FALLS CHURCH, Va. –
Your mental health matters just as much as your physical health, and TRICARE is here to support you with a wide range of
mental healthcare services, from talk therapy to inpatient care. This article describes
how to get mental healthcare with TRICARE and how to request a different provider when you receive a
referral for mental healthcare services, if needed.
“Getting mental healthcare through TRICARE doesn’t have to be complicated,” said Thomas Turnbaugh, LCSW-C, a mental health specialist at the Defense Health Agency. “TRICARE makes it easy to find the right care, whether that’s a first visit or a change in provider.”
How you get mental healthcare depends on your plan
TRICARE Prime for active duty service members
As an active duty service member with TRICARE Prime, your mental healthcare is provided through a
military hospital or clinic whenever possible. You can book mental healthcare appointments at military hospitals and clinics using the
MHS GENESIS Patient Portal. Check your military hospital or clinic’s website to learn how to set up an appointment, as procedures may differ.
What if you need care from a civilian provider? You must get a referral and pre-authorization first. Your primary care manager coordinates your referrals and authorizations. Note: You don’t need a referral for emergency mental healthcare.
TRICARE Prime for other beneficiary categories
If you have a
TRICARE Prime option, you can schedule outpatient visits with a network mental healthcare provider using your
regional contractor’s patient portal. You don’t need a referral for these visits. Referrals and pre-authorizations are required for inpatient stays, partial hospitalization programs, residential treatment, or psychoanalysis.
You can also get outpatient care from a supervised mental health counselor or pastoral counselor, but these require a doctor’s supervision. TRICARE-certified mental health counselors don’t need a referral or supervision. You also need a referral and pre-authorization before any hospital stay for nonemergency inpatient admission.
Other plans
Do you have another TRICARE plan? These may include:
You don’t need a referral for most mental healthcare visits, as described in the TRICARE Choices in the United States Handbook. You can schedule care with any TRICARE-authorized provider. You still need pre-authorization for hospital stays.
Uniformed Services Family Health Plan
If you have the
USFHP, you can search your plan’s provider list to find a mental health provider. You don’t need a referral for most outpatient visits. You do need one for inpatient care.
Steps to change the provider on your referral
If you get a referral for mental healthcare, you have the option to request a new provider that better fits your needs.
Step 1: Find a new network provider
Search your regional contractor’s online directory for a new provider.
Call the new provider’s office first to ask if they will take new TRICARE patients. Also ask for their National Provider Identifier number. Your contractor needs this number to process your request.
Step 2: Request the provider change
Log in to your regional contractor’s secure portal. Find your active mental health referral. Select the change provider option. You can also call your regional contractor directly. If you skip this step and see a new provider without a referral, you may pay
point-of-service fees.
Step 3: Wait for your updated authorization letter
Your contractor will send a new authorization letter once they process your request. You can view this letter in your secure patient portal. Check it to confirm your new provider’s name and location are correct.
Do you live within 50 miles of a military hospital or clinic? Your contractor must first check if that facility can give you care. If the military hospital or clinic accepts your referral, your civilian referral won’t move forward.
Taking charge of your mental healthcare supports your health and readiness. These steps help you move to a new provider with ease.
Learn more
Visit
Mental Healthcare to learn about covered services. To learn more about referrals, visit
Referrals and Pre-Authorizations.
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