’s community care provider network.

Because addiction is such a struggle for veterans, VA treatment programs are in high demand. There may be a waitlist for a program near you. Finding a private treatment center that offers a veteran-specific program can help you get the help you need while respecting and addressing your military service.

 TRICARE

TRICARE offers health coverage for active-duty military members and some veterans. This coverage can work with your VA benefits to get you on the path to recovery.

With TRICARE, you may have access to treatments such as:7

  • Detox.
  • Drug testing.
  • Inpatient treatment programs.
  • Outpatient treatment programs.
  • Opioid and other substance abuse disorder treatment.
  • Family therapy.

Medicare

Medicare is a federal program that provides health insurance for Americans over 65 and people with certain disabilities. While many veterans use Medicare alongside VA benefits, but you cannot use both simultaneously.

To use your VA benefits, you’ll need to see a VA doctor or attend a VA treatment program. When you visit a non-VA doctor or look for a private treatment program without using your VA insurance, your Medicare Part A and Part B will apply.

The VA hospital does offer more benefits than Medicare-approved providers. But if the VA programs are full or are too far from home, your Medicare benefits can help you get the treatment you need. Be sure to check with the treatment program to get advice about whether it would be best to get a VA referral or use Medicare.

Medicaid

Almost 10% of veterans are low-income and qualify for Medicaid. Medicaid is a state-based health insurance program that helps lower-income people get the medical care they need.8

Not all addiction programs will accept Medicaid for payment, but some will. Before you decide to use Medicaid instead of VA benefits, be sure to connect with the treatment program to ensure that Medicare is accepted.

Will VA Benefits Cover My Spouse or Family Members?

Some VA benefits are available to the spouse or family members of active duty service people and veterans. These can include health care, dental insurance, and prescription medication coverage.16, 17 In addition, you may also qualify for additional benefits, such as access to life insurance, home loan programs, and funding for school or vocational training. You can find out more information about the benefits available to family members here.

Sources

  1. U.S. Department of Veterans Affairs. (2013). Veterans.
  2. U.S. Department of Veterans Affairs. (2021). About VHA.
  3. U.S. Department of Veterans Affairs. (2020). Veterans overview.
  4. U.S. Department of Veterans Affairs. (2020). VA utilization profile FY 2017.
  5. Congressional Research Service. (2014). The number of veterans that use VA health care services: A fact shee
  6. U.S. Department of Veterans Affairs. (2020). Eligibility for VA health care.
  7. U.S. Department of Veterans Affairs. (2014). Claims for VA benefits and character of discharge.
  8. U.S. Department of Veterans Affairs. (2020). Substance use treatment for veterans.
  9. U.S. Department of Veterans Affairs. (2018). Medication copayments.
  10. Substance Abuse and Mental Health Services Administration. (2021). Medication-assisted treatment (MAT).
  11. National Institute of Drug Abuse. (2018). Principles of drug abuse treatment: A research-based guide. (Third edition).
  12. U.S. Department of Veterans Affairs. (2021). Community care.
  13. Jankowski, R.L., Black, A.C., Lazar, C.M., Brummett, B.R., & Rosen, M.I. (2019). Consideration of substance use in compensation and pension examinations of veterans filing PTSD claims. PLOS One, 14(2).
  14. TriWest Healthcare Alliance. Billing frequently asked questions.
  15. U.S. Department of Veterans Affairs. (2020). VA health care and other insurance.
  16. U.S. Department of Veterans Affairs. (2020). Health care for spouses, dependents, and family caregivers.
  17. U.S. Department of Veterans Affairs. (2020). VA benefits for spouses, dependents, survivors, and family caregivers.