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.

Emergency 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 

Non-emergency Services

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

Do you need mental health services or substance use disorder treatment during the COVID-19 National Emergency?

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