Does TRICARE Cover Treatment in Mental Hospitals?

As a TRICARE member, hospitalization for mental health and substance use disorder services are available to you and your family in certain situations.

This post is intended to offer basic information to assist you in getting the help you need. You can visit http://www.tricare.mil/mentalhealth for more detailed and specific information.

Inpatient Hospital Services

While you don’t need prior authorization for emergency hospital services, TRICARE members do need approval for hospitalization related to ongoing treatment.

NOTE: If you are experiencing a medical or psychiatric emergency and need immediate hospitalization, you can seek treatment at the nearest hospital that can provide care.

Covered Emergency Services Include:

• Management of withdrawal symptoms (Detoxification)
• Your stabilization
• Any medical complications you may have from your disorder

Covered Non-emergency Services Include:

• Diagnosis and treatment of mental health disorders which require around-the-clock care and/or ongoing medically monitored treatment. This includes cases in which patients pose a serious risk to themselves and/or others, require specialized medications or treatment, have significant impairment in functioning and/or are unable to maintain themselves in the community with only outpatient services.
• Treatment for acute substance use disorders

Partial Hospitalization for Psychiatric and Substance Use Disorder Treatment

TRICARE covers authorized partial hospitalization program facilities for the treatment of mental health and substance use disorders.

You may qualify for partial hospitalization if you:

• Are seeking treatment in the U.S. and its territories
• Have a mental health or substance use disorder
• Can function with support in some of your major life areas
• Don’t need to be in a hospital full time but have a significant impairment that interferes with your normal functioning
• Require medically monitored management of withdrawal symptoms (detoxification) with direct access to medical services
• Need stabilization, have acute symptoms, need treatment for partially stabilized mental health disorders, or are transitioning out of an inpatient program

Let Us Help!

We understand that finances weigh heavily on your decision to pursue mental health and/or substance use disorder treatment.

We also recognize that navigating your way through insurance coverage can be confusing and overwhelming.

As a TRICARE-authorized provider, members of Honey Lake Clinic’s admission staff are highly trained and experienced at working with TRICARE to get you the help you need.

A member of our staff will be happy to run a Verifications of Benefits (VOB) as a courtesy—at no cost to you—to clarify exactly what your specific policy will cover, and to help understand your benefits and what to expect from the process