TriWest Healthcare Alliance Mental Health Services and Benefits

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TriWest Healthcare Alliance offers mental health services and benefits to its members. These services include counseling, therapy, and treatment for mental health conditions like depression and anxiety.

Members can access these services through a network of licensed therapists and psychiatrists.

TriWest's mental health services are designed to be convenient and accessible, with options for in-person and virtual appointments.

What Is TriWest?

TriWest Healthcare Alliance was established in 1996 to compete for a U.S. Government contract to manage civilian health care benefits under the TRICARE program. TriWest was awarded the contract for the TRICARE Central Region in 1996.

The company was awarded an extension to this contract, which continued until 2004. TriWest's service area expanded significantly in 2003 when it was awarded a contract for the TRICARE West Region, covering 21 states and 2.7 million beneficiaries.

TriWest's contract was worth approximately $10 billion and included states such as Alaska, California, Hawaii, northern Idaho, Oregon, and Washington.

What Is

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TriWest is a healthcare company that specializes in providing TRICARE benefits to the US military and their families. They're a prime vendor for the TRICARE program, which means they're responsible for managing the program's operations in the western United States.

TriWest was founded in 1996 and is headquartered in Phoenix, Arizona. Their mission is to provide high-quality healthcare services to those who have served their country.

The company is known for its customer-centric approach, with a focus on delivering personalized care to its beneficiaries.

What Not?

TriWest has a list of excluded items that aren't covered by their insurance plans, but the specifics depend on your individual plan.

You'll need to verify what's covered versus not covered with your insurance provider, such as TRICARE, or check your VA benefits to see what's eligible.

TriWest facilities do offer community care, but you'll need to meet certain eligibility requirements to access it.

In some cases, community care from a TriWest facility may be an option, but it's essential to check with your insurance provider first to confirm coverage.

History

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TriWest was established in 1996 to compete for a U.S. Government contract to manage civilian health care benefits under the TRICARE program.

TriWest was initially awarded the contract for the TRICARE Central Region in 1996 and began operations. It was later awarded an extension to this contract, which continued until 2004.

In 2003, TriWest was awarded a new contract to expand its service area to 21 states and 2.7 million beneficiaries. This contract was valued at approximately $10 billion and included Alaska, California, Hawaii, northern Idaho, Oregon, and Washington.

TriWest was also awarded a contract to continue providing military families access to health care and manage the 21-state TRICARE West Region for the Department of Defense. However, this contract was later awarded to UnitedHealth Group in 2012.

TriWest faced several challenges, including a lawsuit in 2011 that resulted in a $10 million settlement with the Justice Department. The lawsuit alleged that TriWest "systematically defrauded" Tricare by billing the government higher rates than they had negotiated with health care providers.

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Here are some errors that led to excess payments to TriWest, as listed by the VA Inspector General in 2017:

  • Duplicate Errors – Payments for medical claims that have been paid more than once
  • Other Health Insurance (OHI) Errors – Payments that were not adjusted for the amount OHI was responsible to pay the provider
  • Pass-Through Errors – Payments to reimburse the TPA that were more than the TPA paid the provider
  • Rate Errors – Payments that did not use the appropriate Medicare or contract adjusted rate.

These errors resulted in almost $40 million in overpayments to TriWest, according to the VA Inspector General.

Eligibility and Benefits

To be eligible for TriWest Healthcare Alliance, you must be a veteran, active-duty service member, or a family member of one. This means that anyone who is part of the military community can access their services.

TriWest Healthcare Alliance is a network of healthcare providers that offer a wide range of benefits, including primary care, specialty care, mental health services, and more. They have a network of over 60,000 providers across the country, making it easy to find a doctor near you.

One of the biggest benefits of using TriWest is that you don't have to pay out of pocket for many services. In fact, many services are covered at 100% by the VA, which means you won't have to pay a dime.

Mental Health Services

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Mental health services are a crucial part of TriWest Healthcare Alliance's coverage. They cover mental health services such as counseling and behavioral therapies like cognitive behavioral therapy and dialectical behavioral therapy.

TriWest also recognizes the intense stress experienced by veterans and provides coverage for many mental health conditions commonly faced by those who have military experience. This includes PTSD, anxiety, depression, eating disorders, ADHD, and substance abuse.

Bereavement sessions are also covered when someone is experiencing overwhelming and prolonged grief.

Mental Health Services?

Mental health services are an essential part of maintaining overall well-being, and it's great to know that TriWest covers them. Mental health services like counseling and behavioral therapies are frequently covered by insurance providers, including TRICARE and VA health benefits.

If you're looking for therapy, you'll want to find an in-network provider through the VA who is a credentialed mental health professional like a psychologist, social worker, or counselor. These providers must take an evidence-based approach to working with you.

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Some common evidence-based therapy approaches include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR). These therapies have clinical research backing their efficacy and are suitable for specific mental health diagnoses.

Here are some evidence-based therapy approaches covered by TriWest Healthcare Alliance:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Acceptance and Commitment Therapy (ACT)
  • Exposure and Response Prevention Therapy
  • Internal Family Systems (IFS)

Types of Mental Health Conditions

TriWest Healthcare Alliance covers a range of mental health conditions, including PTSD, anxiety, depression, eating disorders, ADHD, and substance abuse.

These conditions are commonly faced by veterans, who often experience intense stress as a result of their military experience.

PTSD, or post-traumatic stress disorder, is a condition that can develop after a person experiences a traumatic event.

Anxiety and depression are also common conditions that can affect anyone, regardless of their background or experience.

Eating disorders, such as those related to food or body image, can also be covered by TriWest Healthcare Alliance.

ADHD, or attention deficit hyperactivity disorder, is a condition that affects focus and impulse control.

Substance abuse is another condition that can be covered by TriWest Healthcare Alliance.

TriWest Healthcare Alliance also covers bereavement sessions for individuals experiencing overwhelming and prolonged grief.

Here are some of the mental health conditions covered by TriWest Healthcare Alliance:

  • PTSD
  • Anxiety
  • Depression
  • Eating disorders
  • ADHD
  • Substance abuse

Therapy and Treatment

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TriWest Healthcare Alliance covers a wide range of therapy types, including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR).

These evidence-based approaches have clinical research backing their efficacy and are suitable for various mental health diagnoses. Your therapist must be an in-network provider through the VA and a credentialed mental health professional.

TriWest Healthcare Alliance covers mental health conditions such as PTSD, anxiety, depression, eating disorders, ADHD, and substance abuse. They also provide coverage for bereavement sessions when someone is experiencing overwhelming and prolonged grief.

You can access these services through online therapy, which is covered under your TriWest Healthcare Alliance benefits. However, a referral is still required to access care in the community, including online therapy sessions.

Here are some of the evidence-based therapy approaches covered by TriWest Healthcare Alliance:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Acceptance and Commitment Therapy (ACT)
  • Exposure and Response Prevention Therapy
  • Internal Family Systems (IFS)

What Types of Therapy?

TriWest Healthcare Alliance covers a wide range of therapy types through the VA healthcare system. These services must be provided by a credentialed mental health professional like a psychologist, social worker, or counselor.

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Some examples of evidence-based therapy approaches include Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT). These therapies have clinical research backing their efficacy and are appropriate for specific mental health diagnoses.

TriWest Healthcare Alliance will only cover therapies that have clinical rigor and are evidence-based. This means that therapies like career counseling and life coaching are not typically covered.

If you're looking for therapy options, it's essential to find a therapist who takes an evidence-based approach. This ensures that the therapy you receive is backed by research and tailored to your specific needs.

Here are some evidence-based therapy approaches covered by TriWest Healthcare Alliance:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Acceptance and Commitment Therapy (ACT)
  • Exposure and Response Prevention Therapy
  • Internal Family Systems (IFS)

Therapy Cost with My Plan?

TriWest Healthcare Alliance plans provide coverage for mental health services, including therapy sessions, which can help decrease your out-of-pocket costs.

You'll pay a copay of around $50 per session, which is significantly lower than the private market rate of $180-250 per session.

Some mental health services through the VA system are free of cost to you, including treatment related to sexual assault that occurred during your service or readjustment counseling.

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To access these benefits, you'll need to be connected to the VA system and find an in-network provider, which can be done through a local TriWest Healthcare Alliance representative or the VA's website.

It's worth noting that TriWest Healthcare Alliance plans often don't provide coverage for therapy sessions with therapists who are outside of the VA system, so be sure to find an in-network provider to access your benefits.

Medication-Assisted Treatment (MAT)?

Medication-Assisted Treatment (MAT) is a type of treatment that combines medications with behavioral healthcare and comprehensive rehab programs.

The medications used in MAT are approved by the Food and Drug Administration, such as buprenorphine and Suboxone.

These medications can help with withdrawal symptoms and tapering off certain substances, making them an effective part of a treatment program.

Medication-assisted treatment is often used for people with alcohol and opioid use disorders.

Because the medications used in MAT are FDA-approved, they're usually covered by insurance.

Frequently Asked Questions

Is TriWest Healthcare Alliance the same as TRICARE?

No, TriWest Healthcare Alliance is not the same as TRICARE, but it is a managed care support contractor that helps administer the TRICARE program in the West Region. TriWest works with TRICARE to provide healthcare services to military families in the region.

How do I contact TriWest Healthcare Alliance?

To contact TriWest Healthcare Alliance, call 888-TRIWEST (874-9378) or download the Automatic Monthly TRICARE Payment Set Up Request form to mail to the provided address.

Forrest Schumm

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Forrest Schumm is a seasoned copy editor with a deep understanding of the financial sector, particularly in India. His expertise spans a variety of topics, including trade associations, banking institutions, and historical establishments. Forrest's work has shed light on the intricate landscape of Indian banking, from the Indian Banks' Association to the significant 1946 establishments that have shaped the industry.

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