This blog post discusses Tricare health insurance coverage for therapy services for active duty service members and their dependents with either Tricare Prime, Tricare Prime Remote or Tricare select. It does not guarantee coverage for mental health services. Please check with Tricare directly to verify your eligibility and benefits.
There are two things that are certain in the life of a military spouse: the unpredictability of life, and the struggle to understand and navigate Tricare.
Military health insurance is complex. You’ve got Tricare Select, Tricare Prime, Tricare Prime-Remote, Tricare East and Tricare West. It’s enough to make your head spin! Your Tricare benefits can be confusing. But, it’s important to know what services you are entitled to under your Tricare health insurance plan.
One health care benefit that’s often misunderstood is behavioral and mental health services. Especially Tricare coverage for those services when you access them online. Having access to emotional support is very important for military spouses. Military life has constant ups and downs and can take a real toll on your emotional well-being. Talking with a therapist can help you learn how to cope with whatever you are facing. And online therapy provides women, especially military spouses, the support they need to thrive.
Let me answer your Tricare Health Insurance Questions
Here are six frequently asked questions about Tricare mental health services and online therapy. For the purpose of this article, I will be primarily focusing on the benefits available to active duty service members and their dependents who have either Tricare Select, Tricare Prime, and Tricare Prime-Remote in the Tricare East and Tricare West regions.
Does Tricare Health Insurance Cover Counseling And Therapy Services?
YES! Tricare Select, Tricare Prime, or Tricare Prime-Remote all cover therapy services. Your benefits cover mental health services for active duty service members and their dependents. Tricare allows you to work with a therapist to receive individual counseling, family therapy, or outpatient substance use treatment.
Does Tricare Cover Online Therapy?
This is a question I have been receiving a lot recently, and I’m so glad to say that the answer is YES! It does not matter if you are in the Tricare East or Tricare West region or if you have Tricare Select, Prime, or Prime-Remote, you are eligible to see a counselor for online therapy using your Tricare insurance. This benefit is covered in the exact same way that traditional in-office therapy sessions are covered under Tricare.
I hope more military spouses will realize their Tricare insurance covers online therapy. Going to an in-person counseling appointment can be a real challenge. Especially if you are stationed in a remote area, are a stay at home parent, or have limited access to transportation. Tricare health insurance benefits give military spouses the ability to receive support and work on emotional wellness from a secure video platform with a licensed therapist. If you’re struggling with anxiety or depression or have a hard time with the constant transitions and changes you face as a military spouse, online therapy can help. I recommend looking into online therapy using your Tricare benefits.
Do I Have To Pay Out Of Pocket For Online Therapy With Tricare?
The costs for counseling services under Tricare are the same regardless of whether you meet with a therapist in a traditional office or online. The only major difference in cost exists between the different types of Tricare plans. Here is the cost breakdown for 2020:
Tricare Prime and Tricare Prime-Remote: There is no cost for you to see a counselor or therapist in-office or online.
Tricare Select: This gets a little more tricky. I will try to break down the details as clearly as possible. There are two different groups with different sets of benefits under Tricare Select:
Group A: The sponsor’s enlistment or appointment date occurred prior to January 1, 2018. This means that the service member became active duty before January 1, 2018.
If you see a provider who is in-network with Tricare, your cost will be $33 per session. If you see a non-network provider, your cost will be 20% of the cost of the claim. For example, if Tricare pays the therapist $100 for the session, your out-of-pocket cost would be 20% of that, which is $20 per session. A provider will be able to tell you the exact cost of each session.
Group B: The sponsor’s enlistment or appointment date occurred on or after January 1, 2018. This means that the service member became active duty after January 1, 2018.
If you see a Tricare in-network provider, your cost will be $26 per session.
If you see a non-network Tricare provider, your cost will be 20%. You can see the example above for how the cost is calculated.
One thing to also keep in mind with Tricare Select is you will have to meet your annual deductible before Tricare will cover your claims for therapy. As an example, if you have a $200 deductible, you will have to pay $200 for your counseling sessions. Then Tricare will begin to cover the sessions. But when you meet your deductible for the year you will then only have your $33 or $26 copay per session.
For further questions regarding the breakdown of the costs associated with seeing a therapist for in-person or online therapy, check out Tricare’s helpful tool. This tool on the Tricare website will tell you if you have a co-payment or cost-share due at the time of your appointment.
Do I Need To Have A Referral To See A Therapist For Online Therapy With Tricare?
Previously, you needed a referral from your primary care provider to see a therapist. But, recently, that has changed. You no longer have to get authorization to see a therapist, in-person or online. If you have Tricare Prime or Prime-Remote, you can self-refer to a Tricare in-network online therapist on your own. But, if you are a Tricare Prime or Tricare Prime-Remote beneficiary and you want to see a non-network therapist, you will need to get a referral from your primary care provider. Unless, you want to use the point-of-service Tricare benefit, and pay the out-of-pocket expense.
If you are a Tricare Select beneficiary, you can see a therapist for online counseling without any kind of referral, regardless of if they are in-network or non-network. Simply contact the therapist yourself to schedule your online therapy appointment.
Can An Active Duty Service Member See A Therapist For Online Counseling?
YES, active duty service members are able to see a therapist for online counseling. They are required to get a referral from their primary care manager. They also need authorization through Tricare to see a therapist. Once they receive the referral and authorization, they are eligible to work with an online therapist.
How Do I Find A Tricare Provider For Online Therapy?
Tricare East and Tricare West each have their own websites where you can look up in-network and non-network providers in your area. You’re not limited to the town you live in, you can explore the site and look for therapists throughout your state. They may not indicate on the Tricare site whether they provide online therapy. But this is a good place to start looking for a Tricare mental health provider.
Psychology Today has a directory that is very helpful when searching for a therapist. You can search for providers who specifically accept Tricare and provide online therapy. You can also search for a therapist who provides any other service you may be interested in. For example, you could look for a provider who helps women with anxiety. You can use your search criteria to help narrow your search to find the type of online therapist you are looking for.
Find a Tricare therapist in your area
Hopefully these six FAQs about Tricare coverage for online therapy have answered your questions. If you still have questions or would like help in finding a Tricare provider who offers online counseling where you live, please feel free to reach out to me. I would be happy to help connect you with an online therapist in your state who is a good fit for you. If you live in Louisiana or Hawaii and would be interested in online therapy contact me by phone 504-534-5636 or click to email me to schedule a free 15-minute consultation.
Begin Online Therapy With Ashley Clark Comegys LCSW
With the stress and change that come with military life, it's important for military spouses to take care of their emotional wellbeing. Online therapy can help and it is covered by your Tricare health insurance! If you are interested in starting online therapy in Louisiana or Hawaii, follow these three simple steps:
1. Call 504-534-5636 or click here to email me,
2. Schedule a free 15-minute consultation with me via phone or video
3. Access the mental health services you are entitled to, and find compassionate support from an online therapist.
Online Mental Health Services Offered By Ashley Clark Comegys LCSW
As an online therapist in Hawaii, Colorado, and Louisiana, I provide a variety of online mental health services for women. These include individual counseling for women, counseling for women experiencing grief and loss, counseling for military spouses, therapy for mothers, counseling for women who have survived trauma, and depression counseling.
Please note, due to the laws that regulate my license as an LCSW, I am only able to provide online mental health services to residents of the state of Louisiana, Colorado and Hawaii.
Ashley Comegys is a Licensed Clinical Social Worker who focuses on working with women with anxiety. She holds a license in both Louisiana and Hawaii, and specializes in providing online counseling in both states. Based in New Orleans, LA and Mililani, HI Ashley helps women find healthy ways to cope with the anxiety that often follows life transitions, grief, loss, and trauma. If you need help finding ways to cope with your anxiety, contact Ashley to schedule your free 15-minute consultation.