Tricare

Last updated: November, 2020

Tricare insurance serves our veterans and active military families by offering them health insurance coverage not only within the military hospitals and clinics network but also local, civilian commercial networks - including mental health services and therapists. The plans available to you and how much you pay for therapy depend on your military status or relationship to an individual in the military. Read on to learn more about Tricare’s therapy coverage.

Does Tricare cover therapy?

Yes, it does! Tricare takes care of its service members and their families by offering coverage for mental health treatment. This means that you will not have to pay for your therapy sessions in their entirety out-of-pocket.

However, the amount that you will pay depends on your plan, which depends on the following criteria:

Based on the above, the amount that you pay (if anything!) for therapy may differ. We’ve collated the different plans’ coverage for you below!

How do I check if my Tricare plan covers therapy?

While all plans cover at least a part of the therapy costs, you can find out more information about therapy coverage under your plan from your primary care manager, the Tricare team member available for your questions and requests.

How much does therapy cost with Tricare?

As mentioned above, the amount that you pay for therapy depends on many factors. To figure out your costs, find your plan below for Tricare network provider rates:

Note that Group A corresponds to sponsors who joined the military before January 1, 2018 and Group B corresponds to sponsors who joined the military after January 1, 2018.

Tricare Prime

Tricare Select

Tricare Young Adult Prime

Tricare Young Adult Select

To find additional plans (including Reserve plans and For Life options), please visit the Tricare website to determine out-of-pocket costs.

Point-of-service (POS) costs describes going to a provider without a referral - and means that you pay more, including a deductible and coinsurance:

Source: https://tricare.mil/Costs/POS 

If you would rather avoid using your insurance in this way, feel free to ask your therapist about sliding scale payment options.

What types of therapy does Tricare cover?

Tricare offers coverage for both outpatient and inpatient mental health care. It also offers coverage for family therapy and group therapy.

A few examples of therapy types covered by insurance include:

Tricare requires that treatment is evidence-based and detail a diagnosable mental health condition.

What types of therapy does Tricare NOT cover?

Oscar Health will not cover services unrelated to a diagnosable mental health condition or those deemed unnecessary, such as:

For a full list of mental health exclusion, please visit the Tricare website.

Does Tricare cover couples therapy?

Tricare does cover couples therapy! However, couples therapy sessions must be based on a diagnosable mental health condition and deemed medically necessary.

Do I need to see my doctor before visiting a Tricare therapist?

It depends - active military personnel will need a referral before seeing a therapist, as well as certain Tricare plans (if you would like to see a therapist without a referral from the primary care manager, this would count as point-of-service care). However, family members of military personnel do not need a referral - which makes it easy for you to begin looking for a therapist right for you!

Does Tricare cover online therapy?

Yes, it does! Tricare will cover telemental therapy to reduce the risk of the pandemic.