Mental Health Parity - TRICARE Glossary | TRICARE.com

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## Definition Mental health parity is the legal requirement that TRICARE must provide mental health and substance use disorder benefits that are no more restrictive than the benefits provided for medical and surgical care.

## What it means in practice For TRICARE beneficiaries, mental health parity means that your out-of-pocket costs and access to care for a depression diagnosis or PTSD treatment must be comparable to what you would pay for a broken leg or diabetes management. TRICARE cannot impose higher copays, stricter "prior authorization" rules, or lower visit limits on mental health services than it does for physical health services.

In practice, this means if you are a TRICARE Select Group A retiree, and your primary care outpatient copay is $37 (2026 rates), your outpatient mental health visit copay must generally be the same $37. TRICARE also eliminated most quantitative limits on visits; there is no longer a "cap" on the number of therapy sessions you can receive in a year, provided the care is medically necessary.

Parity also applies to "Non-Quantitative Treatment Limits" (NQTLs). This refers to how the regional contractors—Humana Military in the East and TriWest Healthcare Alliance in the West—manage care. They cannot use more aggressive utilization reviews or more difficult provider admission standards for mental health networks than they do for medical networks. If TRICARE covers an Intensive Outpatient Program (IOP) for substance abuse, the criteria for entry must be transparent and clinically equivalent to those for a medical rehabilitation facility.

However, parity does not mean mental health care is free. It simply means it is treated equally. You are still subject to your plan’s annual deductible and catastrophic cap. Additionally, while many outpatient mental health visits with office-based providers no longer require a referral for active duty family members on TRICARE Prime, active duty service members (ADSMs) still require a referral and authorization for all mental health care sought outside of a Military Medical Treatment Facility (MTF).

## Related terms * **Medical Necessity:** The standard used by TRICARE to determine if a specific treatment is appropriate, reasonable, and required for the diagnosis or treatment of a condition. * **Catastrophic Cap:** The maximum amount a beneficiary will pay out-of-pocket for covered TRICARE services each calendar year. * **Qualifying Life Event (QLE):** A change in your life, such as marriage or retirement, that allows you to change your TRICARE enrollment outside of Open Season. * **Prior Authorization:** A requirement for your health provider to obtain approval from Humana Military or TriWest before providing certain services or medications. * **Telemental Health:** The delivery of mental health services via secure video conferencing, covered by TRICARE as a standard benefit.

## Sources * TRICARE.mil - Mental Health Coverage: [https://www.tricare.mil/CoveredServices/IsItCovered/MentalHealthCare](https://www.tricare.mil/CoveredServices/IsItCovered/MentalHealthCare) * Defense Health Agency - Mental Health Parity Final Rule: [https://www.federalregister.gov/documents/2016/09/02/2016-21125/tricare-mental-health-and-substance-use-disorder-treatment](https://www.federalregister.gov/documents/2016/09/02/2016-21125/tricare-mental-health-and-substance-use-disorder-treatment) * Health.mil - Mental Health Hub: [https://health.mil/Military-Health-Topics/Total-Force-Fitness/Psychological-Fitness/Mental-Health](https://health.mil/Military-Health-Topics/Total-Force-Fitness/Psychological-Fitness/Mental-Health)