TRICARE is a health insurance program funded by the government, designed for active-duty service members, veterans, and their families. It offers extensive health coverage that encompasses medical, dental, and pharmacy services for those who qualify. The program includes a broad spectrum of healthcare services, such as routine doctor appointments, hospital admissions, preventive care, and even mental health support. While the specifics of TRICARE mental health coverage can differ based on the plan and the type of care required, it does cover a range of mental health services and conditions like depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder, and other behavioral health issues.
Mental health is considered an essential part of overall health and well-being. Addressing mental health issues is crucial for ensuring that service members remain physically and mentally fit to fulfill their responsibilities. By offering comprehensive mental health services, TRICARE promotes a culture where service members and their families can seek assistance without the fear of stigma or negative consequences. If you are a TRICARE sponsor or a family member in need of mental or behavioral health services, you will likely find that the care you require is covered. Although costs may vary based on your specific plan, financial concerns should not deter you from seeking treatment. All TRICARE insurance plans for mental health include a variety of treatment options, such as inpatient care, outpatient therapy, prescription medications, and both group and family therapy according to the Military Benefit Association.
Understanding TRICARE’s Coverage for Mental Health Services
For individuals enrolled in TRICARE, understanding the types of mental health services covered by TRICARE is essential. The specifics can differ based on your plan and beneficiary status. Keep in mind that copayments and deductibles may apply, depending on the type of care you receive, and some services might need preauthorization or a referral, particularly under TRICARE Prime. Additionally, seeking care from out-of-network providers could lead to increased expenses. Here is an overview of mental health services covered by TRICARE:
- Inpatient Care – TRICARE provides coverage for inpatient mental health treatment when it is medically necessary, which includes stays in psychiatric facilities or inpatient care at general hospitals.
- Outpatient Care – Beneficiaries can access outpatient services, which encompass therapy sessions with licensed mental health professionals such as psychologists, counselors, or psychiatrists. This includes individual, family, and group therapy, as well as structured programs like partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs).
- Substance Use Disorder Treatment – Addiction and substance use disorder fall under mental health issues and offer coverage for various treatments including detoxification, inpatient services, IOP, PHP, and medication-assisted treatment (MAT).
- Telehealth – Beneficiaries can take advantage of telehealth services for mental health care, enabling them to attend virtual appointments with their providers.
- Medication Management – Coverage extends to psychiatric medications prescribed by licensed healthcare professionals as part of the treatment for mental health conditions.
- Family Support – Counseling and support services for families are included when necessary, although couples counseling is not covered.
TRICARE offers comprehensive mental health coverage that includes a diverse array of providers such as psychiatrists, clinical psychologists, social workers, family therapists, and licensed professional counselors. While TRICARE ensures strong support for mental health needs, beneficiaries need to review their specific plan details to understand access, referral requirements, and associated costs.
Mental Health Treatment That Works
Does TRICARE Cover Treatment for Depression?
Depression rates among those in the military and their family members are higher than in the general population. According to PsychCentral, 23% of active-duty military and 20% of veterans are living with depression. Some reasons why military personnel are more likely to be diagnosed with depression include:
- Exposure to life-threatening situations
- Separation from family and friends who provide emotional support
- The extreme stress associated with combat experiences
- Concerns regarding physical health and fitness
- Frequent moves and relocations
- Regular deployments
- The challenges of reintegrating into civilian life
Depression is a serious mental health condition with symptoms such as low mood, fatigue, sleep issues, and hopelessness that can greatly impact the quality of life and can significantly worsen if left untreated. Fortunately, TRICARE mental health covers depression treatment including psychotherapy, cognitive behavioral therapy (CBT), support groups, and prescription antidepressants. This coverage goes beyond just weekly therapy sessions, encompassing more intensive programs available in both inpatient and outpatient mental health facilities.
Does TRICARE Require a Referral for a Psychiatrist?
A psychiatrist is a medical professional, either an M.D. or D.O., who focuses on mental health and is trained to evaluate both the mental and physical dimensions of psychological issues, as noted by the American Psychiatric Association. They employ a range of treatments, including different types of talk therapy, and have the authority to prescribe medications. When it comes to seeing a psychiatrist, TRICARE usually mandates a referral, although this requirement can vary based on the specific mental health plan you have.
For those under TRICARE Prime, a referral from your primary care manager (PCM) is typically necessary to consult a psychiatrist. Conversely, individuals enrolled in TRICARE Select and TRICARE for Life can visit a psychiatrist without needing a referral and have the flexibility to see any TRICARE-authorized provider. If you’re uncertain about the referral process, it’s wise to consult your PCM or TRICARE customer service for clarification on your plan’s specific requirements. In urgent situations requiring mental health services, you may also be able to access emergency care without a referral.
How Many Therapy Sessions Does TRICARE Cover?
TRICARE insurance coverage for mental health covers a wide range of mental health services, including therapy, without a fixed limit on the number of treatments available. However, the number of therapy sessions covered can vary based on the type of therapy, the specific plan, and the individual’s condition. Generally, TRICARE allows for up to 20 outpatient therapy sessions each year for those diagnosed with a mental health condition. Should additional sessions be necessary, prior authorization may be needed, usually granted following an evaluation to establish medical necessity. Furthermore, TRICARE may also cover inpatient or intensive outpatient programs for mental health issues when recommended by a healthcare provider, providing a more structured approach than standard weekly therapy.
Contact Moment of Clarity to Learn More About TRICARE Mental Health Coverage
Military personnel, veterans, and their families often face unique and significant mental health needs compared to civilians. Due to the intense and sometimes traumatic experiences associated with military service, especially in combat, veterans and active-duty members are more likely to experience conditions such as post-traumatic stress disorder (PTSD), depression, and anxiety. This highlights the need for specialized mental health support.
At Moment of Clarity, we recognize these specific challenges and have created mental health programs designed exclusively for active-duty service members, veterans, and their families, all within a peaceful and secure setting. Our structured outpatient programs extend beyond traditional weekly therapy, offering the intensive care necessary while allowing patients to maintain their daily lives and responsibilities. TRICARE mental health coverage may help cover some or all of your treatment expenses at Moment of Clarity. We accept most major insurance plans and will collaborate with your provider to minimize your out-of-pocket costs.
If you or a family member is facing mental health difficulties, reach out to Moment of Clarity at 949-625-0564 to explore your treatment options or to verify your TRICARE coverage today.
External Sources
- Military Benefit Association – Using TRICARE for Behavioral and Mental Health
- PsychCentral – The Impact of Depression in Military Personnel and Families
- American Psychiatric Association – What is Psychiatry?
