The cost of mental health services is one of the biggest barriers to getting necessary treatment. Recent data shows that over 42% of Americans with mental illness can’t afford treatment, despite over 30% having health insurance. Knowing whether your health insurance plan includes mental health care helps determine how to afford this necessary health care.
So, does TRICARE cover mental health therapy? Let’s analyze the TRICARE plans and the mental health services contained therein.
How Do I Know I Need Mental Health Treatment?
Mental health refers to your emotional, psychological and social health. You can control your thoughts, feelings, and actions when you have good mental health. On the other hand, poor mental health causes you to experience negative feelings and emotions and lose control over how you react to your environment.
Everyone experiences mental health issues from time to time. However, you may have a mental illness or mental health disorder if you can’t get back to a state of good mental health.
According to the National Institute of Mental Health (NIMH), any mental illness (AMI) occurs when a psychological, emotional or behavioral disorder affects your life in any capacity. For example, poor mental health may cause you to stop bathing, sleeping or eating regularly. It can also make you retreat from your social life, affecting the quality of your relationships. Over 52 million Americans experience AMI each year.
Serious mental illness (SMI) severely impairs your thoughts, feelings and actions. It limits your ability to care for yourself, your loved ones and your dependents. SMI also affects how you interact with others, making it difficult or impossible for you to maintain social and professional relationships. Over 14 million Americans experience SMI each year.
Getting mental health treatment is essential, whether you have AMI or SMI. Experiencing these symptoms persistently should prompt you to seek help from a mental health care provider:
- Sadness, fear or guilt
- Anxiety, irritability or anger
- Fast-shifting moods, e.g., moving from extreme sadness to euphoric happiness
- Poor concentration
- Inability to understand yourself or your environment
- Tiredness or low energy levels
- Unusual eating, sleeping or sexual patterns
- Paranoia, delusions and audiovisual hallucinations
- Obsessiveness over physical appearance
- Headaches, stomachaches or general pain
- Binge drinking or overusing illicit or prescription drugs
- Avoiding loved ones and social situations
- Thoughts of suicide
How Do I Check If My TRICARE Plan Covers Therapy?
TRICARE coverage gives you access to one of these insurance plans:
- TRICARE Prime, Prime Remote or Prime Remote Overseas
- TRICARE Select or Select Overseas
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- TRICARE Family Plan
- TRICARE For Life
Each plan offers partial or full coverage for various mental health disorder treatment methods. You can check which mental health treatment plan your cover offers by logging into your TRICARE account or calling your nearest TRICARE contractor.
TRICARE Coverage for Mental Health Treatment
Psychological testing or assessment is an evaluation used to diagnose a mental illness.
TRICARE will cover all forms of psychological testing used to diagnose you and create a mental health treatment plan.
Commonly referred to as therapy, psychotherapy is a treatment method that primarily uses conversation to address your unhealthy thoughts, emotions and behaviors. A licensed psychologist or therapist leads each therapy session, offering evidence-based advice to help you develop better mental patterns and behaviors.
Family therapy and group therapy are part of psychotherapy. The former seeks to address conflicts among family members and help them develop better boundaries and communication patterns.
Group therapy lets you share and listen to other people’s experiences with mental health and drug addiction to find better ways of resolving your personal and social issues. Group therapy can also provide you with a support group you can rely on throughout your mental health journey.
TRICARE covers all inpatient and outpatient psychotherapies.
Your treatment plan may include medications that help manage the symptoms of your mental illness. Medication-assisted treatment also requires you to be placed on long-term prescriptions to control cravings for opioids or drugs.
TRICARE insurance plans cover medications prescribed by an authorized mental health provider.
Ancillary or alternative therapies involve treatments such as occupational therapy, arts and crafts, music and other forms of recreational therapy.
A TRICARE cover lets you participate in ancillary therapies during residential or inpatient treatment. Your coverage may also allow ancillary treatment as part of partial hospitalization and intensive outpatient programs.
Does Mental Health and Substance Use Go Hand-In-Hand? Will I Be Covered?
Substance use disorder (SUD) is a mental illness that impairs your ability to control how much drugs or alcohol you use. Severe SUD is commonly referred to as addiction, a condition that makes it impossible for you to go without drinking or using drugs despite the health, personal, relationship, social or professional consequences. Statistics from the National Alliance on Mental Illness show that around 17 million Americans with SUD experience a co-occurring mental illness such as depression, anxiety or bipolar disorder.
TRICARE covers these forms of treatment for drug addiction and mental health:
- Emergency and nonemergency inpatient treatment
- Detoxification and care for withdrawal symptoms
- Residential treatment
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Opioid treatment programs
- Medication-assisted treatment
Do I Need a Referral for Addiction and Mental Health Services?
Nonmilitary members of all TRICARE plans, except TRICARE For Life, don’t need a referral or authorization to access emergency or nonemergency mental health care.
TRICARE covers most forms of outpatient care, allowing you to benefit from various mental health therapies. However, you’ll need a referral or prior authorization for outpatient psychoanalysis or addiction treatment.
Can Active-Duty Service Members See a Therapist?
TRICARE covers mental health treatment for active-duty service members and reserves military personnel who pursue treatment at a military hospital.
Military personnel seeking mental health care must get a referral and authorization from their primary care manager to see civilian mental health care providers in the TRICARE network.
Does TRICARE Cover Mental Health Online Therapy?
TRICARE offers online therapy as part of its covered telehealth services. Most people, including family members of military personnel covered by TRICARE Prime, don’t require prior authorization to access online therapy from providers in the TRICARE network.
However, people in active military service require a referral from their primary care manager before accessing online therapy services.
Find a TRICARE Therapist in Your Area — Find Olympus Recovery
If you’re interested in mental health therapy at our facilities, call our team at (866) 305-7134 to see if you’re covered. You can also verify your insurance coverage to see if your insurer covers our mental health and substance abuse programs.