TRICARE covers mental health care for active-duty military service members, retirees, and their families. Although coverage is wide-ranging and comprehensive, specifics vary depending on your TRICARE plan and your location. Some services may require a referral or preauthorization.
Does TRICARE Cover Mental Health Treatment?
Yes! TRICARE covers treatment for mental health issues in a wide range of settings. However, the level and type of care depend on the severity of the problem and other factors.
Inpatient treatment: TRICARE covers inpatient treatment only when provided by a TRICARE-authorized hospital or substance use rehab facility. If you believe you or a family member need inpatient treatment, make an appointment with your primary care provider, and request an assessment. You’ll need a referral and preauthorization for all non-emergency mental health treatments.
Emergency treatment: Call 911 immediately or go to the nearest emergency room if your or a family member is at risk of harming himself or others or needs skilled, around-the-clock care. You don’t need preauthorization for emergency mental health treatment, but if you are admitted for further care, you must report the admission to your regional contractor within 72 hours.
Acute inpatient care: If mental health disorder creates a risk to self or others, and around-the-clock care is needed, a medical provider may refer the person to acute inpatient treatment.
Residential treatment: A medical provider may recommend this form of inpatient treatment for children and adolescents with a diagnosed mental health disorder. The facility must be authorized by TRICARE, and you’ll need a referral and preauthorization. Residential treatment is useful for youth who need structured care until they are stable and can continue with regular outpatient treatment. A youth in crisis may need emergency treatment or acute inpatient care.
Partial hospitalization (PHP): People who are partially stabilized and don’t need full-time, inpatient treatment often benefit from partial hospitalization. PHP generally involves attending a mental health or substance use treatment facility five to seven days per week, up to eight hours per day. This treatment may not be available in areas outside the U.S. and its territories.
Outpatient treatment: In most cases, you don’t need prior authorization for outpatient treatment from a TRICARE-authorized provider. If you want to work with a pastoral counselor, you must get a referral first, and a medical provider must supervise treatment, even if the counselor is in the TRICARE network.
Psychotherapy: TRICARE covers inpatient and outpatient counseling or psychotherapy for individuals, families, and groups when treatment is psychologically or medically necessary. Treatment must be provided by a TRICARE-approved provider, limited to no more than two sessions per week, and only one session of the same type in a single day.
- Individual therapy: TRICARE covers psychotherapy sessions lasting up to 60 minutes, and up to 120 minutes for crises.
- Family therapy: TRICARE covers sessions lasting up to 90 minutes, and 180 minutes for crises.
- Group therapy: TRICARE covers sessions lasting up to 90 minutes.
Psychoanalysis: This type of specialized, long-term therapy aims to explore repressed emotions to gain a deeper understanding of troublesome thoughts and behaviors. Therapists must be approved by TRICARE and must have special training in psychoanalysis. Preauthorization is always required.
Medication: TRICARE may cover medications as part of a treatment plan when prescribed by an authorized medical or mental health provider.
Psychological testing and assessment: TRICARE may cover psychological testing and assessment in some situations when deemed psychologically or medically necessary. However, TRICARE doesn’t cover:
- Job or academic placement
- General screening
- Child custody disputes
- Referrals by teachers or parents
- Testing for learning disabilities or learning disorders
Does TRICARE Cover Online Therapy?
Yes, TRICARE covers many telehealth services, but some are available only during the Covid-19 pandemic. Check with your mental health provider to see if they have telehealth capability and what services are available. Also, contact your regional contractor for specifics; you may need a referral or authorization.
What Will TRICARE Mental Health Treatment Cost?
You may be responsible for a copayment or cost-share percentage, but the cost varies substantially, depending on the type of treatment, your location, and your TRICARE plan. You can minimize expenses with treatment provided by a military clinic or hospital or a TRICARE network provider.
Active duty service members pay nothing for mental health treatment provided or authorized by military clinics or hospitals. If you receive care from a civilian mental health provider, you must first get a referral and prior authorization. Keep in mind that treatment will almost certainly be more expensive.
Reach Out for Help Today
At 1st Step, we are proud to partner with TRICARE, and we are here for you. Let us lend a helping hand as you explore the issues affecting your life. For a confidential consultation or verification of your TRICARE plan, give us a call at 855-425-4846 or contact us online.