TRICARE, Your Military Health Plan

In This Section:

• When to Get Help
• Making an Appointment
• Selecting a Provider
• Getting Care When Traveling

Making an Appointment

There are specific referral and prior authorization rules you must follow before getting care.  These rules vary by program type and your beneficiary category.  

So we can give you the most accurate information about how to make a mental health/behavioral health care appointment, please enter your profile. Below is an overview of the rules for getting care.

Active Duty Service Members
You may receive mental/behavioral health care at any military treatment facility (MTF) without a referral. For care outside of an MTF, you must have a referral from the MTF.

All Others Enrolled in a TRICARE Prime Option
TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas, TRICARE Young Adult-Prime Option

• You do not need a referral or prior authorization for the first eight behavioral health outpatient visits per fiscal year (October 1-September 30) if you receive care from network provider. Prior authorization is required after the eighth outpatient visit before you can continue to receive care.
• If you visit a non-network provider without a referral from your primary care manager, point of service fees will apply.
• If you get care from a mental health counselor, licensed professional counselor or pastoral counselor, you must have a referral and the care must be supervised by a physician (even if these types of counselors are in the TRICARE network). 
• You must have a referral and authorization for all inpatient mental health care.

TRICARE For Life 

• You do not need a referral or prior authorization for mental/behavioral health care
• When Medicare benefits are exhausted, TRICARE becomes the primary payer and you will need prior authorization from TRICARE.

US Family Health Plan

• You do not need a referral or prior authorization for the first eight mental health and behavior outpatient visits per fiscal year (October 1-September 30) if you receive care from network provider.  
• Prior authorization is required after the eighth outpatient visit before you can continue to receive care.

All Other Health Plan Options
TRICARE Standard and Extra, TRICARE Standard Overseas, TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult-Standard Option

• You will never need a referral for outpatient mental/behavioral health care. Prior authorization is required after the eighth outpatient visit before you can continue to receive care.
• If you get care from a mental health counselor, licensed professional counselor or pastoral counselor, you must have prior authorization from your regional contractor and the care must be supervised by a physician (even if these types of counselors are in the TRICARE network).
• Prior authorization is required for inpatient mental/behavioral health care.

Mental Health Contacts

Last Modified:July 23, 2012