Appointments for Beneficiaries Enrolled in TRICARE Prime

Are you enrolled in a TRICARE Prime Plan? If you are, and you're not an active duty service member, you must follow these rules for outpatient and inpatient care. 

Outpatient Care from a Network Psychiatrist or Psychologist

• Schedule an appointment with a network psychiatrist or psychologist in your region.
• You don't need a referral or pre-authorization for outpatient visits except for psychoanalysis and outpatient therapy for substance use disorder.

You must see a network provider in your region. If you see a non-network provider or a network provider in another region without a referral, you'll have to pay point-of-service fees.

Outpatient Care from a Counselor

You can get care from a supervised mental health counselor or pastoral counselor, but a doctor must supervise the care, even if in the TRICARE network. Certified mental health counselors don't need doctor referral and supervision.

Inpatient Care

If you need to stay in the hospital, you must have a referral and pre-authorization from your regional contractor.