The last several years have been fraught with many stressful events that have impacted us on a larger societal level as well as in our individual lives.
Things like the COVID-19 pandemic, the formula shortage, the war in Ukraine, and most recently, the overturning of Roe v. Wade have created stressors both individually and collectively. These events are in addition to the day-to-day stressors we face as moms such as managing kids’ schedules, and military stressors like deployments or PCSs.
Through all of these challenges, you may have found an increase in your level of anxiety, experienced feelings of overwhelm, or maybe you’re even struggling with depression. You may have even decided that you need the support of a therapist to help you begin working through it all and coping with the stress.
Trying to find a therapist or counselor who accepts Tricare and has appointment openings can be challenging.
Many providers have completely booked schedules due to the increased level of need so many people have had in the last few years. Sometimes a therapist may have a waitlist, but that might be anywhere from a few weeks to a few months out. When you are ready to start seeing a therapist for counseling, you want to begin right now and you don’t want to wait that long.
If you have Tricare Prime benefits, it makes sense to see an in-network Tricare provider as it would not cost you anything to see a counselor and you wouldn’t need a referral. But if you aren’t able to find an in-network provider with many openings, there is another option for you to receive therapy services.
These therapists or counselors might be referred to in three different ways:
Tricare authorized non-network provider
A Tricare certified non-network provider
Or, a Tricare participating non-network provider
These all mean the same thing, but you may find a therapist listed with one of these three different titles. If a provider has one of these titles, it means that they have a special certification with Tricare, so even though they are not in-network, they can still see Tricare clients and bill Tricare directly. For simplicity, I will be referring to them just as “non-network providers” for the rest of this post.
There are two different ways for you to see a non-network provider as a Tricare Prime beneficiary.
If you have tried to get in to see an in-network therapist but they have not had any openings, you can ask your primary care manager (PCM) to put in a request for a referral from Tricare for the non-network provider you are trying to see. Your PCM will need a few pieces of information from the non-network provider: their NPI number or tax ID number, and their practice address.
If your provider sends in the referral to Tricare and informs Tricare that you have not been able to schedule an appointment with an in-network provider due to lack of availability, Tricare will most likely give the provider the approved authorization. With that authorization and referral, you would have no out-of-pocket cost for your therapy sessions, even though you are seeing a non-network provider – sessions would be covered 100%.
POS Options
The second option for seeing a non-network provider if you have Tricare Prime is to use what is called the Point of Service (POS) option. If you use the POS option, that means:
a. You do not need a referral to see the provider.
b. You will have to meet your deductible before Tricare will pay anything for sessions. Most Tricare Prime members have a $300 deductible.
c. After your deductible is met, you will have to pay 50% of the rate that Tricare pays per session. For example: If Tricare will pay $100 for a therapy session, you would be responsible for paying $50 per session after your deductible is met.
Tricare Select
If you are a Tricare Select beneficiary, you do not need a referral to see a non-network provider, and your cost per session would be 20% of the rate. Following the above example, if Tricare pays $100 for a counseling session, you would pay $20 per session.
It can be hard to have to wait to see an in-network provider or a counselor on base, but you do have other options through a non-network provider. If you are in the Tricare West region, you can use this directory to find a non-network provider in your state or in your area. And if you are in the Tricare East region, you can use this directory to find a non-network provider in your area.
Whether you want to see a therapist in person or online is no different when it comes to using your Tricare benefits.
Tricare covers online therapy the same way it does in-person therapy, regardless of if you see an in-network provider or a non-network therapist.
Begin Tricare Online Therapy with Ashley Clark Comegys
If you are a military spouse in Louisiana or Florida and are interested in seeing a non-network therapist for online therapy that accepts Tricare, you can use the contact form. Reach out directly to me to schedule a consultation and see if I am the right therapeutic fit for you. To start your therapy journey, please follow these simple steps:
Schedule a free 15-minute consult via phone or video
Start benefiting from therapy!
Other Services Offered With Ashley Comegys, LCSW
I’m happy to offer a variety of mental health services for the residents of Colorado, Hawaii, Florida, and Louisiana. These services include therapy for anxiety, depression, postpartum depression, trauma, and grief. I also offer online postpartum support, and therapy for military spouses. Learn more by visiting my blog or about page today!