TRICARE Mental Health Coverage & 2026 Costs | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense. For official policy and the most current government updates, visit TRICARE.mil.*

## Is it covered? Yes, TRICARE covers a wide range of medically necessary mental health and substance use disorder services. Coverage includes outpatient therapy, inpatient psychiatric care, and intensive outpatient programs, though specific referral rules apply based on your plan and military status.

## What TRICARE covers TRICARE’s mental health benefit is designed to cover services that are clinically indicated for the diagnosis and treatment of a mental health disorder. Covered services include:

* **Outpatient Treatment:** Individual, family, and group psychotherapy sessions. * **Inpatient Care:** Emergency and non-emergency psychiatric hospitalization. * **Residential Treatment Centers (RTCs):** Covered for children and adolescents under age 21. * **Partial Hospitalization Programs (PHP):** Day treatment programs that do not require an overnight stay. * **Intensive Outpatient Programs (IOP):** For treatment of mental health or substance use disorders. * **Psychological Testing:** When used to help diagnose a condition and guide treatment. * **Medication Management:** Psychiatric visits for prescribing and monitoring medications. * **Office-Based Opioid Treatment:** Including Medication-Assisted Treatment (MAT).

**What is NOT covered:** * Aversion therapy. * Experimental or unproven therapies (e.g., certain types of biofeedback or wilderness therapy). * Counseling for "marital problems" or "educational issues" without a primary mental health diagnosis. * Custodial care or long-term care in a residential facility that does not provide active treatment.

## Costs Mental health costs depend on the beneficiary category (Group A vs. Group B) and the specific plan. Below are typical 2026 rates for outpatient mental health visits.

| Plan Type | Active Duty Service Member | Active Duty Family Member | Retirees & Families | | :--- | :--- | :--- | :--- | | **TRICARE Prime** | $0 | $0 (with referral) | ~$38 per visit | | **TRICARE Select** | N/A | ~$31–$40 per visit | ~$43–$60 per visit | | **TRICARE For Life** | N/A | N/A | $0 after Medicare pays* |

*\*Note: TRICARE For Life (TFL) acts as a secondary payer to Medicare. If Medicare covers the service, TFL typically pays the remaining balance. 2026 Select copays vary slightly based on whether the provider is Network or Non-Network.*

## Pre-authorization & referrals Navigating the paperwork for mental health depends heavily on your status and plan:

* **Active Duty Service Members (ADSMs):** Always require a referral and authorization for all mental health care, whether provided at a Military Medical Treatment Facility (MTF) or in the civilian network. * **Active Duty Family Members (ADFMs):** * **Prime:** Do NOT need a referral for the first 8 outpatient sessions per fiscal year from a network provider, but generally require a referral for ongoing care. * **Select:** No referral required; you can see any TRICARE-authorized provider. * **Retirees and others:** * **Prime:** Referral required for civilian care. * **Select:** No referral required. * **Mandatory Authorizations:** Regardless of plan, **pre-authorization is always required** for inpatient psychiatric stays (except emergencies), Residential Treatment Centers, and Partial Hospitalization Programs.

## Where to get care To ensure lower out-of-pocket costs, you should use an "In-Network" provider.

1. **Direct Care:** Benefit-eligible patients can seek care at a Military Hospital or Clinic if space is available. 2. **East Region:** Managed by **Humana Military**. Use their online provider directory to find mental health specialists. 3. **West Region:** Managed by **TriWest Healthcare Alliance** (effective Jan 1, 2025). Use the TriWest portal to search for network therapists and psychiatrists. 4. **Doctor On Demand / Telemynd:** TRICARE covers telemental health visits through approved platforms. These are often the fastest way to get an appointment.

## Sources * TRICARE.mil: [Mental Health Care Overview](https://www.tricARE.mil/mentalhealth) * TRICARE Policy Manual 6010.63-M: [Chapter 7, Section 3.8 (Mental Health)](https://manuals.health.mil/) * Defense Health Agency (DHA): [Mental Health Resource Center](https://health.mil)