Experiencing the debilitating nature of any mental health condition is difficult enough while worrying about the treatment costs to help manage the illness. When people have insurance that covers therapy, psychiatry, and other mental health services, they’re more likely to seek help when needed rather than delaying care due to financial concerns. TRICARE mental health coverage is crucial for military service members since early intervention often leads to better outcomes and prevents conditions from worsening to the point where they require more intensive and expensive treatments.
Mental health insurance in Los Angeles also reduces the financial burden that can come with ongoing mental health care, which sometimes requires months or years of consistent treatment. When mental health conditions are properly treated, there are significant reductions in lost productivity, decreased emergency room visits, lower hospitalization rates, and fewer disability claims.
The average delay between onset of mental illness symptoms and treatment is 11 years, according to the National Alliance on Mental Illness. As access to treatment and insurance coverage expands, the percentage of adults who have received any mental health treatment has increased in recent years. This article will further explore the benefits of how insurance increases access to mental services and how to ensure every patient can receive affordable treatment for mental health.
Does TRICARE Cover Mental Health Services?
Yes, TRICARE covers mental health services. As a military health insurance program, TRICARE provides coverage for various mental health treatments and services for eligible beneficiaries (active duty service members, retirees, and their families).
TRICARE’s mental health coverage typically includes:
- Outpatient therapy/counseling sessions
- Psychological testing and assessment
- Inpatient mental health treatment
- Partial hospitalization programs
- Medication management
- Substance use disorder treatment
- Telehealth mental health services
However, specific coverage details, referral requirements, and cost-sharing amounts can vary depending on:
- Your specific TRICARE plan (Prime, Select, etc.)
- Your beneficiary category
- Whether you’re seeing network or non-network providers
- The type of treatment needed
Mental health coverage policies are constantly changing, and the details of your individual plan will determine your exact benefits.
Mental Health Treatment That Works
Call 949-625-0564Do I Need a Referral From TRICARE for Mental Health?
Whether you need a referral from TRICARE for mental health services depends on your specific TRICARE plan and beneficiary status.
For TRICARE Prime plans:
- Active duty service members need referrals for all non-emergency mental health care.
- Family members and other Prime beneficiaries typically need referrals for specialty mental health care (psychiatrists, intensive outpatient programs, etc.)
- However, Prime beneficiaries can usually receive up to 8 outpatient mental health therapy sessions per fiscal year from a TRICARE-authorized provider without a referral.
For TRICARE Select and other non-Prime plans:
- Referrals are generally not required for mental health services
- You can typically see any TRICARE-authorized mental health provider directly
There are some important exceptions and considerations:
- All TRICARE beneficiaries need prior authorization for certain services like inpatient mental health care
- If you’re seeing a non-network provider, additional rules may apply
- Active duty service members have different requirements regardless of their plan
How Do TRICARE’s Mental Health Benefits Compare to Other Insurance Plans?
TRICARE’s mental health coverage generally offers comprehensive benefits comparable to or better than many private insurance plans. Active duty service members receive full coverage with minimal out-of-pocket costs for authorized care, while family members and retirees have access to a broad network of providers with reasonable copays.
TRICARE is particularly strong in its coverage of various treatment modalities, including individual therapy, group therapy, inpatient care, partial hospitalization programs, and medication management. Another notable advantage is TRICARE’s integration with military treatment facilities, which can provide seamless care coordination between physical and mental health services, which civilian plans often struggle to achieve.
However, TRICARE does face some limitations compared to certain premium private insurance plans. Network availability can be challenging in remote locations, sometimes requiring beneficiaries to travel significant distances for specialized mental health care. While TRICARE has expanded its telehealth options, some premium commercial plans offer more extensive virtual mental health platforms with broader provider networks and specialized digital therapeutic tools.
Insurance verification for mental health treatment and referral requirements can also be more stringent under TRICARE, particularly for active duty members, creating potential administrative barriers to care that some civilian plans have eliminated. Despite these differences, TRICARE remains a valuable and robust mental health benefit that continues to evolve to meet the unique needs of the military community.
How Does TRICARE Handle Mental Health Emergencies or Crisis Situations?
TRICARE provides comprehensive coverage for mental health emergencies and crisis situations to ensure beneficiaries receive immediate care when needed. For true emergencies, TRICARE covers emergency room visits and emergency ambulance transportation without prior authorization.
If you’re experiencing a mental health crisis that poses an immediate risk, you should go directly to the nearest emergency room or call 911. For urgent mental health situations that require prompt attention but aren’t immediately life-threatening, TRICARE offers several options:
- Crisis hotlines: All TRICARE beneficiaries have access to the Military Crisis Line (1-800-273-8255, press 1) and the National Suicide Prevention Lifeline (988)
- Urgent care facilities: Most TRICARE plans allow a certain number of urgent care visits without referrals
- Military hospitals and clinics: May offer walk-in mental health services or same-day appointments for urgent needs
- After-hours care: Many military treatment facilities have after-hours mental health services
Following an emergency or crisis, TRICARE covers necessary follow-up care, which might include:
- Inpatient psychiatric hospitalization
- Partial hospitalization programs
- Intensive outpatient programs
- Stabilization and referral to appropriate ongoing care
Use TRICARE Mental Health Coverage for Treatment at Moment of Clarity
TRICARE mental health coverage provides essential support for military members facing unique stressors inherent to service life. From combat exposure and deployment-related separation to frequent relocations and the challenges of military culture, service members encounter psychological demands that civilians rarely experience.
Moment of Clarity in Southern California is proud to offer specialized mental health care through our specialists who understand military culture. TRICARE enables access to competent treatment for conditions like PTSD, depression, and adjustment disorders that might otherwise go untreated. By normalizing and facilitating access to mental health care, TRICARE helps reduce the stigma around seeking help, encouraging earlier intervention and potentially preventing career-ending mental health crises.
Contact Moment of Clarity at 949-625-0564 today to learn more about TRICARE mental health coverage you can access for mental health.
External Sources
- National Alliance on Mental Illness – Mental Health By the Numbers
- TRICARE – TriCare 101
- National Institute of Mental Health – Mental Illness
- CDC – Mental Health Treatment Among Adults Aged 18–44: United States, 2019–2021
