MOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

Our military community of active and reserve servicemembers, retirees, families, and survivors lead busy and sometimes stressful lives. It is important to know TRICARE beneficiaries have mental health and substance use disorder (SUD) coverage for times you or your family experience stress, depression, grief, anxiety, mental health crises, and/or the misuse or abuse of alcohol or drugs.

How to access this care might depend on your beneficiary category and your health plan. Check with your regional contractor to see whether you need
a referral or preauthorization. For detailed information, go to the TRICARE mental health care webpage. 

What is a mental health emergency? It’s when the patient is at immediate risk of serious harm to self or others because of a mental disorder. The individual needs immediate and continuous skilled observation at the acute level of care, based on a psychiatric evaluation.

Active duty servicemembers should always seek nonemergency mental health care at military hospitals or clinics when available. If care there is unavailable, they must receive a referral and preauthorization from their primary care manager before seeking civilian care.

[RELATED: No Waivers Needed for TRICARE Prime Users Outside Drive-Time Standard]

Visit the Mental Health Appointments page at TRICARE.mil to learn more on how to set up an appointment based on your TRICARE plan.

For those in TRICARE Prime (retirees or family members), schedule an appointment with a network psychiatrist or psychologist in your region.

A referral or preauthorization for outpatient visits is unnecessary except for psychoanalysis and outpatient therapy for SUD.

If you see a non-network provider or a network provider from another region, you’ll pay point-of-service fees.

You can receive care from a supervised mental health counselor or pastoral counselor, but a doctor must supervise the care. Certified mental health counselors do not need a doctor referral nor supervision.

If you need to stay in the hospital, you must have a referral and preauthorization from your regional contractor.

[RELATED: Defense Officials Considering Cuts to Military Treatment Facilities]

Those in the US Family Health Plan can search their provider directory to schedule a mental health care appointment. Otherwise, the same TRICARE Prime rules apply.

Other TRICARE plans (Select, Select Overseas, Reserve Select, Retired Reserve, Young Adult-Select) do not require referrals except for psychoanalysis and outpatient therapy for SUD provided by an SUD rehabilitation facility. You must have preauthorization for inpatient mental health care (hospital stays). It is highly recommended you schedule appointments with a TRICARE-authorized provider.

Medicare and TRICARE For Life enrollees must remember to follow Medicare rules for mental health care until those benefits are exhausted.