News | May 20, 2021
By TRICARE Communications
FALLS CHURCH, Va.– When you sprain your ankle or notice a suspicious lump, you seek medical attention. But what if you notice yourself worrying a lot more than before, or you feel more stressed and irritable? Or if you or your family members are concerned about your alcohol or pain medication use? These may be mental health issues, and it’s important to know that treatment is out there, that treatment works, and relief is possible. If you think you or a family member may need mental health services, explore your options with TRICARE.
The Centers for Disease Control and Prevention states that an estimated 50% of Americans arediagnosed with a mental health conditionat some point in their lifetime. For many people, these mental health concerns aren’t addressed until they worsen and interfere in daily life. So, it’s important to talk to your doctor when you do have concerns.
"Taking care of your mental health is just as important as taking care of physical health," said Dr. Krystyna Bienia, clinical psychologist and senior policy analyst at the Defense Health Agency. "There are a wide range of services available to help you learn skills, develop coping strategies, and connect with other resources."
If you’re ready to speak with a TRICARE-authorized provider, you have options. You can talk with your primary care provider. You can also visita mental health care provider.If you need assistance to help you find a provider that’s right for you, contact yourTRICARE contractor. Keep in mind, how you getnon-emergency mental health care depends on the level of care you need, your health plan, and your sponsor status.
Getting Care for Nonemergency Mental Health Care
You don’t need a referral or pre-authorization for any outpatient mental health (except for psychoanalysis) and substance use disorder (SUD) care. This includes services, like therapy and counseling. For example, if you have TRICARE Prime, you don’t need a referral to see a network provider for office-based outpatient mental health services. If you have TRICARE Select, you can see any TRICARE-authorized provider. But you’ll lower your out-of-pocket costs if you choose to see a network provider. If you have TRICARE For Life, Medicare is the primary payer for your mental health care. You only need a referral or authorization from TRICARE if your Medicare benefits are exhausted.
Active duty service members should always seek nonemergency mental health care at military hospitals or clinics first. And you need to get a referral and pre-authorization for all civilian mental health care. Refer to Getting Mental Health Care to learn more.
TRICARE covers treatment for medically and psychologically necessary mental health and substance use disorders. Keep in mind, your costs will vary depending on the level of service. As stated in the TRICARE Mental Health and Substance Use Disorder Services Fact Sheet, you can lower costs by seeking care at military hospitals or clinics or from TRICARE network providers. Download the fact sheet and go to TRICARE Costs to learn more about costs and getting care.
Covered Treatments
Depending on your needs and diagnosis, many treatment levels may be available to you. Keep in mind that some mental health services are excluded from coverage. You can read further to learn about how these options differ.
- Office-based outpatient treatment (psychotherapy, substance use disorder treatment, and more). This may include individual, family, or group therapy. Different types of therapy are available to help people with various mental health needs. These services can help decrease symptoms and increase well-being and healing.
- Intensive outpatient treatment. This is typically a form of therapy, counseling, or rehabilitation where patients go to a treatment center for several days a week, a few hours at a time.
- Partial hospitalization programs. These programs provide daytime treatment, where the patient lives at home and commutes to treatment for six or more hours per day for up to seven days a week.
- Psychiatric residential treatment centers for children and adolescents. These residential centers provide therapeutic structure and monitoring in a home-like environment.
- Inpatient treatment. This is the most intensive level of treatment. This is 24-hour care in a treatment facility or hospital. It’s usually a short-term treatment until the patient can transition to a different level of care.
TRICARE covers medically and psychologically necessary and appropriate services offered through telehealth platforms, including several telehealth options for mental health. With a computer, tablet, or smartphone, you can connect securely with your provider. Not all providers offer telehealth, so ask yours if it’s something they offer. You can also explore other options offered by your TRICARE contractor, like Doctor On Demand and Telemynd if you’re in the TRICARE East Region and TRICARE West Region.
As always, if you think you have a medical health emergency, call 911 or your local emergency number right away. You can also go to the nearest emergency room. You don’t need a referral or pre-authorization for emergency care.
The Military Health System recognizes May as Mental Health Awareness Month. Take command of your mental health and get the care you need. Learn how TRICARE can support your mental health.
