U.S. Air Force Tech. Sgt. Melissa Leonardo, a 379th Expeditionary Medical Group mental health technician, poses for a photo at the Mental Health Office waiting room at Al Udeid Air Base, Qatar. The Mental Health Office is a specialty clinic designed to treat significant depression, anxiety and trauma. (U.S. Air National Guard photo by Master Sgt. Michael J. Kelly)
5/21/2024By:TRICARE Communications
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FALLS CHURCH, Va. – Editor’s note: If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. This resource connects you with trained counselors who can help you get the help you need, 24/7.
Staying healthy is more than just taking care of your body. Even when you’re feeling good physically, you may notice you’re unusually sad, anxious, or exhausted. If so, you may be experiencing symptoms of a mental health concern—and you’re not alone. According to the Centers for Disease Control and Prevention, 1 in 5 adults in the United States live with a mental illness.
TRICARE covers mental health services so you and your family can get the care you need. Using these covered services can help put you on a path to mental and physical wellness.
“Paying attention to your mental health is key to your overall well-being,” said Thomas Turnbaugh, LCSW-C, a behavioral health specialist at the Defense Health Agency. “If you notice that you’re feeling different than usual—or if you’re dealing with a major stressor—reach out to your provider right away to learn how you can get professional care.”
Here’s more information about TRICARE-covered mental health services and how you can access them
Getting emergency mental health care
If you or a loved one is at immediate risk of harm to yourself or others, this is a mental health emergency. Call 911 or go to the nearest emergency room. You don’t need a referral or pre-authorization. Just make sure to contact your TRICARE regional contractor within 24 hours (or the next business day) to coordinate care.
Getting non-emergency mental health care
Before seeking non-emergency care, talk with your primary care provider to determine which services are right for you. And check which services require a referral or pre-authorization.
Your options for getting non-emergency mental health care depend on your beneficiary category and health plan:
- Active duty service members (ADSMs): You should first seek non-emergency care at a military hospital or clinic. If you get services from a civilian provider, you’ll need a referral or pre-authorization. ADSMs may also seek a mental health evaluation by making a request to their supervisor. You don’t need to explain why you’re requesting one, and your information will stay confidential.
- All others with TRICARE Prime: You don’t need a referral to see a network provider for in-office outpatient mental health services. Active duty family members may get non-emergency care from TRICARE-authorized non-network providers without referrals. But point-of-service fees will apply.
- TRICARE Select: You can see any TRICARE-authorized provider for mental health services. But your out-of-pocket costs will be lower if you see a network provider.
- TRICARE For Life: You don’t need a referral or pre-authorization from TRICARE in most cases. This is because Medicare is the primary payer for mental health care. But if your Medicare benefits are exhausted, you’ll need a referral or pre-authorization from TRICARE before you get mental health care.
Still not sure if you need a referral or pre-authorization before getting care? Visit Referrals and Pre-Authorizations to learn more.
Covered mental health services
TRICARE covers certain outpatient and inpatient mental health services, as detailed in the TRICARE Mental Health and Substance Use Disorder Services Fact Sheet.
Outpatient services
Outpatient treatment is available at some military hospitals and clinics. You can also get care from TRICARE-authorized civilian providers. Appointments may be in person or via telemedicine.
Some types of covered outpatient treatment include:
- Psychotherapy: Discussion-based therapy in individual, family, or group settings
- Psychological testing and assessment: Covered when medically or psychologically necessary, or during the assessment process under the Autism Care Demonstration
- Intensive outpatient program: Therapy and medication management where patients go to a treatment center for several days a week, a few hours at a time
- Partial hospitalization program: Daytime treatment, where the patient lives at home and commutes to get treatment for six or more hours per day, up to seven days a week
Inpatient services
You may need more intensive treatment that requires you to stay in a hospital or treatment center. If so, TRICARE covers:
- Inpatient hospital services: Treatment for concerns that require inpatient hospitalization (like psychiatric emergencies or substance use withdrawal symptoms)
- Psychiatric residential treatment centers: Extended care for children and adolescents who need 24/7 treatment in a therapeutic environment
Looking for a full list of covered mental health services? You can find more information on covered treatments. Or you can search for specific services on the Covered Services page.
Note: Some mental health services may not be available overseas. Check with the TRICARE Overseas contractor for more information.
Mental health care costs
Use the Compare Costs tool to check your out-of-pocket costs for mental health services. You’ll have lower costs by getting care at military hospitals or clinics or from TRICARE-authorized network providers. ADSMs have no costs for mental health services from or authorized by the Military Health System.
Mental health is health—and it’s an important part of your overall wellness. Looking for a mental health provider? Check out the Find a Doctor tool. You can also find more resources and information on TRICARE’s Mental Health Care page.
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
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