Inpatient Hospital Services
You don’t need to get prior authorization for emergency services. But you do need approval for ongoing treatment.
You do need prior authorization for non-emergency inpatient hospital services.
TRICARE covers emergency inpatient hospital services when:
- You have a medical or psychiatric emergency
- You need immediate hospital admission
You will get treatment at the closest hospital that can provide your care.
If you have a mental health or substance use disorder, we will cover emergency inpatient hospital services for:
- Management of withdrawal symptoms (Detoxification)
- Your stabilization
- Any medical complications you may have from your disorder
We cover inpatient psychiatric hospitalization for:
- Diagnosis and treatment of mental health
- Substance use disorders
You may get care in:
- Private psychiatric hospitals
- Local, state, or federal government psychiatric hospitals
These facilities help you with management of mental health conditions that require:
- Around the clock care
- Medically monitored treatment
You may receive approval for inpatient psychiatric hospitalization, if you:
- Pose a serious risk of harm to yourself or others
- Need specialized medication
- Need psychological treatment
- Have a significant impairment in functioning
- Need to be in a hospital full-time
- Are unable to maintain yourself in the community with only outpatient services
Several telehealth services are available to TRICARE beneficiaries seeking mental health and substance use disorders treatments.
Some of these services include: Intensive Outpatient Programs, Medication Assisted Treatment, Opioid Treatment Programs, psychotherapy, crisis management, family therapy, group therapy, medication management, and occupational therapy. >> Learn more
Last Updated 6/18/2020