Inpatient Hospital Services
You don’t need to get pre-authorization for emergency services. But you do need approval for ongoing treatment.
You do need pre-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