Tricare

Many of our providers accept Tricare, the insurance for military members and their families / dependents. We thank our military and their families for their service and are grateful for and humbled by the sacrifices they make on behalf of all civilians in our country. The Tricare contract is currently managed by Optum but will be transitioning to MHN later this year. We are preparing for the transfer so our providers who currently accept Tricare can provide continuity of care.

Although it is not currently required to get a referral from a Primary Care Physician (PCP) for retired service members or the dependents of both retired or active duty service members, it is suggested. At the very least, we will need a PCP name for claims to be processed in a timely fashion, however, so please include it in your initial paperwork.

Active duty service members will always need a referral from their on-base PCP to see a provider off-base; please be sure to ask for a referral for the initial session (CPT code 90791) as well as ongoing sessions (CPT code 90837 for individual therapy). It will be at the discretion of the PCP how many sessions to refer but a standard starting place is 20 individual sessions.

Active duty members will potentially need to have the provider periodically report back progress of therapy to someone in the medical community on base as well. Since client confidentiality and the client's therapeutic well-being is of paramount importance to us, we only report what is necessary for the continuation of treatment and for the active duty member to be able to function at his or her job. Please discuss this with us if this is of concern to you so we can see how we might be able to best help you. It is suggested that if you are doing family therapy, you do it through the dependent, usually the spouse or child(ren) to avoid the complexity of active duty member requirements.

(All Tricare beneficiaries, will need an authorization to continue after the first eight sessions, which is something the provider will take care of; there is nothing the client needs to do for this. We only mention this because authorizations and referrals are often confused.)

For cost information, please see:https://tricare.mil/Costs/MentalHealthCosts

  • Active duty members and their families usually do not have a copay or deductible with Tricare Prime (unless using a point-of-service option - see link above).
  • Active duty members as well as Guard Reserve members and their dependents with Tricare Standard or Tricare Reserve Select will have a coinsurance - usually 15% of the contracted rate and a small deductible, depending on rank.
  • Retired members and their dependents with Tricare Prime will have a copay of $12 but no deductible.
  • Retired members and their dependents (including Retired Guard Reserve) with Tricare Standard will have no copay but will have a 20% coinsurance and will need to meet a small deductible.

If you would like to use Tricare as your insurance, before scheduling your appointment, please call to confirm that the provider you wish to see is contracted with Tricare and confirm which type of Tricare plan you have if you do not already know (Prime, Standard, Reserve Select or Retired Guard Reserve). You will need the sponsor's ID number which is their SSN as well as their birthday. You will also need the name of your PCP so please include this information in your initial paperwork. Please supply that information to your provider when making your appointment. Also, always confirm the service address with the provider, our Office Manager, or on this website, as address updates are not always accurate or updated in a timely fashion with the insurance company.

Please note it is the client's responsibility to make sure the provider they choose is in-network and that they know their benefits and their financial obligations before setting the first appointment.

Tricare is different than VA benefits. Please inquire if there is a way we can see you if you get your benefits through the VA and you do not have Tricare.

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