TRICARE Beneficiaries May Seek Mental Health Care If They Need It
Jan, 14, 2005
No. 05-01 TRICARE beneficiaries who need assistance with depression, stress-related illness, chemical dependency, alcohol abuse problems or other related issues should know that TRICARE offers a wide range of mental health care services. Access to those services, also known as behavioral health care, is easy and convenient. Beneficiaries who require emergency mental health services should immediately seek assistance at the nearest emergency room. It is important that beneficiaries understand the requirements for accessing this benefit. All TRICARE beneficiaries are encouraged to receive care from their military treatment facility (MTF), when available. If services are not available at the local MTF, beneficiaries may seek care from a TRICARE-authorized behavioral health provider. Active duty service members enrolled in TRICARE Prime Remote must obtain preauthorization from the Military Medical Support Office (888-647-6676) before receiving any non-emergency mental health services. All non-active duty beneficiaries may seek outpatient mental health services without referral or authorization for the first eight visits during a fiscal year in order to receive TRICARE coverage. When TRICARE Prime beneficiaries go beyond eight outpatient visits in any given fiscal year, they must seek referral from their primary care manager (PCM) and authorization for continuation of mental health care services from their regional contractor. Beneficiaries should check with their regional contractor to determine the process for obtaining outpatient mental health referrals and authorizations and TRICARE when seeking care for the ninth visit and beyond. Certain outpatient services always require preauthorization including: · psychoanalysis · psychological and neuropsychological testing · electroconvulsive therapy · therapy sessions in excess of one hour A physician referral is required prior to the initial evaluation, and oversight must continue through the course of the therapy in order for TRICARE to cover: · licensed mental health counselor (LMHC) care · licensed professional counselor (LPC) care All beneficiaries using TRICARE are responsible for contacting their regional contractor for a listing of additional preauthorization requirements. Marriage counseling is not a TRICARE-covered benefit. Beneficiaries should seek assistance from installation or community social work services. Inpatient mental health requirements for non-active duty beneficiaries differ based on the TRICARE coverage option. Beneficiaries enrolled in TRICARE Prime/ Prime Remote require a primary care manager referral for all non-emergency inpatient mental health services. Prime beneficiaries must also ensure that inpatient mental health service in the TRICARE civilian network is preauthorized (prior to admission) and seek continued stay authorization, when appropriate. Inpatient preauthorization is also required for Standard beneficiaries. The preauthorization and continued stay authorization requirements also apply to Residential Treatment Center care, partial hospitalization program care, and alcoholism detoxification and rehabilitation. All beneficiaries should contact TRICARE regional contractors regarding potential length-of-stay limits. TRICARE Standard beneficiaries living in an MTF catchment area must obtain a non-availability statement from their local MTF before being admitted as an inpatient for mental health services. TRICARE For Life beneficiaries and others covered by Medicare do not require TRICARE readmission and continued stay authorizations when Medicare is the first payer and has authorized the care. Prior to exhausting their Medicare inpatient mental health benefits, TRICARE for Life beneficiaries must contact their TRICARE contractor to obtain a continued stay authorization. To be safe, beneficiaries should check with their regional contractor in advance of seeking non-emergency mental health care to ensure that authorization is not required. Regional contractor contacts are available at www.tricare.osd.mil. One Source, a military Web-based information service for active duty service members and their families, also provides Service-specific information regarding mental health care support programs. One Source can be reached by telephone or through the Web site for each service: One Source, a military Web-based information service for active duty service members and their families, also provides Service-specific information regarding mental health care support programs. One Source can be reached by telephone or through the Web site for each service: Army One Source at (800-464-8107) or www.armyonesource.com (user name: army; password: onesource) Air Force One Source at (800-707-5784) or www.airforceonesource.com (user name: airforce; password: ready) Marine Corps Community Services (MCCS) One Source, (800-869-0278) or www.mccsonesource.com (user name: marines; password: semperfi) Navy One Source at (800-540-4123) or www.navyonesource.com (user name: navy; password: sailor) | 
