Tricare Prime: Mental Health

Good Morning!
We are back with another Tricare Prime post!


Today we are looking at Tricare Prime Mental Health coverage.

For more in depth information about what mental health issues are covered, please see tricare.mil/mentalhealth and speak to your PCM.

Active Duty Service Members coverage
Unless it is an emergency, service members do need a referral to receive mental health care outside of a military hospital or clinic.  They should visit the local military clinic first.

Prime Enrollees
If you are enrolled in Prime, you may see a Tricare authorized in network provider for the first 8 outpatient mental health visits per fiscal year for a medically diagnosed and covered mental condition without a referral.  These usually include clinical psychologist, clinical social workers  and/or certified mental health counselors.  Check with your PCM or regional contractor if you have any questions.  There is also an option called the Telemental Health Program which provides secure video conferencing to provide some mental health services.  See the Tricare website or contact your regional contractor for more info.
For inpatient mental health care services, prior authorization from your regional contractor is required provided it is not an emergency situation.  Psychiatric emergencies do NOT require prior authorization for admission to an inpatient unit but they must be contacted within 24 hours to be made aware of the situation and provide authorization for a longer stay if necessary.

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