Can Tricare cover therapy? Your counseling options for mental health

Medically reviewed by Karen Foster
Updated January 18, 2024by BetterHelp Editorial Team

Do you or your family work for the United States Armed Forces? If so, you may be eligible for health care coverage through TRICARE—one of the primary providers of health benefits managed by the Defense Health Agency for military personnel and retirees. Many have found that the past few years have seen some important changes in what TRICARE covers, including an expansion of options for remote medicine and mental health. This article can help you understand what those changes might mean for you or a family member. 

Perhaps the most significant recent change, from a mental health perspective, is the decision to make online or phone-based mental health treatment a permanent option for people with TRICARE. This might make it easier to make an appointment or maintain consistent health care even when you’re required to change locations for your job.

Keep reading for a more detailed look at how therapy and mental health care will look following these revisions to what TRICARE covers.

A child is sitting on a hospital bed with a teddy bear, and a TRICARE doctor is standing in front of her; she is looking up at the Tricare doctor.
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What are possible mental health challenges for military families?

Many military personnel and their loved ones may face greater difficulties with mental health than others in the civilian world. Service members on active duty may be exposed to traumatic experiences that can increase the risk of disorders like post-traumatic stress disorder (PTSD), anxiety disorders, and depression. 

Additionally, the demands of military life aside from active duty, such as prolonged separation from loved ones during deployment, can place a strain on the mental health of the spouses and children of those who serve. A 2022 survey of teens in military families found that the need for frequent relocation leads to feelings of isolation, depression, and nervousness. More than 40% of respondents rated their mental health and well-being as low due to the difficulties imposed by their parents’ service(s).

As a result, the military has placed a priority on addressing mental health challenges, leading to various changes to TRICARE health services. As of 2022, the Department of Defense publicly affirmed that they were launching an independent committee to review the effectiveness of the military’s programs for suicide prevention and mental health. The recent expansion of TRICARE benefits may also represent an attempt to curb worrying trends in mental health outcomes for service members, veterans, and their families.

Does TRICARE cover therapeutic services?

Your specific coverage for mental health care will depend on which TRICARE insurance plan you have (for example, TRICARE Prime). In most cases, TRICARE covers medically necessary services that are proven, including inpatient and outpatient mental health care services. However, the costs can vary, with costs generally being lower with in-network versus out-of-network providers. 

If you experience a mental health emergency, you can call 911 or visit the nearest emergency room without a referral or pre-authorization. Other resources for mental health emergencies include The Suicide and Crisis Lifeline and The Psychological Health Resource Center of the Military Health System. 

Mental health services covered 

For non-emergency outpatient services like counseling and therapy from a civilian provider, active duty service members (ADSMs) are typically covered with a referral or pre-authorization. However, those who are enrolled in TRICARE Prime are advised to seek non-emergency mental and behavioral healthcare at a military treatment facility or clinic first.

TRICARE Prime members are not required to obtain a referral for consultations with TRICARE network providers for office-based psychotherapy or other types of outpatient services. Individuals with TRICARE Select also have the freedom to visit any TRICARE-authorized provider without needing a referral. Members can find a provider or therapist by first asking their primary care provider or checking the TRICARE website.  

However, TRICARE may not cover all mental health services. One example would be medication-assisted treatment that may be considered controversial (like narcotherapy with LSD). If your TRICARE plan does not cover therapy, you may have to explore other in-person and telehealth options for counseling. TRICARE covers some forms of therapy and some providers. If you have questions about what TRICARE covers, you can reach out to TRICARE_help@amedd.army.mil.

Exploring the telehealth policies

The practice of communicating electronically with healthcare providers as a supplement or replacement for in-person mental health visits has become much more common in recent years for many. Whether you call it remote medicine, telemedicine, or telehealth, this approach to medicine generally does appear to be here to stay. Many people began seeing healthcare providers remotely in response to the COVID-19 pandemic, and acceptance of this practice is statistically suggested to be growing. This may influence how many therapists TRICARE covers for service members. The Centers for Disease Control and Prevention (CDC) estimate that 37% of U.S. adults had used telemedicine within the previous 12 months.

TRICARE began offering coverage of telehealth services on a provisional basis during the pandemic. But having recognized the effectiveness of remote medicine, as well as its growing acceptance and usefulness, they made this change permanent, effective July 1, 2022. 

This coverage extension is also thought to include coverage for telemental health, a term that explicitly defines mental health services that are delivered remotely. In addition, TRICARE covers remote psychiatric services in some cases, such as medication management.*

*At the time of this publication, audio-only and videoconferencing options are covered. However, there may be exceptions for specific types of mental health treatment.

Like other types of medical care covered under TRICARE, only medically necessary telehealth services generally qualify. Active-duty service members also currently need a referral in order to use this benefit. (Retirees and family members covered under TRICARE Prime do not.) When preparing to work with a mental health professional, especially outside of a military hospital or clinic, you may want to double-check that they are a TRICARE-approved provider, meaning that TRICARE covers some or all of their costs.

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Why does telemental health matter for TRICARE users?

Despite the general prevalence of mental health challenges among military personnel, studies suggest that many service members don’t receive treatment. This may not be because the service member does not want help, however. TRICARE covers plenty of services that are likely helpful to service members. The unique dynamics of military life can make seeking and maintaining treatment difficult — and online services could help. Here’s how:

Expanded providers

Many resources report that one of the major barriers to Tricare mental health treatments is a lack of capacity. If you’re like many service members, you may reside in a heavily populated military installation with a limited number of mental health providers nearby. However, when using telemedicine, your options might no longer remain restricted to therapists or psychiatrists in your area. This can make it much easier to find the help you need through quality mental health care.

Better continuity of care

Telemental health could also make it easier for you or your family members to continue receiving care from the same provider if you have to relocate. The need to move frequently can be stressful for military families, and it can also disrupt your continuity of care—which can lead to worse mental health outcomes in some. The ability to stay in contact with a provider who is already familiar with your unique challenges, and with whom you’ve established trust, can be a major advantage of telemental health care.

Increased discretion

Another commonly reported reason many service members go untreated is the possible presence of a stigma surrounding mental health concerns within U.S. military culture. If you’ve been hesitant to seek care because you’re worried about how you’ll be perceived by others in the military, you may find the greater discretion of telemedicine helpful. It can empower you to conduct therapy sessions or psychiatric visits with your healthcare provider in your own home, on your own time.

Telehealth scheduling flexibility

Receiving mental health care online can also be more convenient for many in terms of scheduling. Since there’s no need to commute to a provider’s office to talk with them, you may find that receiving treatment takes up less of your time and is simpler to schedule.

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Are there any downsides to the recent TRICARE changes?

Though it’s good to know that coverage for telemental health is a permanent part of TRICARE, certain other changes may not be as welcome. For example, at the time of this publication, the waiver of copays for remote visits with providers has ended. During the height of the pandemic, it was possible to use telemedicine services without paying out of pocket. However, in August of 2022, the Department of Defense announced that copays would once again be required moving forward.  

Another major change to possibly be aware of is the reclassification of several U.S. states, moving them from TRICARE’s “East” to “West” regions. This isn’t generally directly related to remote mental health services, but if you’re currently receiving treatment, you may need to find a new TRICARE doctor or counselor that is covered by your TRICARE plan. There is a chance your current provider might not be approved in your new region. 

The states affected by the TRICARE change at the time of this publication may include:

  • Arkansas
  • Illinois
  • Louisiana
  • Oklahoma
  • Texas
  • Wisconsin

If you live in one of those states, you may want to stay tuned for further announcements from TRICARE. The change hasn’t yet taken effect — your healthcare coverage will generally remain unchanged through 2023. Beginning in 2024, though, you may be under TRICARE West rather than TRICARE East. You may benefit from speaking with your service provider or representative to clarify your specific personal health needs and how TRICARE can support them. 

Is Online Counseling Effective? 

Though we’ve outlined some of the possible benefits of online counseling above, you may still be skeptical. That can be understandable, and some people may always feel more comfortable consulting with their healthcare providers in person. 

However, we do want to note that current research suggests that online therapy offers comparable results when compared to face-to-face therapeutic intervention. A comprehensive review of the scientific literature published in Cureus concluded that internet therapy was deemed effective for a wide range of mental health conditions. Among the diagnoses studied were generalized anxiety disorder, depression, post-traumatic stress disorder, and chronic pain.

If you’re interested in telemental health services, BetterHelp can assist you in locating a provider that does offer therapy. This can empower you to mental health services from the comfort of your home.

Takeaway

TRICARE covers treatment for essential mental health and substance use disorders. TRICARE’s expansion to cover telemental health care permanently could support thousands of military personnel and family members. If obstacles like relocation, scheduling, and concern about discretion have prevented you from seeking mental health treatment, online counseling could help. BetterHelp’s mental health care services can connect you or a loved one with a therapist in your area of need.

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