TRICARE Mental & Behavioral Health Services Coverage in Tennessee

Does TRICARE Cover Mental Health Services?

Yes, TRICARE covers inpatient and outpatient services related to mental health.¹

How to Verify TRICARE Mental Health

Athena Care is in-network with most major insurance plans. To determine your TRICARE mental health coverage and TRICARE behavioral health coverage, call your insurance company or contact us below. One of our care coordinators can help you navigate your insurance coverage and get the care you need.

Jump to Section

• How to Verify TRICARE Mental Health
• Which Mental Health Services Are Covered by TRICARE Insurance?
• Which Mental Health Conditions Are Covered by TRICARE Insurance?
• How To Find TRICARE Mental Health Providers Near Me in Tennessee?
• About TRICARE Health Insurance
• Does TRICARE Insurance Cover Online Therapy?
• Does TRICARE Cover Medications?
• What Does TRICARE Not Cover?
• How Much Do Mental Health Services & Testing Cost?
• TRICARE vs. TriWest vs. CHAMPVA vs. VA Benefits: What’s the Difference?

Which Mental Health Services Are Covered by TRICARE Insurance?

TRICARE mental health coverage includes a wide range of mental and behavioral health treatments and support. The following is a partial list² of services that your TRICARE mental health benefits may cover:

• Ancillary Therapies
• Electroconvulsive Treatment (ECT)
• Individual and Group Therapy
• Medication Assisted Treatment (MAT)³
• Psychotherapy
• Psychological Testing
• Transcranial Magnetic Stimulation⁴

Which Mental Health Conditions Are Covered by TRICARE Insurance?

Your TRICARE insurance may cover the following mental health conditions⁵ in Tennessee:

• Autism Spectrum Disorder
• Gender Dysphoria
• Depression
• Post-Traumatic Stress Disorder⁶
• Substance Use Disorders

How To Find TRICARE Mental Health Providers Near Me in Tennessee?

With Athena Care, gaining access to mental health assessments and treatments in Tennessee has never been easier. A care coordinator can assist you at one of our various Tennessee locations. Athena Care mental health clinics are open Monday through Friday, 7:00 a.m. to 6:00 p.m.

When choosing TRICARE mental health providers, it’s important to keep the following in mind:

• Education, training, license, and years of experience
• Specialties and services offered
• Treatment methods and philosophies
• Insurance companies they work with
• Office hours
• Pricing
• Session length

Also, don’t be afraid to ask questions.

Here you’ll find a list of practitioners organized by city, along with information about their backgrounds and specialties.

About TRICARE Health Insurance

Managed by the Department of Defense (DOD) health agency, TRICARE is a global healthcare program for active-duty service members, retirees, and their families.⁷ With three TRICARE facilities across Tennessee,⁸ military health remains a top priority.

TRICARE Eligibility

In order to be eligible for TRICARE insurance, individuals must be either:⁹

• Uniformed Service members and their families
  • National Guard/Reserve members
  • Army National Guard
  • Army Reserve
  • Navy Reserve
  • Marine Corps Reserve
  • Air National Guard
  • Air Force Reserve
  • U.S. Coast Guard Reserve
• Survivors
• Former spouses
• Medal of Honor recipients and their families
• Others registered in the Defense Enrollment Eligibility Reporting System (DEERS)

TRICARE Plans

TRICARE offers a variety of health programs. The availability of a plan is determined by who you are and where you live.¹⁰

• TRICARE PRIME:¹¹ TRICARE Prime is a managed care option accessible in Prime Service Areas. They increase the capability and capacity of military hospitals and clinics, ensuring active-duty medical readiness.
• TRICARE SELECT:¹² TRICARE Select is a preferred provider network plan that is self-managed.
• TRICARE For Life:¹³ For TRICARE-eligible beneficiaries with Medicare Parts A and B, TRICARE For Life is Medicare-wraparound coverage.
• TRICARE Young Adult:¹⁴ After eligibility for “normal” TRICARE coverage finishes at age 21 (or 23 if enrolled in college), qualifying adult children can purchase this plan.

Does TRICARE Insurance Cover Online Therapy?

Yes! TRICARE can cover online therapy.¹⁵

Telehealth options include:

• Telemental health services
• Medication assisted treatment (only available during the coronavirus pandemic)
• Opioid treatment programs (only available during the coronavirus pandemic)
• Intensive outpatient programs (only available during the coronavirus pandemic)

Does TRICARE Cover Medications?

Most prescription medications, including mental health medications, approved by the U.S. Food and Drug Administration (FDA) are covered by TRICARE. A pharmacy or medical benefit may also cover prescription medicines.¹⁶

What Does TRICARE Not Cover?

TRICARE does not cover the following services:

• Aversion therapy (electric shock and the use of drugs for alcoholism are not covered, except for disulfiram, approved for treating alcoholism)
• Obesity and/or weight loss-specific behavioral health care services and supplies
• Bioenergetic Therapy
• Biofeedback for psychosomatic conditions
• Carbon Dioxide Therapy
• Counseling services, including but not limited to nutritional counseling, stress management, or marital therapy
• Custodial nursing care
• Diagnostic admissions
• Educational programs
• Environmental ecological treatments
• Experimental procedures
• Filial therapy
• Guided imagery
• Hemodialysis for schizophrenia
• Marathon therapy
• Megavitamin or orthomolecular therapy
• Narcotherapy with LSD
• Primal therapy
• Psychosurgery
• Rolfing
• Sedative action electrostimulation therapy
• Services and supplies that are not medically or psychologically necessary for the diagnosis and treatment of a covered condition
• Sexual dysfunction therapy
• Stellate ganglion block for treating Post-Traumatic Stress Disorder
• Telephone counseling (except in the case of family therapy in a Residential Treatment Center)
• Therapy for developmental disorders, including but not limited to dyslexia, developmental mathematics disorders, developmental language disorders, and developmental articulation disorders
• Training analysis
• Transcendental meditation
• Z therapy

How Much Do Mental Health Services & Testing Cost?

The cost of your treatment will vary depending on your TRICARE mental health coverage, TRICARE behavioral health benefits, and individual treatment needs. The following are typical therapy prices, albeit they may vary depending on location and other factors. In addition, they may not reflect the actual cost of treatment or what you will spend.

For example, In the United States, the typical cost of psychotherapy ranges from $100 to $200¹⁷ a session, dependent upon the state and the length of the session. With health insurance, you’ll most likely have a co-pay that can range from a few dollars to $50 or more a session.

Cognitive Behavioral Therapy (CBT) sessions are typically 45+ minutes long and cost between $100 and $200 per session, while Dialectical Behavioral Therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered. Such factors, like whether the therapist is in-network or out of network, can influence this out-of-pocket cost.

With TRICARE Prime, an active-duty military service member enlisted on or after 1/1/2018 will pay $0 for inpatient/outpatient mental health services in-network or out-of-network with a $0 deductible. At the same time, a medically retired or survivor service member with TRICARE Select will pay $32 in-network and 25% out-of-network for Mental Health (Outpatient/Partial Hospitalization) primary care. Their deductible is $150/individual and $300/family.¹⁸

Even with insurance, you will normally have to pay some or all of your medical expenditures until your total medical expenses for the year reach the deductible. Then, depending on your plan, you may be required to pay a co-pay or coinsurance for each treatment.

For those who do not have insurance, some therapists will work with them on a sliding scale.

If you find a therapist who accepts a sliding scale payment plan, your income will most likely determine the cost of your sessions. This sliding scale may differ from one therapist to the next.

TRICARE vs. TriWest vs. CHAMPVA vs. VA Benefits: What’s the Difference?

TRICARE is a Department of Defense, regionally managed health care program for active duty and retired uniformed service members, their families, and survivors.

TriWest is a third-party administrator for The Department of Veterans Affairs (VA) which manages Community Care Programs. Veterans are primarily cared for through the VA’s network of medical institutions. However, the VA does turn to community clinicians on occasion.

CHAMPVA is a VA program not available to anyone eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and children of a Veteran who meet specific eligibility requirements.¹⁹

VA Benefits are available to uniformed Service members, Veterans, surviving spouses, children, or parents of a deceased or disabled Service member or Veteran.

Other In-Network Insurance Providers

Aetna
Ambetter TN
Blue Cross Blue Shield
Cigna
Evernorth
Medicare
Multiplan
Optum
PHCS
United Healthcare
Vanderbilt