Is mental health and substance abuse recovery covered under TRICARE Prime?
Mental health and substance abuse treatments are covered under TRICARE Prime. If your provider of care believes you need more than five psychotherapy sessions a week in the hospital, or more than two psychotherapy sessions a week as an outpatient, TriWest must review the medical necessity for the care. If you need more than eight outpatient psychotherapy sessions in a fiscal year, approval is required. You must get approval for additional sessions from TriWest. Inpatient care which needs preauthorization is limited to a certain number of days per year unless TRICARE grants a waiver. Active Duty Family Members have no co-payments. Retirees and their families pay $25 per outpatient visit and $40 per day for an inpatient visit.
